Mr. President, I ask unanimous consent that after my remarks, the senior Senator from Hawaii be recognized. Mr. President, what is happening today on the Senate floor is outrageous. I still cannot quite believe my colleagues as their staff…
Mr. President, I ask unanimous consent that after my remarks, the senior Senator from Hawaii be recognized.
Mr. President, what is happening today on the Senate floor is outrageous. I still cannot quite believe my colleagues as their staff members stood behind them in the Senate Chamber to my right. All of them have health insurance that is paid for by taxpayers. All of us--all of them, all of the staff, all of the Senators, all of the House Members--have insurance paid for by taxpayers. Yet they would come to the Senate floor with their votes entrusted to them and given to them by
the voting public in their districts and their States. All of them have health insurance that is paid for by the taxpayers, and they would vote to take insurance away from hundreds of thousands of people in my State and in Washington and in Wyoming and in Alabama and in Hawaii.
Millions of people around the country, most of whom have jobs--people who are working $8-, $10-, $12-, $15-an-hour jobs--are not as well paid as the staff who stand behind us as these floor sessions go on, and they would take insurance away from people like them. I am still just incredulous that that would have happened. This bill affects all of our constituents. It would upend one-fifth of the American economy. Yet the people whom we serve have no idea what is in this bill. We really do not know what is in it.
Over the weekend, people said Senator McConnell was going to bring us all to the floor on Tuesday to vote on the healthcare law. This is the law to repeal the Affordable Care Act. I was part of writing the Affordable Care Act as a member of the Health, Education, Labor, and Pensions Committee. That bill took months and months and months, dozens of hearings, and hundreds of amendments. The committee adopted, and I supported, 150 Republican amendments. It was the way we should do things here. Instead, Senator McConnell met just down this hall--I know the camera does not quite show this. Down this hall in his office, he met with lobbyists from Wall Street, with lobbyists from the drug companies, and with lobbyists from the insurance companies. I do not think the Presiding Officer was part of this--he is, perhaps, too junior--but four or five Republican Senators were in there, and they wrote a bill that, alas, was good for drug companies, was good for insurance companies, and was good for Wall Street. It just left out the public.
Now, we do not really know what is in the bill this time. One of the things we do know is, all of the options are bad for my State of Ohio and that all of the options are bad for the people who elected us to serve here. Let me talk about those options.
First, behind door No. 1, we have the repeal of the Affordable Care Act with no replacement. Again, behind door No. 1, I do not know if that is what this bill is. I do know it is one of the options. So behind door No. 1 is repeal with no replacement. That means repealing the entire Affordable Care Act with no plan to replace it. It creates dangerous uncertainty that of course will drive prices up for everyone. When insurance companies, when the people who have insurance now have no idea what is going to happen, of course it drives prices up. Of course, it means insurance companies will pull out of Wyoming and Alabama and Washington State and Hawaii and Ohio.
According to the nonpartisan Congressional Budget Office, 18 million Americans will lose their health insurance next year, and premiums will go up 20 percent. Professionals hold these jobs. They are people who are not Republicans, who are not Democrats, who are just like the Parliamentarian, who is not aligned with either party. The Congressional Budget Office is just like that.
Again, think about that. Think of the Members of the Senate. Think of the Senate's staff who line up along this wall during floor sessions. All of us have insurance. Yet we are going to take it away. According to this plan behind door No. 1, we are going to take it away from 18 million Americans. There would be less coverage, and premiums would go up 20 percent--higher costs. By the end of this decade, 32 million Americans--that is like 1 out of 10 Americans--who currently have insurance would be without health coverage and premiums would double. So 32 million people lose their insurance within the decade and premiums double.
Let's talk about Barbara. Barbara, whom I met in Toledo just recently, is 63. She is not old enough for Medicare; she relies on the healthcare exchanges. Repeal with no replacement would create massive uncertainty for Ohioans.
