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tv   U.S. Senate Democrats Call for Hearings on Health Care Bill in Late Night...  CSPAN  June 19, 2017 10:00pm-12:01am EDT

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bill in secret? and the answer is very simple. the bill stinks. they're ashamed of it. the bill itself is an embarrassment. the process is an embarrassment. they've said so themselves. no matter how you look at it, this bill is disaster for people and their families. it will be a disaster for anyone who relies on medicaid, which will be cut by at least $800 billion. medicaid is a safety net for people who need care but can't afford it. look at nursing home care. medicaid covers three out of every four long-staying nursing home residents. medicaid covers three out of four long-stay nursing home residents. my wife's grandmother was just in a nursing home and just passed away and had great care. and wouldn't have been able to get the care that she needed were it not for medicaid. and this is not an uncommon
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story. these are millions of americans across the country, by the way, of all income levels. people think of medicaid as people who are financially not in a position to get care at any given moment. that's true. it does take care of the poor, but it also takes care of nursing home care for people who worked all their lives and just don't have enough. it's $9,000 a month in the state of hawaii for nursing home care. it's more than that for hospice care. we all know, nobody escapes end-off-life care. rich or poor, left or right, red, blue, purple, nobody escapes this part of your life. and everybody needs help. there might be a few people who save up enough cash money to be able to shell out $10,000 a month for that kind of care, but for the rest of us, medicaid is that lifeline. there are actually some
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republicans who don't want to cut medicaid. they have seen how the program improves people's lives. arkansas, kentucky, for example, they expanded medicaid. these states have seen big jumps in the number of people who now have their own doctor or who have gotten a checkup in the past year, people who are now more likely to say they are in excellent health. but under trumpcare, we will go back to the bad old days. this bill is also a disaster for older people who will be hit with what the aarp is calling an age tax. and this will get a little wonky, not as wonky as my colleague who spoke about five minutes ago, but a little wonky. right now, companies are not allowed to charge three times as much for an older person as a younger person. three times is the cap. but trumpcare will increase that rate to five times. and so what happens is every year as you get older, your insurance costs will go up and up and up and up. that's why they call it an age tax. in other words, many seniors will see premiums increase --
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premium increases that could cost them thousands of dollars more each year at a time when people are already struggling to find the money to pay for health care. this is also a disaster for patients who don't want to lose their health care provider. right now, an estimated one in five women go to planned parenthood clinics. and i understand that we have different views about reproductive choice. i understand that. but we also understand when we're talking on the level about planned parenthood and we're talking about the federal funding for planned parenthood, everybody who pays any bit of attention to this understands what planned parenthood does for women across the country. again, conservative women, progressive women, planned parenthood doesn't care. and planned parenthood is not using federal funding for abortion. we all know that by now. it's cancer screening, it's quality health care and birth
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control. people talk about giving more choices for health care and saving taxpayers money, but the c.b.o. estimates that defunding planned parenthood will take away options for nearly 400,000 women across the country, and it will cost taxpayers more than $130 million. it's also a disaster for those who are struggling with opioid addiction. this bill will take away treatment for mental health and addiction, leaving hundreds of thousands of people fighting opioid addiction without adequate health insurance. we saw the statistics that opioid addiction, i believe, is killing more people annually than hiv-aids killed at its apex. i believe it has either surpassed or is comparable in terms of cause of death to car accidents. this is one of the leading killers in the country, and medicaid is the program that funds opioid addiction for most of the people who get help. this bill is also a disaster for
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patients with preexisting conditions because it means we're going to go back to the dark days when insurance companies could charge you more for having a preexisting condition. i've heard from people back home in hawaii who were terrified of what this could mean for their health. one woman wrote that she is in the middle of a fight for her life against breast cancer. and she is scared that under trumpcare, she will lose her insurance. she will have to stop her treatments, and she could lose her life. a husband wrote to me that his wife has stage four breast cancer. she has had every possible treatment and surgery imaginable to extend her life, but without the guarantee of affordable coverage for all, her fight will quickly come to an end. she is 29. even people without serious medical conditions will be affected by this preexisting conditions nonsense, and we know that because before the affordable care act became law, insurance companies were able to discriminate based on what they
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determined to be a preexisting condition. one woman in hawaii told me that in the days before the affordable care act, she was rejected by insurance companies because she had back pain at one point in her life. the pain never came back, and she never needed treatment again, and she was young and healthy, but the insurance company wouldn't give her insurance. we cannot accept the end of nationwide protections for people with preexisting conditions. we cannot accept high premiums or so-called high-risk pools that have historically failed in giving people the coverage that they need and they deserve. look, we don't have to do it this way. we don't have the majority, and this is being done under a process called reconciliation, which means that you don't need a filibuster-proof majority. you just need 51 votes. so if you're proud of your bill,
