Thank you, Mr. President. I appreciate very much the comments from my colleague from Massachusetts and my colleague from Pennsylvania. I notice my colleagues from the other side of the aisle are not here tonight to defend this piece of…
Thank you, Mr. President.
I appreciate very much the comments from my colleague from Massachusetts and my colleague from Pennsylvania.
I notice my colleagues from the other side of the aisle are not here tonight to defend this piece of legislation. It doesn't surprise me, given what is in this legislation and given what we have heard over the last week.
The Senator from Massachusetts was explaining what it was we were trying to do when we passed the Affordable Care Act, now years ago. Part of what we were trying to do was to extend coverage to a lot of Americans that didn't have it. In my State of Colorado that meant over 600,000 Coloradans who didn't have it before the Affordable Care Act was passed. Another thing we were trying to do was to say to insurance companies that it is not OK to have as your business practice that you take month after month after month of premiums from people and then when they call on the phone and say: My kid was sick; my kid got struck by lightning; my kid had an accident, to then hold them on the phone as long as possible just as a way of denying their claim. Most people in America are too busy trying to move their family ahead, trying to get by, to stay on the phone all day with an insurance company. While we were at that, we said: It is not fair to deny people insurance in the richest country in the world because they have preexisting conditions. It is not fair that it is a business plan in America to have lifetime caps on people in the richest country in the world who might hit those lifetime caps because they get cancer. It is not fair that in America, the richest country in the world, some seniors have to cut their medicines in half every month just to get through the month and to pay their bills. These were some of the issues that we were trying to address when we passed the Affordable Care Act.
Mr. President, I am from a Western State, like you. I was out all those months in Colorado, having town hall after town hall, not just in Democratic parts of the State but in Republican parts of the State, trying to explain what it was we were trying to do--both to give people better coverage, more predictable coverage, and less costly coverage and also to try to do something to bring down healthcare costs in this country. We succeeded at some of those things. We didn't succeed at others of those things. It was a legitimate attempt at trying to deliver something for the American people that people all over the industrialized world don't have to live with.
Only in this country do people have to make choices about feeding their family and taking care of their kids at the doctor. Only in this country do seniors have to make choices about cutting those pills in half. Only in this country do people have to make choices about paying their rent and taking care of their kids. It doesn't happen in the rest of the industrialized world. Before I hear it from the other side tonight, let me say: Our results are getting worse, not better. For populations across this country, longevity is actually getting shorter, not longer. This is a difficult, complex, but urgent question for our country.
That is what we were trying to do with the Affordable Care Act. Some of it succeeded and some of it didn't. I will talk more about that in a minute.
For 8 years Republicans ran for election after election after election on ObamaCare: ObamaCare is socialism; ObamaCare is a Bolshevik plot to take over the United States; ObamaCare is destroying jobs--just at a time when we were coming out of the worst recession since the Great Depression. We saw uneven job growth in this country but undeniable job growth over the entire period of time they were saying ObamaCare was destroying the country and destroying our economy.
The recession was at the end of the last administration. The Obama administration saw the largest job increases we have seen in this country since World War II. I know it is inconvenient to believe that or to say that. I know that in corners of the internet where false news really does dominate, people don't believe it, but it is true. I am the first to say there are not enough good jobs, and I am the first to say there are not enough high-paying jobs, but compared to the record we inherited, it was a success, all while we had the Affordable Care Act being implemented, all while we were extending coverage to millions of people in America--many of them children who didn't have adequate coverage before we passed the Affordable Care Act.
It has been called every name in the book, just like President Obama was called every name in the book, and they linked those two things-- healthcare reform, the Affordable Care Act, and ObamaCare. That became its name.
Every single attack under the sun was levied on that. Why? Because people really believed it was destroying the healthcare system? Maybe some people did. Because they believed that it was destroying businesses? Maybe some people did. I suspect there was a much more simple reason, and that was to try to win elections.