The people in this body who voted yes today--does the Senate staff who stands behind here who have insurance from--taxpayers like Barbara--do they think about Barbara? Do they think about somebody who reads in the paper that the Senate took the first--still reversible but barely--step toward taking their insurance away? Do they ever think about people like Barbara? Do they, as President Lincoln said, ever get out and get their public opinion pass and listen to people like Barbara? She is 63 years old, and she doesn't know if she will have insurance next month. Imagine that. Do the staff back here, do the Senators who get insurance from taxpayers--do they think: Oh, maybe my insurance won't exist a few months from now. Do they think about that? I am guessing they don't.
Repeal with no replacement creates massive uncertainty for Ohioans like her. We have already seen this year what that uncertainty does to Ohio families, with insurance companies that have been forced to pull out of the market as Congress and the White House create more and more uncertainty. When Aetna pulled out of Dayton and other communities in Ohio--in that part of Ohio--they and others left nearly 20 counties in Ohio without any insurer next year. When they did that, they announced it was because of the uncertainty in this Congress, that nobody really quite knows what is happening.
So that is door No. 1--repeal with no replacement, higher cost, less coverage.
Let's look at door No. 2. Behind door No. 2 is the plan that Mitch McConnell negotiated in secret. As I said, straight down this hall, go to the right, that is Mitch McConnell's office. That is where the drug company lobbyists hung out; that is where the insurance company lobbyists hung out; that is where the Wall Street lobbyists hung out and a small number of Senators, and then they slammed the door shut. That is how they wrote this bill. The Presiding Officer knows this from his constituents in Florida. The drug companies wrote the bill. The insurance companies wrote the bill. Wall Street wrote the bill. And, alas, the bill: tax cuts for insurance companies and tax cuts for the drug companies. The 400 richest families in America--many of them contribute huge numbers of dollars, with lots of zeroes on them, to my Republican colleagues who voted for this bill. The 400 richest families in America will get--under this McConnell door No. 2, there are not just higher costs with less coverage for the public, but 400 families will average a $7 million tax cut for each of the next 10 years. Four hundred families will get a $7 million tax cut for each of the next 10 years.
The McConnell plan would increase healthcare costs for working families. We know that. They would slap on higher costs. They would slap an age tax on Ohioans over 50 when they buy insurance. And when it comes to healthcare costs, Senator Heller from Nevada said it best: There is nothing in this bill that would lower premiums.
So they give tax cuts to rich people. They give tax breaks to the insurance and the drug companies. They cut Medicaid. But there is nothing in this bill, according to Senator Heller, a Republican from Nevada, that would lower premiums. There are, however, those massive tax breaks for drug companies that have been jacking up prices on lifesaving medicines like insulin and those drug companies that played a role in creating the opioid epidemic that devastates my State. More people in my State--as the Presiding Officer, who also represents a large State, knows--more people in my State died of opioid overdose than any other State in the United States.
What does this plan do for the opioid epidemic? I have had dozens-- maybe not dozens--I have done at least 15 or 20 roundtables around Ohio to talk about the opioid epidemic with doctors and counselors, psychologists and therapists and nurses, people who are recovering from addiction and their families, and others. One thing they all agree on is that the single best tool to help with opioid addiction is, alas, Medicaid. The single best tool to combat the opioid epidemic is Medicaid. This bill would take away the No. 1 tool we have to fight that.
So 220,000 Ohioans right now struggling with opioid addiction, getting treatment for opioid addiction--220,000--they are getting their addiction treatment because they have the Affordable Care Act and insurance provided by the Affordable Care Act. We are going to take that away from them.
At one of my roundtables in Cincinnati--the Talbot House--a father
sitting next to his daughter, who I believe was in her early thirties, looked at me and said: My daughter would be dead from an opioid overdose had it not been for Medicaid expansion. I thank Governor Kasich for having the courage to stand up against his President and stand up against the Republican leadership in this town and do the right thing in expanding Medicaid.
