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tv   U.S. Senate Democrats Accuse Republicans of Repeal and Run in Late Night...  CSPAN  January 9, 2017 5:59pm-8:00pm EST

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the presiding officer: are there any senators in the chamber wishing to vote or change their vote? on this vote, the nays are 14, the yeas -- the yeas are 14, the nays are 83. the amendment is not agreed to. under the previouunder the preve will be now be two minutes equally divided prior to a vote in relation to amendment number 20 offered by mr. sanders for the senator prosecute hawaii, miss hirono. -- for the senator from hawaii,
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ms. hirono. the senate will be in order. who yields time? ms. hirono: mr. president? the presiding officer: the senate will be in order. the senator from hawaii. ms. hirono: mr. president, i rise today to urge my colleagues to vote for amendment 20. what this amendment does is to protect medicare and medicaid in a way that will help millions of people in our country, and it comports with president-elect trump's promise to protect medicare, social security, medicaid. so i urge all of my colleagues to vote for amendment 20.
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i yield the floor. the presiding officer: the senate will be in order. the senate will be in order. the senator wyoming. mr. enzi: mr. president, this amendment is corrosive to the privilege of the budget resolution meaning that it's outside of the scope of what's appropriate for a budget resolution. any inappropriate amendment could be fatal to the privilege of this resolution, which would destroy our efforts to real estate peel obamacare. in other words, a vote in favor of this amendment is a vote against repealing obamacare. in addition, this amendment is not germane to this budget resolution. this budget resolution is much more focused than a typical budget resolution. the congressional budget act requires that amendments to a budget resolution be germane. since this amendment does not meet the standard required by
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budget law, a point of order would lie against it. as such, i raise a point of order under section 305-b-2 of the congressional budget act of 1974. ms. hirono: mr. president? the presiding officer: the senator from hawaii. ms. hirono: hire mr. president, pursuant to section 904 of the congressional budget act of 1974, i move to waive section 305-b of that act for purposes of the pending amendment and i ask for the yeas and nays. the presiding officer: is there a sufficient second? there appears to be. question is on the motion to waive. the clerk will call the roll. vote:
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the presiding officer: have all senators voted? are there any senators in the chamber wishing to vote or change their vote? on this vote, the yeas are 49, the nays are 47. three-fifths of the senators duly chosen and sworn not having the affirmative, the motion is not agreed to. point of order is sustained. the amendment falls. mr. durbin: mr. president? the presiding officer: the democratic whip. mr. durbin: mr. president, there was debate on the senate floor that went on for years, and it was a personal thing, a personal issue to two senators. one was a republican, the other a democrat. the republican was senator pete domenici of new mexico, and the democrat was senator paul wellstone of minnesota.
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the two of them had teamed up with a very simple goal in mind. they wanted to make sure that every health insurance policy in america covered mental illness. when you think about the fact that 50% of americans suffer from some form of depression and that mental illness is something that every family, most every family faces at some point, you'll wonder, why didn't the health insurance policies cover mental illness? well, the reason of course was that it takes some extended care for the mentally ill in some cases. in other cases there was an argument made you won't find a cure. but things have changed a lot in the world of mental illness over the last few decades, and changed for the better. there are new medications that are available, and some even better ones on the way. there's a new treatment available and more hope for people.
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well, pete domenici, republican new mexico and paul wellstone, democrat of minnesota, didn't give up. they insisted on it, and they won. they won with the requirement that health insurance policies cover not just mental illness and treatment, but also substance abuse treatment. i'll be honest with you, i followed that debate closely. i didn't pay that much attention to the substance abuse treatment part of their effort. now i have, and i think many people across america have. there was a supplement in the "chicago sun-times" this morning published by the "usa today." it's entitled "obamacare repeal jeopardizes mental health and addiction coange." i tore it out of paper on the airplane to bring it to the floor of the senate because this is a good day to reflect on what this article has to say. we are now in the midst of a budget resolution effort that is
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designed by the republican majority to repeal obamacare. the republicans hate obamacare, they hate it almost as much as the devil hates holy water. they have tried for six years to repeal it with a singular focus. i don't know how many times they voted in the house. some said over 60 times, to repeal it. they've said that for so many years, and we've said to them what will you do after you repeal it and they said well, we've got a plan. for six years they said we have a plan to replace it. we've never seen it. no one's ever seen it. it raises the question about whether they do have a plan. they certainly have a plan to repeal it, but when it comes to replacing it, they don't offer anything. but they're going to go ahead with it. they're bent on doing this regardless of the outcome. and for a lot of people across america, this could be
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devastating. this article talks about a family in kentucky, the home state of the republican leader. melissa fleckenger of edge wood, kempt, had to pay for heroin treatment for her daughter amanda before the affordable care act. her son brian's treatment for heroin addiction was covered by the a.c.a. but enfortunately he died of an overdoses in 2015. this article goes on to talk about what it means to have children who are addicted to drugs and parents who are desperately trying to find treatment. and some of the things that are said in the course of this are really worrysome. because this article spells out what happens to families without health insurance to cover substance abuse treatment. they become helpless, unable to take care of their kids. now the republicans have come back and said, well, we'll
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just do partial repeal of the affordable care act. listen to what this article says. "almost any route taken on capitol hill leads to an unraveling of addiction and mental health coverage for those people. even the partial a.c.a. repeal congress is considering would eliminate the tax credits that reduce the premiums for about 85% of the people who buy insurance on the exchanges. most of those who get tax credits pay less than $100 a month for health insurance and have very low out-of-pocket costs that make it possible for them to afford coverage." what they go on to say here is that putting a requirement in the health insurance policy that it cover mental health illness and substance abuse treatment means nothing if the people can't afford to pay the premiums for the health insurance policy. so the republican plan that would eliminate the tax credits that families need to be able to afford the policy means that