By the way, while we are on the subject, no matter whether you support the Affordable Care Act--and I support some things about it; there are other parts of it that have been disappointing to me--I think it is fundamentally important for people to understand that the Affordable Care Act is not our healthcare system. It is part of our healthcare system. The regulations that it has placed on insurance providers so that people with preexisting conditions couldn't be denied insurance is part of our system. The fact that it tried to create accountable care organizations so people got better primary care so we would reduce the amount of hospital readmissions from something like 18 percent or 19 percent, which wasted billions of dollars in this country, down to 2 percent or 3 percent, that is healthcare.
But there is a lot of healthcare that has nothing to do with ObamaCare or that has something to do with it but it was not the creation of ObamaCare. There is Medicare and Medicaid. There are doctors. There are nurses. There are patients. There are drug companies. That is our healthcare system, and our healthcare system is a mess. It is a mess. It is a mess. We tried to take this thing and improve it when we passed the Affordable Care Act. Some of it worked; some of it didn't work. Some people would argue we went too far. Some people would say we didn't go enough.
But I can state this. I have been doing those town halls again in Colorado, and what I know is that people feel defeated not by ObamaCare but by the American healthcare system--by our healthcare system, which is less predictable and less affordable than in many countries around the world.
Now President Trump knew this. He is a smart politician. I never thought he was going to win. I never thought he was going to win on a campaign that on so many dimensions was out of step with conventional American political thought, and I was wrong. He won. I don't think he represents a traditional Republican view, and that may be one reason he won. In no sense do I think of Donald Trump as a conservative. I think of him as quite radical in his proposals. I think of him as a reactionary force on a political system that the American people, for whatever reason--some of them are probably good reasons--were losing their patience with.
You cannot deny that the guy, somehow, in the far reaches of Trump Tower, had his finger on the pulse of what was going on in some parts of this country. I don't know if it was because he was a reality TV star or what it was, but one of those things was healthcare. He understood the American people's dissatisfaction with our healthcare system, just as these 7 years and 8 years of Republican campaigns have understood it. Majority Leader McConnell made it clear when we were passing the bill: You own it. You own it. He said in a book later that it was very important to him that the American people were able to demarcate between the Democrats' responsibility for the healthcare system as it was and the Republicans' willingness to take no responsibility for it.
Even though we had hundreds of hours of hearings that lasted more than a year and even though we had--they are not countless--well over 100 Republican amendments that were made in committee and on the floor that were incorporated in the legislation, in the end, not a single Republican voted for the bill.
Maybe that was a principled reason, not just a political reason, because maybe there are some people who have the view in the Republican Party that the Federal Government should not have any increased involvement in their healthcare system. In fact, I have heard some people say the Federal Government should play no role in the healthcare system. Yet whatever the reason, not a single Republican voted for ObamaCare.
The rest of the history writes itself, which is that every premium increase in America, whether it was related to ObamaCare or not, becomes part of ObamaCare. Every drug that gets increased in price becomes ObamaCare, and for everybody who loses his insurance, that is ObamaCare when what is happening is really far more complex than that.
There are very legitimate critiques of ObamaCare, but it is not the same thing as our entire healthcare system. I think it is important to make that point because, whether we are considering the Republicans' proposed bill tonight or someone else's proposed bill tonight, we would have to understand it was not going to fix the whole problem all at once.
People in my State are deeply dissatisfied with our healthcare system. I say that as somebody who voted for the Affordable Care Act. I have said it before. People have tried to make a political issue out of it. They write ads about it: Look, Bennet said the healthcare system is not perfect.
I will go further than that. It is a crying shame that people in this country have to spend their lives wrestling with insurance companies, lying awake, wondering whether their kids are going to be able to get primary care or dental care or cancer care if they get sick. That keeps families up every night in my State, not so much the people who are on Medicare but a lot of other people.