This plan, door No. 2, has higher costs, less coverage, and would kick many of those 220,000 people off their insurance. It would disrupt treatment for hundreds of thousands of Ohioans as they fight for their lives. It would pull the rug out from under local police and communities in the midst of an epidemic.
A number of police officers told me that when they go to a home--a police officer or a firefighter or another first responder--when they go to a home where somebody is unconscious because of an opioid epidemic, first they give them Narcan to revive them, and the second thing they do is sign them up for Medicaid. They sign them up for Medicaid so they can get treatment. Otherwise, there is a very good chance that person will die.
The most important tool for fighting opioid addiction is Medicaid. Yet this body voted today--2 Republicans stood up and voted against this--today, 50 Republicans and the Vice President of the United States, who honored us with his presence today with the tie-breaking vote, voted essentially to kick those people off their treatment.
So door No. 2, the insurance company lobbyist plan: higher costs, less coverage. The same plan written by lobbyists.
Let's talk about door No. 3. Behind door No. 3 are higher costs and less coverage. It is the same plan written by lobbyists, just with taxpayer dollars thrown in to buy off votes. Same result--higher costs and less coverage.
They can't just throw money at this bill and make it better.
Take opioids. They want to take away Medicaid, which is the No. 1 tool we have to get people treated, and then they throw in a $45 billion Federal grant program instead.
Governor Kasich said that those dollars--taking away Medicaid, taking away treatment, taking away insurance from the 700,000 Ohioans in Medicaid expansion and hundreds of thousands of Ohioans later--Governor Kasich is a Republican, and he and I see this pretty much the same way. Governor Kasich said that putting that money in after taking away Medicaid is like spitting in the ocean.
The director of Ohio's Medicaid Program said the Republican Senate plan would be devastating for Ohio. For instance, if someone had cancer, I don't think the best treatment for cancer is to cut off their insurance and then give them a Federal grant to pay their oncologist-- not even a Federal grant to pay their oncologist. You don't treat people by a Federal grant, you treat people by insurance and all of the wraparound part of insurance that matters.
It is not just those fighting addiction--I talked a lot about opioids--it is kids with special healthcare needs. It is Ohio schools. There is a program called Medicaid in Schools that helps young people struggling with various kinds of physical and mental illnesses in the schools. That is helpful.
It is rural hospitals. I have been on the phone with literally four dozen hospital CEOs in this State--at least four dozen, a number of them a number of times--and small hospitals in rural communities know that they may close if this bill, the one behind door No. 3, is adopted.
It is seniors in nursing homes, and it is their families who help care for them. Few people realize that three in five nursing home residents in my State rely on Medicaid to cover the cost of their care. That is 60 percent. They are our parents and our grandparents. These are middle-class families and working-class families who end up in nursing homes. They run out of money at the end of their lives. That is Medicaid dollars. Two-thirds of Medicaid dollars don't go to children or opioid addiction, they go to nursing homes to take care of our parents and grandparents.
I met with families again in Toledo last week who rely on Medicaid to help afford nursing home care.
Bob's mother Blanche lives at a home in Perrysburg, a suburb of Toledo.
My mother and father worked all their lives. My mother is
95 and receives a pension of only $1,500 a month. Medicaid
keeps her alive so she is able to spend time with her kids
and her grandkids.
I remember Margaret Mead, the great anthropologist, who said that wisdom and knowledge are passed from grandparent to grandchild. A child can spend time with her grandparents, as my daughters got to spend time with their grandparents, especially my grandmother in her last years. It didn't just bring great joy to the grandparents, it imparts wisdom and understanding and education to the grandchildren. Medicaid does that, too, when people have insurance, when people are taken care of in nursing homes and assisted living.
We talk about people like Blanche who worked hard to build a good life for their families. They paid their taxes. They paid their insurance premiums. They paid into Medicare and Social Security. So we are going to cut their Medicaid in the last years of their lives. They shouldn't have to lose everything because they need more intensive care in the later years of their lives, and neither should their families, who are already squeezed--people in their forties and fifties and early sixties--who worry about their children's education on the one hand and then worry about paying for nursing home care for their parents on the other.