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there's no way they're going to get coverage for themselves and their kids. who's going to be affected by that? i tell you what i found in illinois. what i found in illinois is that the current opioid-heroin epidemic is everywhere. there is no town too small and there is no suburb too wealthy to avoid it. story after story of teenagers and young people addicted who have no place to turn. and if the republicans have their way in the senate and the house, they will close the door for many of these young people. i see my colleague from the state of new hampshire here. i was stunned to read -- i don't know if it's still the case. but i was stunned to read several months ago that when you look at the average number of deaths from opioid and heroin across the nation -- and illinois is, i'm not making excuses here, we're average -- the rate of death for heroin opioid overdose in west virginia is twice the national average
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and the rate in new hampshire three times the national average. listen to what the repeal of the affordable care act would mean in new hampshire. and i might say to the senator from new hampshire she's quoted in this article. "repealing the a.c.a. would cause in new hampshire nearly 120,000 people to lose coverage in that state we're federal data shows a nearly 200% increase in overdose deaths in the past five years. more than 48,000 medicaid claims were for substance use disorder in 2015, making an a.c.a. repeal, in the words of senator shaheen, literally a matter of life and death. ohio, at the cincinnati center for addiction treatment, c.e.o. san degree keen said about 30% of keen's patients were covered for treatment because of the expansion under a.c.a. overdose deaths in ohio climbed from 2,531 in 2014 to 3,050 in
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2015, up more than 20%. kentucky, the home state of the republican senate leader. overdose deaths here total 1,248 in 2015, up 17% from the previous year. fentanyl, stronger than heroin, was involved in 420 fatal overdoses in 2015, an increase of 250% over the previous year. the lady who was quoted earlier who lost her son to the overdose wasn't surprised. she knows several other people who have overdosed and many others who have died including one last week. chicago, i'm proud to represent it, but up to 30% of the 9,000 prisoners at the cook county jail have a diagnosed mental illness. the a.c.a. has been a game changer for those who were in and out of cook county jail said
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c.e.o. of thresholds, a chicago treatment provider. it costs less than $20,000 a year for threshold's highest level of community-based mental health care with a housing voucher. $20,000 a year, less than that. you know what it costs to incarcerate that same person? $70,000 a year to incarcerate them. about a third of the patients being treated by thresholds are covered by the affordable care act. what's the alternative, i say to my republican friends. they can't wait to repeal this but they don't have an alternative. meanwhile in illinois, in new hampshire, in maine and every state in the nation, mental illness is still a challenge and substance abuse is on the rise, and people are dying from heroin and opioid overdoses. this is the height of irresponsibility, to repeal this measure with no replacement. it is sad to say we've reached this point that a political
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score has to be settled now that the republicans are in control of the house and senate, now that they have an incoming president, republicans finally get their day. someone said to me why is public sentiment starting to change on this issue, and even among republican politicians? and i said they have been saying irresponsible things for a long time, but now people are taking them seriously. and as they take them seriously, they realize what a devastating impact it's going to have. nicholas christoff wrote in "the new york times," if the republicans ran a home renovation business they would start tearing down your roof this month and promise to return in 2019 with some options for a new one if you survive. last week senator rand paul of kentucky wrote an op-ed arguing that repeal should not be done without simultaneously being replaced. senator bob corker, republican of tennessee, has said that repealing the law without
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replacing it is -- quote -- "a flawed concept. and that having a replacement ready first would be a more prudent approach in the republican senator's words. senator susan collins, republican of maine, has said she'd like to see -- quote -- "detailed framework" accompanying any repeal. senator tom cotton, republican of arkansas said -- quote -- "i don't think we can just repeal obamacare and say we're going to get back with an answer two years from now." over and over again these republican senators are realizing how totally irresponsible it would be if we go forward with this proposal. and i'll tell you what troubles me as a representative of a state that has the great city of chicago and a wonderful metropolitan area, but i come from the other end of the state, the rural part of our state. i wonder what's going to happen to our rural hospitals if the affordable care act is repealed. i think about franklin hospital in benton, illinois, population 7,300.
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the hospital has been there 60 years. for the past 15 years it's been teetering on the brink of bankruptcy. it all changed six years ago with the passage of the affordable care act and the expansion of our medicaid program in illinois. because of those changes, franklin hospital found that they could survive. expanding medicaid cut the hospital's uncompensated care in half. in franklin's emergency room they saw 600 fewer no-pay patients and 428 more medicaid patients compared to a previous year. this combined with increases in medicaid funding allowed franklin hospital to invest in much-needed improvements and to consider bringing nuclear medicine in a retail pharmacy to benton, illinois. what does that mean in that city? well, it means all the difference in the world. there's something else that has to be said.
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if that hospital, franklin hospital in benton closes, it won't just mean a longer drive for critical health care, it's going to mean the loss of 4,300 jobs. 4,300 jobs in benton, illinois. so when the president-elect talks about saving 600 or 800 jobs, carrier corporation, good. i'm glad. but then for his party to turn around and to pass a measure which could kill 84,000 to 95,000 jobs in illinois is a move in the wrong direction. i say to my republican friends, go home and talk to the people you represent. listen to what they have to say about what we're dogfacing addiction -- doing facing addiction, mental illness and rural hospitals who are on the brink of closing if you have your way politically. this is no victory for the people of america to repeal the affordable care act without a replacement that's as good or better. mr. president, i yield the floor.
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mr. wyden: mr. president? the presiding officer: the senator from oregon. mr. wyden: mr. president, my colleague from illinois has addressed very clearly what some of the human consequences of this are going to be, and i'm going to take a few minutes as well to describe it, and i'm very pleased that our colleague, senator murray, is here because she has really led the effort, and i have been very pleased to join her, in terms of trying to promote expanded health care services for vulnerable women in america. and i saw senator murray where there was a comment made by some who advocate the repeal of the affordable care act, they said nobody was going to get hurt. nobody in america was going to get hurt.