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you have got senator hatch, he's the chairman of the finance committee, one of the most respected republicans in the country, actually. you have got senator alexander, likewise the chairman of the health, education, labor and pensions committee. both of them have a long history of being able to do deals. orrin hatch with teddy kennedy and my predecessor, dan inouye. lamar alexander with just about everybody, chuck schumer, patty murray. i mean, these are conservative members of the senate. no doubt about their republican credentials, but they are also people who are capable of crafting legislation in the right way. and i have no doubt that they like their gavel. i have no doubt that they like chairing hearings. and i have no doubt that they have the personal, intellectual, emotional, political stamina to go through a process that may take more than a couple of days. and i'll tell you, this is the
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world's greatest deliberative body, it is, and this is a bunch of impressive people who i serve with in the united states senate, but you know what? without a hearing, you get a garbage product. you get a bill that just stinks, that staffers say that they are keeping secret because, quote, we are not stupid. they are so embarrassed at this product that they are keeping it secret, because they know the moment this thing gets posted, everybody from everybody's home state, and not just democratic states and not just purple states but every home state is going to say my community health center is going to get shut down. wait a second, my opioid treatment program is going to get shut down. my hospital may no longer exist. they know this bill stinks, and there is a simple solution. all we need is three republicans to say let the senate be the senate. the house did whatever the house is going to do. there was a weird white house
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rose garden signing ceremony without a bill even being enacted. it was the most bizarre thing i have ever seen where everybody was congratulating each other for inflicting pain on the american people. but the senate has to be the senate here, and what that means is that we have to be that cooling saucer, right? we have to actually slow down and have a deliberative process, and all we need is three members of the united states senate on the republican side to say a very simple thing. and they can be as critical of obamacare as they want. they can be as partisan against us as they want, but all they have to say is this -- i'm not voting for a bill that doesn't get a hearing. i'm not voting for a bill that doesn't get a hearing. let this thing see the light of day. i yield the floor. mr. murphy: mr. president. the presiding officer: the senator from connecticut. mr. murphy: thank you,
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mr. president. i thank my friend from hawaii for convening us here tonight. so this isn't theoretical. this isn't about numbers. this is about real people. we know them. they exist throughout our states. i have told this story a few times on the floor of the senate before. when i think about the progress that's been made over the course of the last six years, i think about betty burger. betty is a woman who lives in mayor dan -- in meridan, connecticut. betty did everything we asked them to do. they were morally upstanding citizens, contributed to their community, they had full employment, they were raising good kids, and her husband switched jobs. he switched jobs and he had a one-week, maybe a two-week period of time in between those two jobs, and as luck or lack of it would have it, during that brief intermission between
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employment, their son was diagnosed with cancer. cancer then became a preexisting condition which meant that her husband's new employer would not cover the son as part of a family plan. the cancer progressed and progressed and progressed. his family, the burgers, had no means to keep up with their payments. their story unfortunately is not foreign to folks who have heard from constituents who have gone bankrupt because of health care costs. the burgers lost everything. the burgers first went through their savings. then they went into their son's college account. then they sold their car. then they sold their house. they lost everything they had trying to make sure that they had health care for their son simply because he got diagnosed with cancer during the one tiny
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interim between their family's insurance coverage. that preexisting condition doomed that family. there but by the grace of good would that be us. that could happen to any one of us, and yet today medical bankruptcy is frankly a thing of the past. why? well, it's not because health care costs any less. it's because we have said that we are not going to allow insurance companies to deny coverage to someone because they have a cancer diagnosis. in fact, we're not going to allow insurance companies to charge you more just because you are sick. and guess what? people have been able to keep their college savings account, they have been able to keep their car, they have been able to keep their house even if they get sick. that's what this bill has meant. 20 million more people are insured. yes, but the number of personal bankruptcies in this country have plummeted by 50%, almost
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entirely because there aren't burgers any longer. there aren't people who had to live through what the burger family had to live through. that's what this is about. this is about real people who are going to go through miserable, terrible experiences because of the bill that the senate -- senate republicans are just days away from putting onto the floor. i know my colleagues have covered this exhaustively, but i just want to show you visually what c.b.o. says the house bill does. i know it's in vogue for the president or republicans to say that obamacare is in a death spiral, but that's not what c.b.o. says. c.b.o. says that if you keep the american -- the affordable care act and you actually implement it rather than undermine it, rather than sabotage it as the president of the united states is today, well, then the number
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of people that don't have health insurance, it remains fairly stable from 2017 to 2026. it's about 28 million people. but if you enact the american health care act, a bill that passed through the house, that number goes almost immediately from about 26 million up to 40 million. right about 15 million people lose insurance right off the bat, within a heartbeat of passing this bill. about 14 million people lose insurance, and then over time it grows to 51 million people. that is not the american -- the affordable care act in a death spiral, right. that's market stability. this is a death spiral. the death spiral starts upon passage of the act that is being secretly negotiated today. and i get it that 25 million is kind of a hard number to get your head wrapped around. what does 23 million people really mean? these numbers are so huge. here is what 23 million people is.