Another huge portion of the people Medicaid helps are Ohioans who are workers, who pay taxes, who have children with a disability or with serious special needs. Nearly 500,000 kids in Ohio--20 percent of Ohio kids, 2 in 10--have special healthcare needs. Boaz, whom I met in Cleveland, was born with several heart defects. He wouldn't be alive today without treatment covered by Medicaid. Benjamin Dworning from Akron, born with Down syndrome, visited my office recently with his parents.
It is not just kids with special needs who will lose out. Ohio schools could lose $12 million a year. Twenty-two percent of rural hospitals would be at risk of closing. It goes on and on.
These are all problems created by this bill behind door No. 3, written by lobbyists, written down the hall in Senator McConnell's office by drug company and insurance company and Wall Street lobbyists. That is the bill--undisclosed, unknown until he regurgitated it on the Senate floor and gave us this bill.
Cleveland.com wrote: ``As for the proposed $200 billion to ease the path for ACA funding losses, this too would pale compared with the losses themselves.''
Again, Governor Kasich--he, a Republican; I, a Democrat--said this is spitting in the ocean.
So that is what is behind door No. 3--higher costs, less coverage.
That brings us to door No. 4. What is behind the last door? We have no idea. It is the ultimate mystery plan.
Remember what Washington uncertainty has already done to Ohio families? There are 20 counties with no insurer next year.
As an editor at the Columbus Dispatch--Ohio's most conservative newspaper--said to me about a month and a half ago, uncertainty is like carbon monoxide for business, a silent killer.
Now, the Republican Party, which fashions itself as the party of business, seems to have specialized over the last 10 years in injecting uncertainty into the economy--uncertainties such as, are we going to pass the Export-Import Bank, which Senator Murray worked so hard on, so our companies can export American-manufactured, well-made products? Are we going to pay our debts or are we not going to meet our obligations and shut down the government? Are we going to leave hanging out there the Affordable Care Act repeal? All of these things create uncertainty, and as a result, business investment freezes. We know what happens. So who knows what kind of damage this latest vote will do in the insurance market.
What we know for certain is that this mystery plan behind door No. 4 will mean higher costs and it will mean less coverage, because nothing so far--nothing that has been put on the table--could result in anything else. The math doesn't work. How can anyone stand here--again, staff standing by the wall here and Members of the Senate, all getting insurance provided by taxpayers--how can you stand here and
threaten to take away the insurance of others and at the same time drive up costs?
The Affordable Care Act is not perfect. Of course, it is not. We have work to do. Senator Schumer talked today about it. Sit down with us. We would love to work through many of the items and get more young, healthy people into the insurance pool, to stabilize the insurance market, to go after the high cost of prescription drugs and maybe, even to consider Medicare at 55. We were one vote away from opening up Medicare in a revenue-neutral way for people between 55 and 64 who might have lost their insurance as they get sick or as they get older. There are all of those options, but don't start with repeal, throwing millions of Americans off of their insurance.
I agree with Governor Kasich one more time. Yesterday, Governor Kasich said: Until Congress can step back from political gamesmanship-- which we saw in spades today, as Senator Johnson and Majority Leader McConnell were negotiating the last parts of the bill, and as, more or less, 98 of us sat here and watched and wondered what was going on and saw that political gamesmanship--and come together with a workable bipartisan plan, it is a mistake for the Senate to proceed with the vote we just took on Tuesday. He said that yesterday.
Instead of down the hall Senator McConnell working with insurance company and drug company lobbyists, instead of listening to the drug companies so that he puts the tax break for drug companies in the bill, let's listen to the people of Kentucky, Wyoming, Texas, Louisiana, Alabama, North Carolina, Ohio, Hawaii, and Washington. Let's listen to the people of the States of my colleagues in this body.
Let's work on a bipartisan plan to fix what is not working in the Affordable Care Act. Let's keep what is working and make healthcare work better for the people whom we serve.