So Candidate Trump saw this unease in the American people, this concern that the American people had with our healthcare system, which I share, and in his campaign--in his very populist campaign for President--he promised to provide ``such great healthcare at a tiny fraction of the cost.'' Those knuckleheads in Washington do not know what they are doing. I am going to deliver you ``such great healthcare at a tiny fraction of the cost.'' That was his promise to the American people. That is what he said he was going to deliver.
He differentiated himself from other Republicans by saying: ``I will never cut Medicare.'' ``I will never cut Medicaid.'' He said: Those other Republicans say they will. I am not going to do that, but I am going to supply better healthcare than you are getting now at a tiny fraction of the cost. He said: ``Everybody is going to be taken care of much better than they're taken care of now'' with no cuts to Medicare and no cuts to Medicaid.
We had our election, and people voted for this nominee who made not just these promises but many other promises about what he was going to do for our economy based on, I think, largely, a complete fiction about what is actually going on in our country--for that matter, in the world--with respect to our economy. So he won. He did not just win--the Senate is Republican, and the House of Representatives is Republican.
Now, after running elections for 8 years to get rid of that scourge on America, that stain on America, that legislation that has destroyed our economy and destroyed our healthcare system, they wrote a bill. It took them a long time, really, to get it through the House of Representatives, which was shocking, because they had 8 years to figure out what was wrong with the current system and how to address the current system. They tried it once, and they could not even bring it to a vote in the House. They could not even bring it to a vote.
Then, understandably, the people who sent those Republicans to office in the House said: What are you talking about? You said you were going to repeal ObamaCare. You told us all of these terrible things that ObamaCare had done. Your first order of business was to repeal ObamaCare. How dare you not have a vote?
I am glad they said that because people should keep their promises.
I have believed for a long time that people want consistency out of their politicians, that they will put up with inconsistency if you say to them that the facts are different than I thought they were and that is why I changed my view. Yet, in these times of fake news, of the media having the challenges it has, and the rest of the things that ail our system, consistency is not something that a lot of politicians pay attention to. I think they think that is because voters do not pay attention to it, but, in this case, they did. They said: You said you would repeal ObamaCare. You did not just say it once. You said it year, after year, after year, after year. Finally, they then passed a bill in the House. Not a single Democrat voted for it.
We learned from that process, which took place before the Congressional Budget Office had even scored the bill--imagine that. There were all of these people who criticized the Affordable Care Act, and proponents were rushing the bill through. As I said, I think there were 200 Republican amendments adopted. It was a bill that held almost countless committee hearings in the Senate Finance Committee and the Senate HELP Committee. It was a bill that consumed 25 days of legislative process on this floor, a modern record in terms of time. In fact, we had all of that process, and I will come back to this.
Here is what Senator McConnell said about that. After all of that process, he said on this floor, I think, that Americans were ``tired of giant bills negotiated in secret and then rammed through on a party- line vote in the middle of the night.'' Oh, that bill was negotiated completely in public, painfully in public. I used to go home, and people in my townhalls literally had copies of the bill. Do you remember the chant: ``Read the bill. Read the bill''? That is because everybody had the bill.
On the House side, it is important for people to understand that they passed the bill without even getting a score from what is called the Congressional Budget Office. The head of the Congressional Budget Office is appointed by Republicans when the Republicans are in the majority, not by the Democrats. It did not even get a score. We had a score on the Affordable Care Act before we passed the bill. We had a score that every single American could see about what it would cost and what money it would spend, what money it would save, how many people would be added to the insurance rolls. We had that. They did not have the decency to do that in the House.
They should have because--guess what happened--when the score came out, it said that 24 million people would lose their health insurance after
a candidate for President said that you are going to have ``such great healthcare at a tiny fraction of the cost.'' ``Everybody is going to be taken care of much better than they're taken care of now,'' unless you are one of those 24 million and, I would argue, many of the rest as well. I will come to that.