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and the reality is that's not true for the hundreds and hundreds of thousands of women who depend on planned parenthood for basic health care, for preventive health services, for essential services, for example, like cancer screens. so this notion that somehow nobody is going to get hurt by repealing the affordable care act is simply contradicted from rural oregon to rural maine when you see the kind of pain and suffering this is going to end up generating for some of the poorest and most vulnerable women in our country. the fact is what has been set in
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motion by republicans here in the senate is a scheme that i call repeal and run. it's about very large tax breaks to the most fortunate, paid for by taking health insurance away from millions of working people. under it the insurance companies are back in the driver's seat. health care costs skyrocket across the board, and that's true, even for those who get their insurance at work. the replacement plan our colleagues on the other side have promised for years is just somehow hidden away with tens of millions of americans in the dark about what's coming next for their health care. whenever i hear about the replacement, the whole notion of what would be there for families in the future, it reminds me of
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what used to be the old movie house in town. it had a big marquee up at the top of it and it would always talk about the movie coming soon, but the movie never actually got there. and when i hear about the replacement, that's what i think about is everybody is going to be sitting in the dark again. and what's essentially at stake here is whether or not america is going to go back to the days when health care was for the healthy and the wealthy. that's what health care used to be all about. if you were healthy, no problems, nothing to worry about. if you were wealthy, you could just write out checks when you had a whole host of pre-existing conditions.
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but what the senate is going to vote on this week is whether to green light the first step in this scheme to go back to the days when health care was for the healthy and wealthy with a budget resolution. i think it's fair to say budget resolutions usually aren't the prime topic at dinner table conversations in america, but this year there are serious consequences, serious consequence, personal, life and death consequences because of this scheme that is being pushed through the senate. that's where i believe the focus ought to be and why i'm going to spend the remainder of my time talking about persons whose lives in oregon are going to be directly affected and in some cases endangered. melita chrisian is from a rural
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community. she's a personal support worker providing care to adults with intellectual and developmental disabilities. she's always carried health insurance until she was unexpectedly laid off from her job. she was without coverage for more than a year, but then she was able to buy a plan through the affordable care act. now, for melita, having insurance meant cancer screenings that very likely saved her life. doctors found tumors that had to be removed. later she was diagnosed with a degenerative hip and back problems that cause her pain every day making it difficult to get through a physically demanding and grueling job. her prescription drug coverage which she gets through a plan under the affordable care act is
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what makes it possible for melita to get up every morning and get through that day, get through that work day, thanks to the care she's received, melita made it to her daughter's wedding and she was proud that she even baked the cake. now, another oregonian, rita from salem, comes from a family that's been struggling with depression. it's a condition that's been stigmatized for far too long in this country, and i know something about this, mr. president, because my late brother jeff faced the stigma of mental health. he was a schizophrenic and he passed at far too early an age. far too many of those with mental illness have been denied
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care and shunted to the fringes of society. before rita got coverage through the affordable care act, she was forced to pour a staggering share of her income into health-related expenses. it was nearly two-thirds in 2011. even then she didn't have access to the mental health treatment she needed. her depression used to keep her out of work. with coverage from the affordable care act and tax credits that made it affordable, rita's costs have fallen substantially. she now gets the prescription and therapy that helps her manage her condition and she can live a healthier life. another of my constituents is mary who lives in milwaukee, oregon, with her husband and 7-year-old daughter. she has a hereditary disease
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known as h.a.e., a rare genetic condition that causes dangerous swelling lasting days at a time and affecting various parts of the body. if mary goes without treatment, attacks come on regularly, even multiple times a week. when they do it's completely disabling. before she got insurance through the affordable care act she rotated through health plans and insurers to maintain coverage and avoid hitting caps on treatments. she sought out clinical studies to get free care, typically participating in one each year. so on top of holding down a job, raising a daughter, battling a life threatening condition that affects one in 50,000 americans, she was basically out trying to cobble some decent health care together. the system was so badly broken,
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she basically sewed her own health care safety net, but the a.c.a. protected patients like mary from discrimination and guaranteed access to care. these are three oregonians, mr. president, but they come from different backgrounds, and they battle different conditions, but they share a lot in common with each other and with people around the land. not long ago in the eyes of insurance companies, the women that i just mentioned, they would have warned their pre-exist -- worn their pre-existing conditions like scarlet letters but the insurance they now have gives them the opportunity for healthier, more productive lives, and that's what's in danger because of the scheme that is being pushed through congress, pushed through the senate by republicans right now. costs are going to shoot up if
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the plan goes forward. the premium subsidies millions of americans count on to buy insurance could be eliminated. even if americans with pre-existing conditions have access to health care after this repeal scheme goes through, it doesn't mean they can afford it. what my colleagues on the other side have said repeatedly for years is they're going to repeal and replace. no gap. no harm done to anybody. the replacement would be ready on day one. it sure looks like that promise is going to be broken. the replacement still hidden somewhere, but the process of repeal rolling forward. in the meantime, millions of americans who are left guessing what's going to happen to their care if this plays out. the bottom line for me and my colleague, my colleagues is really this. if members on the other side
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wanted to debate how to solve this country's health care challenge, we'll have that debate. i would say to my colleagues on the other side, i have spent about as much time as anybody here in this body looking for bipartisan approaches to addressing health care. so let's find ways to bring down costs for families. let's make prescription drugs more affordable. let's uphold the promise of medicare because that's what it is. it is a promise of guaranteed benefits, but we're not going to be able to do that on a partisan scheme called the budget resolution and reconciliation. that's not about bringing people together for a bipartisan effort. that's about tearing things down. tearing down the affordable care
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act. so i want it understood, mr. president, and my colleague, senator murray is here. she and i worked together closely because of our committees. we feel very, very strongly about how uniquely important this time is because this is a time when our country has to decide not to go back to the dark days when health care was reserved for the healthy and wealthy. that is what the other side has on offer right now. it is a proposition that i and colleagues are going to fight with all our strength and with that, mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from washington. mrs. murray: thank you, mr. president. i come to the floor of the senate tonight with my