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it's the entire population of alaska, delaware, hawaii, idaho, kansas, maine, montana, nebraska, nevada, new hampshire, new mexico, north dakota, rhode island, south dakota and let's just throw in west virginia. that's what 23 million people is. that is a humanitarian catastrophe, right? and remember, 23 million people is what you get to at the end of ten years, but 14 million people lose it right off the bat. there's no way for our health care coverage to provide covered to 14 million people who had insurance one day and don't have tt next. by the way, they tend to be the sickest people because that's who's going to lose health care first. so why are we doing this? why would you choose to inflict this kind of pain on people? why would you ask to run for congress in order to put this kind of hurt on the american public? and here's the answer. i wish this weren't the answer.
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like i wish there was a different answer but here's the answer. 23 million people lose health insurance. the cost of that is about $800 billion of money out of the health care system. and it's not coincidence that that then gets transferred into 650 or so odd billion dollars in tax breaks for the pharmaceutical companies, the insurance companies, and for really, really rich people. that's not just by accident that it worked out that the amount of money that you took from poor people and from middle class people and from sick people isn't the exact money that you're transferring to the pharmaceutical industry, the insurance industry, and rich people. here's another way of looking at it. here's where the tax cuts go. the lowest quintile, the middle quintile, even the fourth quintile don't get a lot of money out of this tax break. it's the top quintile, the top 20% of income earners that get an average tax cult of $2,700
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and here's the big benefit, the top 1% of incomers got $37,000 tax cut out of this bill. top 1% of income earners get a $37,000 tax cut from this bill. let me say that again. 23 million people lose health care so that the top 1% of income earners get a $37,000 tax cut who runs for congress to do that? what constituency is asking for the united states congress to pass a bill that takes health insurance from all sorts of working americans, people that are playing by the rules, people like the burgers in order to pass a tax cut for the super wealthy? i don't know what's happening behind these closed doors. i don't know exactly what they're talking about, but i'm going to guarantee that it's not
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fundamentally different than what the house bill did which is what i'm describing here. it's still massive numbers of people losing health care, rich people getting a tax cut, and lots of folks getting hurt. why? just because republicans made a political promise to do this. and i know i have other colleagues who want to talk so let me just turn for a moment to this process because the process doesn't matter. the majority is breaking the senate. they are breaking the senate. and don't think this won't be how this works if you're in the minority. the fact of the matter i is that we acknowledge that there's a lot that is still very wrong with the american health care system. our constituents command us to try to make those things better. and we would love nothing more than to sit down with the republicans and try to figure out how we can come together on a path forward to make this health care system better. and i know you don't believe us, but you didn't even try.