So they passed that bill, a terrible bill. I think that bill has the lowest approval rating among the American people of any piece of legislation that has existed in the time I have been in the Senate. It is still not as low as the approval rating of this place, which used to be 9 percent, but it is low because people know it does not really address their healthcare problems. It is not a healthcare bill.
Then the President found out what was in the Congressional Budget Office's score, and he had some Republican Senators over to the White House and said: I hope you will not pass a bill like that. That is a mean bill.
That is not my description. That is President Trump's description of the House bill. That is a mean bill.
He said: I want a bill with a little more love in it than that bill out of the Senate.
He has to be disappointed tonight because the Congressional Budget Office's score came back and said that under the Senate's version of the bill--the less mean bill--only 22 million people will lose their health insurance and that far from having better insurance at a lower price, half of the country--literally half the country--is going to pay thousands more in out-of-pocket expenses because of what has become known as TrumpCare.
There are three principal parts to the bill in the Senate and in the bill that has passed the House. There are some differences, but I would say they are differences without a distinction. They are immaterial distinctions. There are three major components to these so-called healthcare bills.
The first is a massive tax cut for the wealthiest people in America. If you are making $200,000 or less in Colorado or in any State in the country, you will not get a penny from this tax cut--not a penny. As my colleague from Pennsylvania said, if you are one of the top 400 taxpayers in America, together, you are going to get $33 billion in tax cuts. That is an average tax cut for each of those 400 Americans of $82.5 million. There is not a person in Colorado at any one of my townhalls who has said to me: Michael, the key to doing a better job with our healthcare and the key to fixing ObamaCare--and I am talking about the critics of ObamaCare. There is not a one who has said to repeal those taxes on the top 1 percent of taxpayers in America at a time when our income inequality has not been greater than in 1928 and at a time when we are collecting in revenue only 18 percent of our gross domestic product and spending 21 percent. Not a single person has stood up in a townhall meeting and said the key to success here is in cutting those taxes. Just to be clear, I should mention that $82.5 million is over a 10-year period. It is about $8.25 million a year.
As Senator Casey, from Pennsylvania, noted, that $33 billion adds up to be the equivalent of what it would cost to pay for the Medicaid of 772,000 people who live in just four States--the entire Medicaid population of four States.
But what they would consume in healthcare to try to support themselves and their family is not $8.5 million a year; it is not $85 million over 10 years; it is, on average, $4,500 a year on healthcare. That is the first part of this bill--a massive tax cut that is not going to benefit anybody in my State who earns below $200,000.
The second element of this bill is a massive cut to Medicaid, which is one of the fundamental safety net programs in this country. The cut, whether you look at the House cut or the Senate cut, is massive. It is about a quarter of the program. It is about $840 billion. And in the Senate bill, the cuts are even deeper than they were in the House bill. I wonder what the President would say about that. The House bill was mean. I bet he would say the Senate bill is cruel because it perpetuates those cuts.
I have heard the rhetoric from politicians in Washington about why it is so important to cut Medicaid. They need to cut Medicaid so they can pay for the tax cuts for people who are so wealthy, most of them probably don't even need to mess around with insurance to pay for their healthcare or their doctors. Now they are going to have another $8.5 billion a year. Now they are going to have another $85 million over 10 years if they want to spend it not on insurance but on whatever else they want to spend it.
So on the one hand, they had to find the money to pay for this tax cut. They found it from some of the poorest Americans there are. How do they justify that? They justify it by painting a picture that says that there are Medicaid recipients all over America who are receiving Medicaid but not working, and therefore we should cut the program because if we cut the program, they will know they have to get a job in order to buy health insurance, and they won't be on the Federal Medicaid Program. They say to go to work, and that is why we can cut this program. Keep people out of that hammock they are lying in instead of working for their healthcare.
What an insult to the almost 50 percent of Medicaid beneficiaries in Colorado who are poor children. Are they supposed to go to work, or can they go to school? And while we are at it, maybe we should think about giving them better schools so they can actually compete in this economy. But are we really going to take away their healthcare?
