EXECUTIVE CALENDAR--Resumed
Mr. President, I am proud to take the floor, and I am especially proud to take the floor after my colleague from Louisiana, whom I believe has offered a very good-faith proposal, both in the specifics of the bill that he has introduced but…
Mr. President, I am proud to take the floor, and I am especially proud to take the floor after my colleague from Louisiana, whom I believe has offered a very good-faith proposal, both in the specifics of the bill that he has introduced but also in his encouragement that Democrats should participate together with Republicans as the Senate takes up the House-passed American Health Care Act. I do applaud my colleague, and I find much in his presentation to support. I find some points of difference, which I will get into, but much to support.
I am strongly opposed to the House-passed American Health Care Act, TrumpCare. I found that one of the sets of reasons really crystalized yesterday. The Democrats had a hearing, and we invited patients to come from around the country to talk about their healthcare experiences.
There were six witnesses in the hearing. One was a Virginian, a man named Michael Dunkley, from Alexandria. His story was a common one but a tough one. He has been the caretaker for his wife, who has had multiple sclerosis for many years and then got diagnosed with cancer. He talked about trying to deal with being a full-time caregiver for a wife with multiple sclerosis and dealing with cancer before the Affordable Care Act and the unsustainable cost that it led to with his family. But after the Affordable Care Act, he was able to afford coverage for himself and his wife.
We heard from a mother from Indiana whose daughter was born with Down syndrome and how the medical bills connected to her child's treatment forced her, first, to stop working because she needed to be a full-time caregiver. She described the pain of cuddling her newborn in her arms and going to the mailbox and pulling out a $64,000 bill and knowing that this is what the rest of my life is going to be like and the rest of my child's life. Then she talked about how her family got relief because of the Affordable Care Act.
We heard from a witness who has multiple sclerosis, a woman who is now a substitute teacher. Because the State she lived in, Texas, didn't expand Medicaid, she had to move to another State because she couldn't afford health insurance to deal with a medical problem. So she chose to move to a State that had done Medicaid expansion, Maryland.
We heard other stories as well. These were painful stories.
(Mr. CASSIDY assumed the Chair.)
I say to the Presiding Officer, I give you credit for modesty. You are too modest. You do have an expertise in this. You do understand this. You have heard these stories before, and I had heard some of them, too, even without a medical expertise. What I found so troubling--and during the testimony of this mother from Indiana about her child with Down syndrome, I could feel tears rolling down my face-- was this. I had heard stories like this before, but what struck me was that the House voted on this bill without caring about any of these stories, without listening to any of these stories, without allowing a process to address any of these stories. I blurted out: The folks who voted for this bill in the House don't care about the challenges you are facing. They don't care about this or they would have listened to you.
I beg my Senate colleagues to treat this differently, to treat it seriously, to take these stories seriously, and to work together. I hope the Senate takes a different course on this.
Let me explain what I mean when I say the House Members who voted for this didn't care about these people and the challenges they were facing. When the House bill was taken up, there was a version of the bill taken up before March 24, and there were three hearings held. At those hearings--at two of the hearings--no patients were invited to speak. Nobody representing patients was invited to speak.
One of the hearings had one witness from the American Cancer Society and one witness who was a State insurance commissioner. Now, that bill came to nothing on March 24, and the bill was rewritten.
It was the rewritten bill that was passed by the House. There were no hearings on the rewritten bill. There were no hearings. There were no opportunities for patients to talk about the bill and what it would mean to them. There were no Democratic amendments that were accepted. No patients or providers were given any opportunity to share their concerns in a hearing or in formal discussion about the bill. No expert witnesses were allowed to testify about the bill.
The House rushed to pass the bill without a CBO score--the Congressional Budget Office--which would have said what would have been the premium effect on people, how many people would have lost insurance, and were folks with preexisting conditions going to be covered or not. The House rushed to pass it before the score came about.