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i'm not sure that we believed you at the beginning of 2009 when you said we want to help people get insurance because we had watched republicans have control of the presidency and the house and the senate for a long time without a lot of progress being made. but dks tried -- but democrats tried. democrats spent a whole year sitting down with republicans trying to figure out if there was common ground, holding committee processes, exhaustive hearings. we had 30 daze of senate debate -- days of senate debate here on the senate floor. i get it in the end republicans didn't support that package and i get it republicans can lay blame at the feet of democrats i understand how that argument works. the fact is when democrats were in the majority, they tried. they opened up the committee process. they let everybody in the public see the debate we were having. why? because it's a big deal. we're talking about one-sixth to
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one-fifth of the american economy. if you're talking about reordering that big a segment of the u.s. economy, if you're talking about millions of people benefiting or losing, that shouldn't happen behind closed doors. my constituents, even though they're represented by democrats, have no less rights than the citizens of iowa or the citizens of texas who are represented by republicans. why are my constituents not allowed to see the details of what's about to happen to their lives? why are only a select group of americans able to have a voice inside that room? why are the people of connecticut going to get like three minutes to look at this bill once it hits the senate floor? my constituents are americans just like the constituents in republican states are americans. they deserve to know what's
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about to happen to them. you're breaking the senate. and it won't get put back together that easily. these are tough questions. they're partisan questions, but it doesn't mean that there's not an obligation to try to find common ground. and if you can't find common ground, don't bury the proceedings behind closed doors where nobody can see it. people hate this bill. they hate this bill. and they hate it in part because they don't trust the process. when they see this balance, tax breaks for pharma, insurance, and rich people and them losing coverage, they want to know why they lose and why super rich people win but they can't get answers because it's all happening behind closed doors. it's not too late. i'll just end with this.
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senator schatz said it right. it's not too late. you can -- my republican colleagues can reject this. say let's start over. let's sit down and see if there are some democrats who want to work on stabilizing these exchanges, seeing if there's some middle ground, being able to build a partisan consensus when it comes to the future of the health care system. it's not too late. i think you're going to hear that consistently from my colleagues this evening. i yield the floor. a senator: would the senator from connecticut yield for a question? mr. murphy: i did. i yielded the floor. the presiding officer: without objection. mr. booker: your charts were stunningly laying plain the benefits and -- who benefits
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from the republican bill we saw in the house, the c.b.o. as you pointed out plainly demonstrate that 23 million americans will lose health care but i heard you talk about this with other issues, about how we as americans are far more connected than we realize. that while family might suffer from lack of health insurance like the folks you talked about at the beginning of your remarks, the reality is when that child doesn't get the health care that they deserve, when they don't chief in life to the great potential that they might have, others suffer as well. and we see this here on the foreign relations committee as you travel to european countries and have far vastly more people insured, vastly more investments in childhood education and childhood health care. i'm wondering if you can extrapolate for me for a moment
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that this isn't just about individual families who are vulnerable. this is really all americans who suffer when you have other americans not getting the benefit of health care in this country. mr. murphy: i think we all got a gut bench. this young man who came back from north korea after having been abused and tortured there passed and if you read the statement from his family it was hard to read. you can't help read that without sort of feeling your heart drop into your stomach. why? because this is a young man with such promise ahead of him who had that future robbed from him. i didn't know him. you didn't know him. the people in my state who are similarly affected didn't know him yet they felt something. i think the reason the bill is so wildly unpopular is because people are going to die. i mean, the fact of the matter is if people don't get coverage for addiction, if folks don't
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get to see a doctor who are mentally ill, they aren't going to survive. and people -- you know, even those that have enough money to be able to pay for the premium increases in this bill, they know there's something -- there's something a little evil in wanting to do this to people. as you remark, even if you're not amongst the 23 million people who lose insurance, the c.b.o. also says that your rates are going up, right? because when those people don't get health care insurance, they show up somewhere else in the system. they show up at the emergency rooms. they get much more expensive care. that cost gets passed on to the rest of us. and so even if you're lucky enough to not be amongst the 23 million, you are going to be personally financially affected by this. the c.b.o. says everybody rates go up by 15% to 20%. but even if it's not the money that you care about, we are all
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connected and nobody should want this to happen to people. we're all weaker if we pass a piece of legislation here that ends up hurting people in such a real meaningful and dweses at a timing way. -- devastating way. mr. booker: if you can, the senator from connecticut, just ask one more question. that interrelatedness, it's a part of a larger system. and these systems we all benefit from. you mentioned momentarily ago hospitals and how -- whether it's my family that gets injured and is rushed to a family or a wealthy family or a poor family, those hospitals are a critical part of the health care system. i was mayor of a city and i imagine my experience is similar to yours in connecticut. our hospitals before the affordable care act were having a really difficult time because so many of those costs at the most expensive point, when a disease had become so much more acute were being pushed into