Then there are a whole bunch of people who have spent down their life savings for the privilege of being in a nursing home paid for by Medicaid. There is not a townhall I have where there aren't sons and daughters or grandsons and granddaughters of people who are in nursing homes paid for by Medicaid after they had to spend their whole life savings down to be there. What a terrible system it is that a family has to be near bankruptcy before we say: We will give you a helping hand. It is a terrible system, but it is what they have. And they can't work. They are in a nursing home. They are in long-term care.
Then there are a whole bunch of people in my State and in other States--and this may be the greatest insult of all--who are working at one job or sometimes at two jobs, and in the richest country in the world, they are working and are getting paid and are not getting paid enough to be off the Medicaid rolls. They are working, and they are still on public assistance. And we are cutting a quarter of the Medicaid Program because people need to go to work.
I am not making this stuff up. I asked Secretary Price, who is the Secretary of HHS, Health and Human Services--he is in charge of the healthcare for this administration--I said: Mr. Secretary, let me take you through the faces of the people in my State who are on Medicaid. And not only did they confirm that that is who is on Medicaid in my State, he said that is the way it looks all over the country.
What an insult to justify a massive tax cut for the richest Americans by taking away poor people's healthcare; by saying they are not working for it, when they are children, when they are in nursing homes, when they are working one and sometimes two jobs in the richest country on the world.
So that is the second part of this healthcare plan--tax cuts for wealthy people and cutting Medicaid for poor people. And in the middle of that is the only thing that could fairly be described as a healthcare plan; it is just a terrible plan.
Senator Paul from Kentucky--one of the more principled people in this Chamber--said it very well when he called it, not politely, ``ObamaCare lite.'' He is absolutely right. If you hate ObamaCare, you are really going to hate ObamaCare lite. It is the same structure, which amazes me because all of the people who said we should repeal ObamaCare are now preserving the very basic structure of how the program worked, but the problem with it is that they have cut the subsidies. They have turned them into tax credits and cut the value of the subsidies. If you think insurance is expensive now in the individual market, wait until you meet ObamaCare lite, in the words of Rand Paul.
So those are the three components of the bill. And it is not surprising to me that for those reasons, Senator McConnell has written this bill in secret. It
is not surprising to me that he hasn't wanted to have a committee hearing. It is not surprising to me that he brought the bill here on the floor last Thursday, then accused people on the other side of not having read the bill and still wants us to act on the bill this Thursday so he can go home before July 4th and say to the American people: We did it. We kept our promise. We repealed ObamaCare. We may have written a terrible piece of legislation that has nothing to do with improving your healthcare, but we repealed ObamaCare. And he is hoping the American people won't notice.
Let me tell you something. The American people are noticing. There is a reason why the House bill has the worst approval rating of any piece of legislation in modern American history. The American people are not stupid.
I was in Frisco, CO, not that long ago, which is a place that everybody should visit from all over the country. There is tremendous skiing, and there is tremendous hiking, wonderful people. And before I had the townhall meeting, I went and visited a healthcare center there that they are justifiably proud of. It turns no one away. It gives phenomenal primary care. It gives phenomenal dental care. They have to figure out every week how to get through, but they always figure out how to get through so that people in Frisco and in the surrounding area have healthcare.
This is not a poor community by American standards. It is a resort community, but there are people who live there year-round. I asked the people who run the clinic: Who are the payers for healthcare in your clinic? Who are they? What pays for healthcare here? And she said: Well, Michael, the Medicaid is 33 percent. That shocked me because if you are in rural Colorado, the Medicaid number is usually a lot higher than that because people don't have access to a lot of resources, and we all know they don't have access to a robust insurance market. Thirty-three percent was Medicaid, 53 percent was uncompensated care, and the rest was private insurance companies that pay for the insurance. That shocked me.