When they passed it by the narrow margin of 217 to 213, they boarded a bus and went to the White House and had a big celebration. It was the kind of celebration that happens at the White House when they invite the Super Bowl winning team or the NCAA football champions to come to the White House. It was a celebration.
Imagine if you are the mom with a kid with Down syndrome and you are getting a $64,000 bill in the mail and you are saying: This is what the rest of my life is going to be like. And the House passes a bill without listening to you, that by some estimates could take health insurance away from 24 million people and could reimpose deep penalties on folks if they have preexisting conditions. And you watch people celebrating that--celebrating it like it is a sports victory?
This is what I found so very troubling during the hearing yesterday-- these
folks' stories, which are not the only stories to be told about the Affordable Care Act. There are good stories. There are challenging stories. But the stories weren't even important enough for the House to even listen to them.
I do think the Senate process should be different.
Where I am going to disagree slightly with the comments you made is that I am going to compare that process in the House to the process that was undertaken in Congress before the Affordable Care Act was passed in 2010, because sometimes it is said: Well, that was just a one-party thing.
Actually, that is not the case. In 2009, before the Affordable Care Act passed, the Senate Finance Committee held not one or two hearings. No, 53 hearings on health reform were held. The committee spent 8 days marking up the legislation, which is the longest markup in 22 years, and it considered 135 amendments.
In the Finance Committee, the then-Democratic chair, Senator Baucus, worked for months with a bipartisan group of three Democrats and three Republicans trying to find a compromise on healthcare reform. While they couldn't find a compromise ultimately on the floor vote, Democrats and Republicans wrote the bill together and considered amendments in that committee offered by both Democrats and Republicans.
The HELP Committee, where you and I serve, was every bit as active. They had an additional 47 bipartisan hearings, roundtables, and walk- throughs on health insurance. HELP considered hundreds of amendments during a monthlong markup, which is one of the longest in congressional history, and many Republican amendments were accepted as part of the process.
When the bill came from the two committees to the Senate floor in 2010, the final Senate bill that was passed in this Chamber included not one or two, not a few dozen but 147 amendments that were proposed by Republicans. This bill, the Affordable Care Act, was shaped by the Republicans.
The Republicans decided, for their own reasons, to vote against the final product, but they offered amendments in good faith--147 of them were accepted. The Senate spent 25 days consecutively in session on healthcare reform, the second longest consecutive session in history.
The House did something similar in 2009: bipartisan hearings, 100 hours of hearings, and 181 witnesses from both sides testifying. Some 239 amendments were considered, and 121 by both Democrats and Republicans were adopted.
Again, in the House on the floor, there were no House Republican votes, but the bill was shaped by Republicans, amended by Republicans. There was a process that included two parties.
I would suggest to you that the difference in the processes--an ACA process that included hearings, hearing from patients, the opportunities to have committee hearings, the opportunities for both parties to amend--led to a situation in 2010 where many stakeholder groups supported the Affordable Care Act: the American Medical Association, the AARP, the American Hospital Association, and numerous other groups, providers, consumers, businesses, and other groups.
Compare that to what is the level of support for the bill as it passed out of the House. Patients oppose this bill: the American Association of People with Disabilities, AARP, the American Cancer Society Cancer Action Network, the American Diabetes Association, the American Heart Association, the American Lung Association, the American Public Health Association, the American Society of Hematology, the Children's Defense Fund, Families USA, the Cystic Fibrosis Foundation, the National Breast Cancer Coalition, the Muscular Dystrophy Association, the National Disability Rights Center, the National Multiple Sclerosis Society, and the National Organization for Rare Disorders. All of these groups represent patients. All of these groups oppose the House bill that contained no input from patients and no meaningful bipartisan process.
Doctors and nurses oppose the House bill: the American Medical Association, the American Nursing Association, the American Osteopathic Association, the American Academy of Pediatrics, the American Academy of Family Physicians, the American Congress of Obstetricians and Gynecologists, the American College of Physicians, the American College of Rheumatology.