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hospital emergency rooms, and my state was having a very difficult time with the costs of that so-called charity care. they literally had tough choices. they weren't just going to close their door when someone goes into a diabetic shock or someone has an asthma attack or some of these diseases that are not treated at an earlier stain. i'm wonder -- stage. i'm wondering if you can help explain in terms of connecticut's perspective why this has an impact for all of us in terms of the systemic health care steams that sustain our communities. mr. murphy: the law says there's only one health care provider that by law has to treat every single person who comes in the door, that can't turn away individuals based upon their ability to pay. and that's the emergency room. but what we al also know is the emergency room is where you get the most expensive care. by the time you get there, you're often in crisis and the care you receive in the
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emergency room is expensive. and then all of the care that you need afterwards is extensive as well. i always remember a woman from connecticut who lost her medicare -- excuse me -- her medicaid coverage and in losing her medicaid coverage, she didn't end up being able to see a doctor for an infection she had in her foot. it was hurting for a long time, that infection. she didn't have medicaid any longer so she decided to let it hurt. she popped some til tylenol and hoped it would go away. one day it was so painful that she pent so the emergency room but it was too late. her foot became so badly infected that she had to have that foot -- that leg below her knee amputated. she had no insurance so we all picked up the cost of that but she had her life altered in a way that is hard for us to fathom. and there's not a single winner in that scenario because
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obviously she -- her entire life is changed because of that. but it's not like we saved any money in treating her so shabbily because we ended up having to cover all of those costs. that's just one story. but if you think about what the house bill does, it repeats that story millions of times over. it's morally bankrupt but it's also fiscally imprudent and foolish. mr. booker: one more thing, senator murphy and if you'd indulge me because i just visited your state and as i was talking to a lot of your members being from new jersey, there might be a small rivalry between our two northeastern states. some of your folks came up to me and got in my face in a polite and joking way about how our constitution was formed. they talked about the connecticut compromise. and as you well know, this was a compromise that allowed our republic to form. and in understanding that -- that we'd have two bodies, the house and the senate, and every state would have two members representing it.
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and in many ways the founders of our country coming out of this viewed this body very different liz than the other body. now, the other body you served in. i'm hoping maybe you could shine some light. i've been here three and a half years. you've had experience as a house member and as a senator. you said some people at home might dismiss this as hyperbolic partisanship. i think you're right. i've seen this body change. what frustrates me, i was here a brief period of time when democrats were in the majority and i heard my republicans on the -- colleagues on the republican side talking about regular order, how important regular order is, how when we're in charge we're going to have regular order. the leader spoke publicly about this thing called regular order. now, the house operates on majority rule, and there is a different -- our founders saw that as a very different body than this, which is in many ways talked about a different rhythm, a different way of doing things. in fact, how one senator over here can have a lot of power within the system.
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sometimes to the frustration of folks to slow things down. now, you made this claim about this being broken. and i think this is a perfect example of it. this idea that this would be the body that on such a big issue would -- would have a chance to be deliberative and to focus on this. could you just -- because i really think that you're right. we have seen this body in a very short period of time that i have been here begin to undermine not just things that happen under the obama administration but undermine traditions that go back decades if not more than a century. i just wonder if you could just give some light on why you really are substantively factually saying that this is probably one of the low moments of the united states senate in the way that this process is being done. mr. murphy: there is right outside the senate chamber a picture of the authors of the connecticut compromise, two of the connecticut delegates to the constitution convention.
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a shout out to connecticut. but no, you are right. the idea of the house is that it is supposed to respond perhaps more quickly to the temporary passions of the public, which is ironic given that the passion of the public today is in deep opposition to this piece of legislation. unfortunately, the house is responding to the passions of one very small portion of the public, which is the sort of extreme republican base which may be the only remaining segment of this country which supports the american health care act. this place is supposed to be able to step back and look at the long term, look at the long view. that's why we have six-year terms so that we don't do something that may feel good in the moment politically but has devastating impacts over the course of time. that's exactly what this debate is about. it's about a massive reordering
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of one-fifth of our economy that has just enormous consequences over time when these people who lose insurance start to feel the effects of that as they believe through their savings over five or ten years and go bankrupt at the back end of that time period. and so this is a place where both parties should be able to sit down and talk about what this really means for folks. and i thought senator schatz put it well. when you don't engage in regular order, not only do you do things that are very partisan and political, but you also do things that don't make sense. one of the things that regular order brings is the ability to talk to experts. we all sit on committees, and those committees bring experts to the table to tell us what the impact of legislation is. there has been no committee process on this bill. we haven't had a single committee meeting. we have one hearing in the health committee upon which i sit. as senator schatz said, the result is a product that is