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colleagues to share the stories of families in our home states whose lives are now healthier or have even been saved because of the affordable care act, including those who depend on medicare and medicaid, people whose voices now more than ever need to be heard here in washington, d.c. but first i'm going to make clear how the republican plan to repeal the affordable care act will rip apart our health care system. and after what came to light late last week, i also come to the senate floor tonight to stand with the millions of women, men, and families nationwide who are rightly outraged that this reckless and harmful effort also includes a plan to defund planned parenthood. mr. president, for seven years now congressional republicans have made all kinds of empty promises about how undermining
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families' health care isn't going to hurt anyone, that if the republican-controlled congress privatizes medicare, cuts medicaid, defunds the nation's largest provider of women's health care, and guts public health and prevention programs, somehow families are going to be magically better off. well, mr. president, let me be clear. ripping apart our health care system with no plan to replace it will create chaos. this is a view shared not just by senate democrats who are here tonight, but by independent experts, and in fact it's a view shared increasingly by state republican leaders across the country, including some senators and congressmen. last friday just to cite one example, the republican governor of arizona urged his party in congress not to rush to repeal the affordable care act saying and i quote, "i don't want to see any arizonan have the rug
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pulled out from underneath them in terms of changing this law." mr. president, if republicans repeal the affordable care act, it is women and kids and seniors and patients with serious illness and people with disabilities who will bear the burden. premiums will skyrocket. out of pocket prescription drug costs will rise, and overall health care costs will increase. it is a perfect storm to make america sick again and absolutely the wrong direction for our families and our economy. mr. president, i have to say i have never seen a start like this to a congress where the majority is jamming legislation through on a fast-track basis with no hearings for public debate or actual legislative text. and i have to say as a former chairman of the budget committee, i have never seen such an abuse of the budget process. what many of my republican colleagues are doing right now
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is unprecedented, but it gets worse. as if all of their harmful plans weren't enough, house republicans announced last week after meeting with vice president-elect pence that they plan to defund planned parenthood in this budget. in other words, congressional republicans are not only trying to undo a law that protects women from being charged more for their health care and insures birth control is covered without a copay, they're also going after the nation's largest provider of women's health care as well. they're doubling down on their shameful and tired obsession with undermining women's access to health care and it will have devastating consequences for women's health and rights and economic security. so, mr. president, i'm here with a very clear message, not on my watch. i and i -- i along with my colleagues across the country have fought this fight before. in 2011, in 2013, in 2016, and
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we will fight it in 2017. we know what planned parenthood means to the millions of patient, men and women who have trusted it for over a hundred years, for cancer and s.t.d. screenings, for h.i.v. test, for birth control, so much more, and we are not going to let extreme politics get in the way of their health care. so, mr. president, if republicans think causing chaos in our health care system, heightening economic uncertainty, attacking women's health and rights and burdening our seniors and their families with higher health care costs somehow makes our country -- quote -- greater, well, they're obviously not listening to millions of families who did not vote in november for higher premiums or health care systems thrown into chaos. i have to say, in fact, in my home state of washington, mr. president, i have heard from moms and dads and grandparents
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who are finally experiencing some stability and are able to cover their families with quality affordable health insurance, many for the very first time. there was a mom from bellingham, washington. she sent me a story about how the affordable care act helped save her son's life. when doctors found a life-threatening blood clot during a routine physical. she was not only able to afford the preventative checkup that found this clot because of her new coverage, but her son's treatment was then covered by the affordable care act through the medicaid expansion. i heard from a small business owner, mr. president, from spokane in washington who told my office about his wife, a retired nurse of 62, and how she was able to get a better plan thanks to the affordable care act. he told us what this meant for his wife and his family. you bet he gets upset when he hears republicans say the law hasn't worked for anyone or that
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they want to privatize medicare by turning it into a voucher program. and finally, mr. president, i want to share the story of kalen. he is a software engineer from seattle. he reached out to my office right after the november election. you see, two years ago, his son bryce was kayaking in west virginia and he injured his back. but the pain in bryce's back didn't go away for months. what doctors first suspected as a stubborn muscle strain ended up to be a rare type of bone cancer called uing sarcoma. horrible news. thankfully, his family had health insurance. today bryce is getting excellent treatment at seattle children's hospital where doctors have been able to ease some of his pain, and he's responding now to chemotherapy. but, mr. president, bryce, who is now almost 18, will need care, expensive care for many years to come, and bryce's dad
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kalen is gravely concerned that if the affordable care act goes away, the preexisting condition protection that we fought so hard for in this law will go away, and his son will not be able to afford health care or get the benefits and treatments he is going to need in the future. now, those are just three stories, but they represent many of the more than 600,000 people in my state who are part of the 30 million americans across the country who are benefiting from this law today. of course there's more reneed to do. i've said it before. the work didn't end when the affordable care act was passed. far from it. democrats are ready. we have said it before. we have always been ready to work together to make health care more affordable and more accessible and better for our families. mr. president, i hope republicans reverse course right now and agree to work with us on improvements to the health care
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system. that's the path to take if they're truly serious about helping families. if they don't and if they continue rushing to take away families' health care with no alternative plan, they will be fully responsible, and they certainly will be held accountable. the real impact will be on millions of families across our country, families like the ones i just talked about and those you're going to hear about throughout tonight. democrats, republicans and independents who do not want to see this law repealed, and they want us to work together to improve it instead. i hope republicans are listening. i urge them to make the right choice. thank you, mr. president, and now i'd like to yield the floor. a senator: mr. president? the presiding officer: the senator from rhode island. mr. reed: thank you, mr. president. first i would ask unanimous consent that michael martin and jeremy gillman, fellows in my office, be granted the privileges of the floor for the remainder of this session of congress. the presiding officer: without objection. mr. reed: thank you,
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mr. president. mr. president, i rise today in opposition to the budget resolution that the senate will vote on later this week. we are nearly halfway through the fiscal year, and republicans have offered this budget resolution not to set the path forward on spending for the year but to give them the ability to repeal the affordable care act through the budget process. it requires less support than is needed under regular order. this budget is nothing more than a sham being used to take away health insurance from more than 20 million americans. what's worse is that my republican colleagues intend to do so without any plan in place to mitigate the impact and protect the people who will be harmed. the uninsured rate is at its lowest point in recent history. since the implementation of the a.c.a. in my home state of rhode island, the uninsured rate has fallen from nearly 12% to under 4.5%. in real terms, that means that over 100,000 people in rhode island have gained coverage because of the a.c.a.