Hospitals oppose the House bill: America's Essential Hospitals, the American Hospital Association, and the Federation of American Hospitals.
There are groups fighting for women's health access: the National Family Planning & Reproductive Health Association and Planned Parenthood.
All of these groups oppose the bill that came out of the House without patient input, without a meaningful committee process, without the ability of Democrats to offer amendments.
Mr. President, I think that points us to a lesson, and I do think it is the same lesson that you spoke about a few minutes ago. Democrats have called for a transparent and bipartisan process to engage in fixes to the Affordable Care Act. I had been on the committee with you no less than a week. I have been trying to get on the HELP Committee since I came into the Senate. I finally achieved my goal in January, and within a week or 10 days of being on committee, I led a group of 13 Democrats. We wrote to our chair, Lamar Alexander, the Finance chair, Orrin Hatch, and the Senate majority leader, Mitch McConnell, and said that we are ready to sit down and talk about improvements and fixes.
I say to the Presiding Officer, my heart soared when I read your comment last week: Any final bill must fulfill President Trump's promises to lower premiums, maintain coverage, and ensure protection for those with preexisting conditions--the same items that you put up on your board just a few minutes ago--because that is the same set of three goals I have. That is the same set of three goals, I think, all my colleagues have.
If we can hold that up as the standard, we will work on a bill together, and the bill should meet three promises: to maintain coverage so people don't lose, to maintain costs so people don't pay more, and to maintain compassion so those with preexisting conditions aren't kicked to the curb. If we can find that bill, we will do it as Democrats and Republicans. We will do it in a way that we can build something that will last. I agree with you on this point.
But I deeply believe this: No bill will achieve those aims if it is purely done by one party. No bill will achieve those aims if it is cooked up and put on the floor without a meaningful committee process in HELP and Finance, without hearing from expert witnesses, without hearing from stakeholders, without hearing from patients, without hearing the kinds of stories we heard yesterday. If we wall ourselves off from the public presentation of this kind of information as we are grappling with the most important spending decision anyone ever makes in their life, as we are grappling with the largest sector of the American economy, if we just rush to get this to the floor and try to make it a one-party product, we will not achieve the three pillars that you and I share and that President Trump has promised to the American public.
So this is my hope. We want to work together, and the right way to work together is this: Send the House bill or a preferable bill, if you have it--your bill or a consensus bill that the group of 12 on the Republican side has. Put that bill in the two committees. Why not have this bill in the HELP Committee and the Finance Committee? Why not hear from patients and doctors and hospitals and nurses and insurance companies and small businesses that struggle to buy insurance for their employees? Let's hear from some expert witnesses about what they like about the status quo or like about the new proposals, what they don't like about them, and how we can fix them. Give us the opportunity to ask some questions. Give us the opportunity to offer some amendments, hopefully some bipartisan amendments, to make this better. Let's treat this at least with the seriousness it was treated in 2009.
You are right to critique that the final vote--save the vote of Arlen Specter, who at the time he voted was a Democrat--that the final vote was partisan. You are right to critique that. We would want to go beyond that, but we can't go backward. We can't eliminate the opportunity for public input, eliminate the opportunity for committee action and amendments. We
should be doing that in a full and robust way.
So I just stand on the floor today to say amen to the boards that you put up there--amen to those three pillars that should be the test of the work that we do in this body--and to pledge that if you put this in the committees where we serve and we have the opportunity to work together, that is the most natural place for us to work in a transparent and bipartisan way.
To ask Democratic Members just to cross the aisle to work on something that will be rushed to the floor with no committee process-- that is not really engagement; that is not really meaningful. But putting it in committees, where we can do our work in the light of day and hear from people like Michael Dunkley and the mother from Indiana and do it with the American public watching--now that is engagement. I guarantee if we do that, we will get to a better result, a result that will be better for people, a result that will be more likely to meet your criteria and mine, and a result that will be more likely to last.
Thank you, Mr. President.
I yield the floor.
I suggest the absence of a quorum.