I said: Fifty-three percent is uncompensated care, people with no insurance? How can that be?
She said: These are people in our community who make too much money to be eligible for Medicaid, but they can't afford private insurance.
They are working full time; that is not the problem. They are not even--as I described before in a case where somebody is paying them too little, so they are eligible for Medicaid; their problem is that they are being paid too much, and they are not eligible for Medicaid as a result, but they can't afford private insurance. I think that is an indictment of the Affordable Care Act that I accept as somebody who voted for it. The idea that we would require people in America to buy health insurance and then not have a market that gave them quality health insurance at an affordable price is ridiculous.
I have had people in rural Colorado say to me: Michael, look, why are you requiring me to buy something where there is not enough competition, so the premium is high and the deductible is ridiculous. So it is of no use to my family, and you are requiring me to buy something that is useless to me. We should have more competition to drive down price.
I say: You are 100 percent correct.
And if we had a functioning Congress that wanted to take a bipartisan approach to fixing that problem, we could fix it, and there are probably 15 or 20 other things along those lines. But the Republican healthcare bill--so-called healthcare bill--does none of that. It does none of that.
So to the extent that you don't like ObamaCare because you feel as though your premiums are going up and you are not getting enough for it, as opposed to the millions of people who have gotten insurance as a result of it, some for the first time--to the extent you are worried about that, the House bill makes it worse and the Senate bill makes it worse.
There is a projection in the CBO report that says that at a certain point in time, your premiums might come down under the Republican bill, but the reason for that is because you will be buying lousy insurance. It is not because Donald Trump, as he said to the country, has provided such great healthcare at a tiny fraction of the cost. That is not the reason. It is because they provided terrible healthcare at a fraction of the cost. That is not a benefit to anybody. If an insurance company can put you on lifetime caps, of course they are going to charge you less.
I am all for working together in a bipartisan way to address the issues in our healthcare system that, frankly, go far beyond the Affordable Care Act to make sure people in America don't have to continue to make the choices people all over the world don't have to make about having to stay in a job they hate because they have to keep the insurance or being able to quit a job and do something else because they know the insurance will be there. Nobody else has to make those decisions. And nobody else in the world goes bankrupt because of healthcare, but that is still a problem in America.
I think fundamentally the problem we have here tonight is proponents of this legislation didn't set out to fix our healthcare system; they set out to repeal ObamaCare or the cartoon of ObamaCare they have been running on for the last 8 years. That is what they set out to do. Along the way, they obscured it all so they could have the opportunity to cut taxes on the wealthiest Americans--which, for some reason, is an obsession with some people around here--and dramatically cut access to healthcare by poor children.
I know there are people who are hearing this will not believe what I am saying is true. It is true. I hope you will familiarize yourself with the facts. I hope, in particular, people who feel the last bill we considered on this floor didn't get the process it deserved--people who quite rightly wanted to make sure Members of the Senate and the House had actually read the bill, people who wanted to know what it was like to live in a country where your health insurance is uncertain from month to month, where you have to decide between paying the rent, buying the food or being on health insurance; people who are dealing with and whose families are dealing with the effects of this terrible opioid crisis that wasn't even really a gleam in our eye when we passed the Affordable Care Act.
I especially say to people living in rural America how sorry I am that people aren't paying attention to your needs; that your hospitals may be cut because of an ill-considered piece of legislation which has nothing to do with delivering healthcare in rural Colorado or rural America.
We can do so much better than this, but to get to a place, unfortunately, where Democrats and Republicans have the opportunity to work together, the first order of business has to be to defeat the bill on the floor. I hope people know this is the week when it is critical to call and let your voices be heard, let people know you expect something better than what we are getting, and that Americans ought to have a healthcare system that is affordable, that is predictable, and that actually creates stability instead of instability for their families.
Mr. President, I yield the floor.
I suggest the absence of a quorum.
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.