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that's about 10% of my population. over 30,000 middle-class rhode island yans get tax credits amounting to $250 each month to help them afford coverage under the state's health insurance marketplace. we cannot go back to a system that allows private insurers to deny coverage for preexisting conditions or charge more to those who need insurance the most. in fact, the republican plan to repeal the a.c.a. would mean that nearly half a million rhode islanders with preexisting conditions, nearly half of the state's population, will be denied coverage or charged more. again, as senator murray described so eloquently, the case of a young man who needs years of expensive treatment, but if preexisting conditions are once again possible, if that young man is dropped from his parents' plan at 21, both of those factors will probably deny him the coverage that he enjoys
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today, and that's not what we want to do. i hope it's not what we want to do. in my state, there are over 160,000 rhode island yans with diabetes, over 112,000 with asthma, and nearly 63,000 cancer survivors who would be forced to pay more for coverage. these are huge numbers in my state. roughly about a million people in population. they have these conditions, and insurance companies, as they did in the past, they have said we won't cover you. by the way, you will be saving two, three -- paying two, three, five, ten times as much for the coverage we have extended to someone else. we have also been able to approve through the a.c.a. coverage for those who are getting their care through their employer. before the a.c.a., insurance plans, including employer-sponsored health coverage, would impose annual or lifetime lissments on coverage, meaning coverage could end just when it was most needed. you could have a job, you could
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have insurance at your job, but if you had a serious condition, when you reached that limit, that's it. no more possibility by -- responsibility by the company. that's exactly the time you need the help because you have already either exhausted some of your own resources or you're in a position you have been sick for so long, your ability to go back to the workplace is practically nonexistent. the a.c.a. prohibits these limits along with ensuring free preventative care and coverage for dependents up to age 26. ensuring real coverage to nearly 600,000 workers in rhode island with employer coverage. there is a perception out there that a.c.a. doesn't apply to employer coverage, that it has no effect. that if it's repealed, that's fine because i get my health insurance from my employer. that's not the case. the impact will be there, and it could be for many people devastating. additionally, the a.c.a.
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strengthened the rate review processes to help control premiums. prior to the a.c.a., double-digit increases were always the norm. when i served in the house and my first years in the senate, it invariably, when trade associates came to visit me, the first or second issue on the list was our insurance coverage just went up 20%. we can't afford it any longer. we're dropping coverage or telling our workers you want a raise or do you want coverage, you can't get both. well, we've got to do more to keep premiums under control and bring down costs, but there has been an improvement under the a.c.a. in my state and in many other places. in two of the last three years, premiums actually went down from the previous year in rhode island, and during open enrollment for 2017, rhode islanders saw decreases of as much as 5% in their premiums. in fact, due to the a.c.a., consumers in rhode island have saved nearly $220 million since
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2012, according to state resources. so, mr. president, this program has done something that we were feverishly trying to do, which was to somehow bring costs under control, reduce them if we could but certainly eliminate that double-digit growth that every year, every employer group was come and saying -- coming and saying we can't afford this, we want to cover our workers but we can't, and we're giving them that choice. or we have to sadly say we can't give you insurance any longer. now, repealing the a.c.a. would add all of these consumer protections and put insurance companies back in charge. one other thing we have done in the a.c.a., we actually require that a significant amount of the premium is used for health care, not overhead. we have actually built into the law if you are going to charge a premium, it better go to help people get health care, not just
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to boost your profits, dividends or anything else. that is another fact that's influenced positively this rate structure and this rate and premium structure. and then, of course, there is -- will be a huge economic impact of a.c.a. repeal. for years i have heard my republican colleagues, very sincerely, very, very adamantly declare that the a.c.a. is a job killer, that it's going to destroy millions of jobs. that was one of the refrains that echoed throughout this chamber as we were debating the a.c.a. and for months and years afterwards. but what happened? we have had an unprecedented 75 consecutive months of job growth, something we haven't seen since 1939. repeal of the a.c.a. would wreak havoc on this process. premiums for everyone not just the individual market will skyrocket. large businesses will see their health care costs go up, which
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means workers will forego pay increases as their employers struggle to simply maintain health care coverage or it will drop the coverage entirely. we have come a long way since the economic downturn in 2008. we have much more work to do to keep things moving in the right direction, but one of the worst things we could do for our economy is to repeal the a.c.a. rhode island and another -- in another aspect of this stands to lose $7 billion in federal funding over the next ten years if repealed. again, that is a staggering number for my state, $7 billion. that would be devastating for the state because they would have to step up as best they could, and frankly they don't have the kind of resources to replace that loss. it would have an effect on the hospitals and other health care providers. hospitals in rhode island stand to lose nearly $2 billion in funding on top of the added
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expenses of emergency room care of the newly uninsured. because we remember the old model of health care. the old model was you didn't have insurance, you went to the emergency room, and those emergency rooms were crowded with people, they were much more expensive to treat because they were there without any previous experience with the physicians, without health records in many cases. they had to do diagnostic tests that would have been available, that are now available at the health care facility because they have insurance. all of that would come undone, it would have a huge impact on the economy. the largest employer in the state of rhode island, it's a hospital system. and i don't think we're alone. if you go out into rural parts of the united states, in many cases the biggest employer in the county or several counties is the health care, it's the hospital, it's the hospital system, and when they no longer
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can make their books balance, they're going to have to start closing down operations, laying people off. that's what's going to happen. this is not far-fetched because we've seen it before. we've seen struggling hospitals, struggling under emergency room uncompensated care. we have seen all of these things happen before. and repealing the a.c.a. would lead to a combination of all these factors, skyrocketing premiums, the loss of federal funding for health care in states which would have a ripple effect throughout the economy. if rhode island or any other state has to step in and partially make up for the loss of medicaid funds or any other aspect of this program, where are they taking it from? education, infrastructure, public safety, they'll suffer. ultimately, it's the jobs, the jobs of the people in my state and the jobs of people across the nation.
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so there are things we can do to strengthen the a.c.a. senator murray was very clear about attempts that we have made. she has been one of the great leaders in this effort to make improvements. we have been working on improving medicare since 1965. and we still have some work to do. but that was a different program. that was a program that was a bipartisan program, one that was embraced and developed and supported. in fact, one of the irony das is some of the stawrchlest supporters and protectors of medicare are republicans as well as democrats. but that was a program that took several decades to work through and we're still working through issues with respect to medicare. and we're prepared to do that with the affordable care act in a principled, thoughtful, practical, pragmatic way, not to score points, political points, but to make it a system that's more affordable, more effective,
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that gives more american families a chance. and you don't, frankly, have much of a chance for a good education, a good job, a secure retirement when your health is in jeopardy and your finances are equally in jeopardy. at this point the republicans have offered no plan to replace the a.c.a., and it's a tough task. i served on the help committee as we were drafting the a.c.a., and we spent over a year on this law. we spent countless moments reaching out to our colleagues on the republican side to say can we make this better, what improvements, et cetera. we had constant -- we had humannous -- numerous votes. it's tough work. and to suggest that we can just repeal this and something will magically appear, i don't think that's particularly logical,
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obvious, or will happen. and there's been seven years since the passage of this bill roughly that the republicans have had a chance to prepare a detailed plan to replace aspects of a.c.a. or replace it at all. i don't think that plan is out there. it certainly has not been communicated. we have to ensure and senator murray was very effective in making this point, that we can improve a.c.a., not demolish it, that if we get into a legislative process, we produce a better outcome for the american people, not an outcome of denial of health care and financial uncertainty and perhaps even financial ruin. so we have to get to work and i think we're prepared to do this but in the context of something pragmatic and productive for the
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benefit of the american people. now let me switchgears just for a moment and talk about medicare and medicaid because when people talk about medicare and medicaid, they usually don't make an association with the a.c.a. they think that's something else. i can recall being at a public discussion in august of 2010 when we were discussing a.c.a. before it became law, and someone came up and was very critical of the program because they didn't want publicly-funded insurance in any way, shape, or form. i asked where do you get your health care? well, i have a private -- where do you get your health care? i'm on medicare which is as i recall a single-payer national system of health care funded entirely by the government with some copays by participants. medicare and medicaid are effective in a significant way
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by the a.c.a. we made historic improvements to these programs, enhancing benefits. indeed we added nine years of solvency to the medicare trust fund. one of the great issues that reverberates throughout this chamber is we have to control retirements, we have to prepare for the future. we have to make sure that these social programs, like medicare and social security and medicaid and others are -- we added years of solvency through the a.c.a. if it's repealed subtract nine years of solvency from the medicare trust fund. tell seniors, tell people who are in their 50's who are getting ready to enjoy the benefits here, sorry, just take nine years off your expected medicare benefits or at least a portion of the benefits. the a.c.a. made a number of other improvements. they closed and are closing the donut hole for prescriptions. they've eliminated cost-sharing for preventive services, for cancer screenings, for example, for medicare recipients.
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over 15,000 rhode islanders saved $14 million on drugs in 2015. that's an average of $912 per beneficiary, medicare beneficiaries because of what we did with respect to the donut hole. in the same year over 92,000 rhode islanders, again huge numbers in my state, took advantage of free preventive services representing over 76% of the beneficiaries, 76% of the medicare beneficiaries in might state took advantage of free services. otherwise they'd be paying out of their pocket and frankly many seniors don't have those resources to pay out of their pocket. and repealing the a.c.a. means these benefits go away, and it shortens the trust fund by about a decade. repeal would also mean cutting $270 million in funding to pay for seniors, disabilities through the medicaid program. the a.c.a. expanded eligibility and streamline enrollment made it easier for the most vulnerable to access quality
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health care coverage. as a result, prockly -- approximately 70,000 rhode islanders were able to access coverage for the first time through medicaid. their previous source of health care, most times the emergency room if they could get there. now, i want to point out a couple of things about medicaid. medicaid has been a program for our senior citizens that happens to also help struggling americans. seniors make up a small percentage of the medicaid population, but account for approximately half of medicaid spending nationwide. nearly 60% of nursing home residents are covered by medicaid. think about that. 60% of all nursing home residents need medicaid. the next time you hear someone casually suggest drastic cuts and changes to medicaid, think about that. those cuts will work their way back to nursing homes throughout your state, and those families of those seniors, they're not
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all people who have been poor, on their minds all their lives, they are our neighbors and they will feel it. in rhode island over 30,000 seniors access health care coverage through medicaid. and my colleagues across the aisle want to make drastic cuts to medicaid. make no mistake, custom -- cuts to medicaid means cuts to services for seniors and return to premedicaid times when the elderly had few options. in 1950's, 1960's before medicare and medicaid, your grandmother or grandfather was in your living room in a hospital bed being taken care of by typically your mother. that's the way you grew up back in the 1950's and 1960's and most low income neighborhoods. that's at least my experience. if you want to go back, that's what happened in some respects if repeal it. if the republicans want to come
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and work with us, we're ready. more than ready. about you we can't stand by and allow them to do the damage they propose to take away coverage from 20 million americans, cut benefits for seniors. that's not the right direction for america and for our country. with that, mr. president, i would yield the floor. a senator: mr. president? the presiding officer: the senator from new hampshire. a senator: mr. president, i'm here to join so many of my colleagues to oppose the efforts to repeal the affordable care act outright repeal without a replacement plan will hurt hundreds of thousands of people in new hampshire as well as millions across this country, the estimate is anywhere from 20 to 30 million people who will lose their health insurance coverage. there are all kinds of reasons why this is a bad idea. many of those have been addressed by my colleagues very eloquently. mrs. shaheen: i just want to talk about a couple of those reasons. the first is one that senator
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durbin alluded to earlier, and that is what repeal of this law will mean for the heroin and opioid epidemic that is facing new hampshire and so many states across this country. repeal will dramatically worsen that epidemic because it will deny treatment for people who are abusing substances and also deny them access to mental health services. that will mean a surge in overdose deaths and will reverse so much of the progress that we're beginning to make. now, i understand that sweeping health care reform is not easy. we all know that the affordable care act is not perfect. it needs work, but the way to address it is not to repeal it. it's to work together to make it better. rather than the rush to destroy
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the affordable care act with no replacement in sight, we should be working together on a bipartisan basis to make common sense improvements to the law. it can be done. i know because tim scott and i worked together to pass the pace act last year to make it easier for us to control health care, insurance increases and to allow states to make a determination about group size for health insurance plans. now, one of the things that i am hopeful about is that president-elect trump and the course of many visits to new hampshire over the last year again and again pledged to take robust action to combat the opioid epidemic in new hampshire and across america. and yet by repealing the affordable care act, president-elect trump and republican leadership in congress would make the opioid crisis so much worse.
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this would be a broken promise to communities all across this country who are struggling with addiction. the affordable care act has given millions of americans access to treatment and recove recovery. it saved countless lives. and repealing it would deny treatment to people suffering from substance use disorders. it will cost lives. it will take a terrible toll on communities across america. in new hampshire alone, health care reform has helped over 100,000 people gain access to health care coverage. people like keith from ringe, new hampshire. keith was one of the thousand granite staters able to access quality, affordable health insurance through our expansion program. he told my office that the medicaid expansion literally saved his life. keith was suffering from several health issues when he went to see his doctor after he signed
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up for the new hampshire health protection plan which is what we call our expansion of medicaid. he told us that had he not had insurance, doctors likely would not have caught his kidney cancer early like they did, but because he had that health insurance, keith was able to afford and access treatment for his cancer. he is thankfully now cancer free, and he credits having insurance through medicaid expansion with saving his life. now, as i said, new hampshire is in the midst of a heroin and opioid epidemic. we've talked about the grim statistics frequently in the last year as we've come to the floor. in 2014 we lost 47,000 americans due to heroin and opioid overdoses. and in new hampshire when all of the analysis is in from 2016,
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we're expecting to lose almost 500 people due to overdose deaths. as senator durbin pointed out, we have one of the highest percentage of overdose deaths in the country. but it doesn't have to be that way because addiction is an illness. it's an illness that doesn't have a cure but we made progress in treating it. the affordable care act ensures that substance misuse services are covered by insurance and is a direct result of the affordable care act. many of those suffering finally have access to counseling and therapy like medication assisted treatments. and in addition to covering substance misuse, the affordable care act is also built on mental health parity provisions that require group health plans and insurers offering coverage of mental health services to provide comparable coverage to what they provide for other
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medical care when it comes to substance misuse. the affordable care act extended these parity goals by requiring mental health services to be covered as essential health benefits, and it also helped expand access to these services by ensuring more -- insuring more patients. now, we worked very hard in a bipartisan way over the last year in this chamber to pass the comprehensive addiction and recovery act, to pass the 21st century cures act that provided a billion dollars to address heroin and opioid problems in this country. both of those provide significant benefits to people who are suffering from substance misuse, but if we repeal the affordable care act, we're going to undo all of the progress that we've made through these supplemental pieces of law because it would reverse the
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treatment access that so many people in new hampshire and across this country have. why would we deliberately take away access to this life-saving treatment from so many people who are struggling to overcome addiction? repealing the affordable care act will affect people like ashley hurto of dover who said that her access to health care as a new medicaid enrollee was critical to her addiction recovery. as she told our newspaper, "the union leader," i am living proof that by giving individuals suffering with substance use disorders access to health insurance, we as a society are giving people like me a chance to be who we really are again. i had the opportunity last friday to visit a program called hope on haven hill in rochester, new hampshire. it provides help for women with
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substance misuse issues who are pregnant or who have just delivered babies. it works but has these young women are enrolled in our medicaid expansion program. without that, they would lose any opportunity for treatment for their substance misuse. and when i visited them, they talked about what it was like to be in a place where it was like a home, where people wanted to help them so that they could provide a better life for themselves and their children. without access to life-saving addiction treatment, many people like ashley, like those young women at hope on haven hill, would succumb to their addiction. and what is so frustrating again about this situation is that it's completely preventable.
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it's not only the right thing to do, it is the economic thing to do because the costs of failing to provide treatment for people who have substance misuse disorders is to make sure that they cannot become profitable tax-paying members of our society. now, i want to address one other benefit of the affordable care act because, as senator murray said, it is so critical to 50% of our population, and that is access to health care for women. before the affordable care act, women paid more for health insurance and contraceptives was something that made insurance cost more, and particularly for women who don't have the economic means, the affordable care act has for the first time
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made contraceptives available to women without cost-sharing requirements like co-pays and deductibles and coinsurance, and study after study has shown access to contraceptives is one of the greatest indicators of success for women. when women are able to plan their pregnancies, they're more likely to be able to graduate from high school, to enroll in college, to have stable and higher-paying jobs, to make sure that their health outcomes are better for themselves and their children and their families, and it's especially frustrateing that last week our republican colleagues and the house leadership announced that they're going to use the budget process not only to repeal the affordable care act and the help that that provides to women for contraceptive coverage, but they're also going to use this vehicle to defund planned parenthood. this is not only irresponsible but it's dangerous. just this morning, senator
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hassan and i visited a planned parenthood clinic in exeter, new hampshire. we talked with women who have benefited from the vital services that this center provides to thousands of granite staters. they talked about how 94% of the services that are provided in new hampshire planned parenthood clinics are related to prevention, but they also talked about -- and this is the word that one of the volunteers used in talking about the women that she had met with who had come to planned parenthood clinics. she said what they tell me is that planned parenthood saved me . for so many women who have economic challenges, for those low-income women who need access to services in new hampshire and across the country, they don't have any other place where they can get services if we close
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down planned parenthood clinics. we have two counties in new hampshire that doesn't have community health centers, that doesn't have a place where women can readily go, so defunding planned parenthood, closing the doors to planned parenthood health centers in new hampshire and across this country would put millions of women in the situation where they have nowhere to go to access basic health care services. that will cost women. it will cost women and their families access to preventative care, and ultimately it's going to cost the lives of women. so repealing the affordable care act is going to actively worsen health outcomes. it will provide less access to care for our most vulnerable populations. it will increase unplanned pregnancies. it will mean that people who
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have preexisting conditions will not be able to access health insurance in the future. the list goes on and on. the repeal of the affordable care act will not only throw millions of people off their health care, but it will also impact the coverage of millions of others because millions of americans will see their premiums rise, they'll see reinstatement of lifetime limits, they'll see reinstatement of expensive cost-sharing requirements, higher deductibles. we'll see a reinstatement by health insurance companies of coverage denials or sky-high premiums because of preexisting conditions. why would we go back to those exclusionary and detrimental practices? why would we go back to a time when we had over 20 million fewer people in this country who had access to health insurance? now is the time for us to come
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together. instead of scrapping this law, we should be working together to improve it, to make it work for all americans, because make no mistake, repealing the affordable care act without a replacement plan, stripping away health insurance for tens of thousands of granite staters, for over 20 million americans, it is not only counterintuitive but it is dangerous. we can do better in america. thank you, mr. president. i yield the floor. a senator: mr. president? the presiding officer: the senator from massachusetts. ms. warren: thank you, mr. president. mr. president, for eight years, republicans have complained about health care in america. they have blamed everything in the world on president obama. they have hung out on the sideline, name calling, making doomsday predictions and cheering every stumble that they could blame on someone else. they spent a rot -- lot of
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energy rooting against families who needed help paying for health insurance or who wanted coverage but were frozen out because of a preexisting condition. they jeered and carried on, but what they didn't do ever was lift a finger to try to improve health care in america. but they're in charge now. they get to call the shots. so what's the first thing on the republican agenda now that they're in control? is it working to help improve health care in america, working to bring down premiums and deductibles, making fixes to expand the network of doctors and the number of plans that people can choose from, any of those? nope. the very first thing on the republican agenda in the 115th congress is to shatter health care in america. the first thing, rip health insurance out of the hands of millions of americans who need it. the first thing, massively raise the cost of health insurance for everyone who has it.
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the first thing, create chaos for hospitals, clinics and insurance companies and send their costs spiraling out of control. the first thing, abandon the people they were elected to represent. the first thing, repeal and run away. republicans have been rushing around capitol hill for the past couple of weeks, huddling in meetings and trying to come up with a plan to replace the affordable care act, and they are shocked, shocked to discover that guaranteeing americans access to health care is a complex business, and they don't have any good ideas. now after eight years of complaining, they are trying to convince each other that it will all be okay if they just repeal health care access with nothing to replace it. they're trying to reassure each other that they know what they're doing. get real. they don't have a clue what to do next. for eight years, they have had
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no plan, and they don't have a plan now. let's be very clear about what's going on here. republicans want to tear apart our nation's health care system, a health care system that protects kids with cancer, protects women getting mammograms, protects independent contractors, protects new moms, protects college kids, protects grandparents, protects disease survivors and protects so many of america's families. they want to tear it apart, and they don't have the first clue what to do with it afterwards. repeal and run, that's the republican plan. in massachusetts, we know how important health reform is because we have been working on it now for years, long before the affordable care act was even a spark on the horizon in washington. my republican colleagues could learn a lot from our work in massachusetts. in massachusetts, the belief that everyone should have access
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to affordable health insurance coverage is a shared value that democrats, republicans, business leaders, hospitals, insurers, doctors, consumers and advocates have all worked to implement over the past decade. it's not just the lip service we're hearing right now here in washington. it is real commitment. and because of it, in massachusetts, we got real results. just because we're all behind this effort together in massachusetts doesn't mean that health care reform has been a cakewalk. finding ways to cover more people and bring down costs, all while improving the quality of care, it is a tough job. you have to be in it for the long haul. and that's why in massachusetts we didn't just pass one health care law and not in 2006 and then just run away. we came back a couple of years later with additional legislation to make fixes and
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adjustments. we have formed committees to study how things were working and make recommendations for more changes. we passed amendments. we revised our regulations where they needed to be changed to support implementation. we worked to make coverage more affordable. we set standards to make sure that insurance is a good value. and we invested in prevention programs to keep people healthy in the first place. we got more coverage for more people, and we lowered health care costs. we kept working month after month, year after year because we know what it means for a family to have the peace of mind that comes with affordable high quality health insurance coverage. we kept working because we knew it was the right thing to do. and we kept working because we knew that's what massachusetts residents expected us to do. once we started something, we had to see it through.
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and when it got tough, we worked harder. we didn't repeal and run. when the affordable care act was signed into law in 2010, massachusetts went all in. we expanded our medicaid program, we used federal funds to cover people who still lacked insurance even after our state reforms. we set up a state health insurance exchange, the health connector, and we combined federal and state dollars to make sure that insurance was truly affordable. and just two months ago, we signed an ambitious new medicaid agreement with the federal government that will allow us to set up innovative partnerships among health providers, insurers and community organizations so that we can better serve medicaid patients in our state. we have a great deal to be proud of in massachusetts. more than 97% of our citizens
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are insured. people have coverage. they have good coverage, coverage that they can afford. and this wasn't something we got done overnight, but it's something we worked at, and it's something we can achieve in every state if we're willing to do the work. democrats and nonpartisan government officials have worked for years here in washington to try to make this health system work, and we have made real progress. now republicans in congress are ready to throw away these years and years of progress. they are ready to threaten the collapse of our insurance markets. they are ready to threaten the health and the safety of millions of americans simply to make a political point. they are ready to repeal and run. in massachusetts right now, families are watching this


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