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garbage, that just logistically does not work because neither the house nor the senate engage in the kind of deliberation that would get you to the facts. so, yes, this place is supposed to work differently, but also you're supposed to use the committee process to make sure that you're not passing something that just makes sense politically, that makes sense from a policy standpoint as well. mr. booker: thank you, senator murphy, for giving me those few moments. i wonder if the chair would be willing to recognize me to give some remarks for a few moments myself. the presiding officer: the senator is recognized. mr. booker: thank you very much, mr. president. so i just want to pick up from that conversation that we were having which is senator murphy so really laid it plain on his charts about larger issues with this bill, but i want to get back to the point he was just talking about that i have observed here in the united states senate for about three and a half years, is the functioning of this body. i love history. it's something that i'm one of these guys that doesn't read any
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nonfiction anymore. i love reading about this country, about its past leaders, about great moments in history. what's interesting about this body, being someone who has the privilege to stand on this floor quite literally given to me by the state that i love, new jersey, and i walk on this floor and i feel a sense of history every time i'm here. three and a half years, and it hasn't lost its wow factor for me. i get to stand on this floor. and i have to say i love my state, and in my campaigning, i don't think the issue that i am new jersey's first black senator really came up that much. new jerseyans just want to know would i come down here and fight for them, but i was aware of the history about being the fourth african american elected in the history -- popularly elected in the history of this body. and i came down here as a student of many of the great moments in time on this floor, and many of the records that were set. i think some of those records
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are really germane to this moment right now. the longest filibuster on this floor where one senator could actually grind the white house of the senate down to a crawl because of senate rules and senate traditions. in this case, something i wasn't even alive for, but something that to me is frustrateing but it's a moment of history that shows what regular order is. it slows down this body. a filibuster takes 60 votes to overcome. and so here was this moment, it was actually almost exactly 60 years ago that it was the 1957 civil rights act, and it was strom thurmond that gave this long filibuster trying to block something that, yes, indeed was going to have societal impact on this country. the 1957 civil rights act. now, this is one illustration of
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how when monumental pieces of legislation are coming to this floor, the history of this body, the traditions of this body to slow things down, to have a process, to have rules, especially for things that are so monumental. in this case of the 1957 civil rights act, something we look back in the past and say wow, it took them a long time to get there. but it demonstrates what this body's rules have been about for a long time. let me go with another record that i mentioned earlier tonight, but it's -- it shows again that when monumental pieces of legislation are coming, this is a body that looks closely, takes its time, is deliberative and has a time-honored process. and that is the other records
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set by the longest consecutive session in senate history was a debate about truly one of the more important things in our society, which is issues of war and peace. the longest consecutive session in senate history of debate, of deliberation, open and public for not just the nation to see but for the world to see was a debate during the first world war about whether to arm merchant ships. it brought about tremendous consternation, tremendous debate as we were doing the leadup into the first world war. now, what's interesting is if you think about the forming of our country, in that debate, again, constitutional convention
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, public, open, transparent. issues were debated. and one of the fundamental reasons for organizing our government was seen as the protection of the american people. the ideals of a common defense. the public welfare. these were the things literally put into the preamble of our constitution about what this government is about. that these are the most important ideals. in fact, we herald some of these ideals. they have become part of our civic gospel. everyone knows when they hear the words liberty and justice for all. part of our civic gospel. well, part of that gospel as well in the core center of our country is that this is a nation about life, liberty, and the pursuit of happiness.
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that word life, this government, this republic affirming the ideals of life is only understandable that we are debating epic pieces of legislation that will go to affect the lives of tens of millions of americans. i was in a children's hospital today. families in peril, families in crisis talking about the lives of their children. i've seen it happen. unfortunately, to neighbors and people in my community when the lives of their children are at stake or threatened or inflicted with disease. it puts so many things in perspective. and so here we have legislation speeding its way to the senate floor that go to the fundamental ideals of this nation.
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will we be a country that has a system of health care that affirms life? now, it is no coincidence that when we're talking about records in the senate, it is no coincidence to me that the longest time that there was a consecutive session in senate history for debate, no coincidence to me that one was about war and peace, the rush that some people saw then towards war in world war i. but what's fascinating is that folks should know that the second longest consecutive session in senate history was about health care. and it was in 2010.
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it was over the affordable care act. a bill that the full senate spent 25 consecutive days considering. 160 hours, not including, though, those 160 hours in session does not include hundreds more hours in committee hearings, in meetings. all that took place in the development of a bill that came to this floor and set a record about being the second longest debate. it is perfectly justifiable that that bill should have taken so much time, so much focus, that the world's greatest deliberative body would deliberate, would do its job.
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and for that piece of legislation, don't believe the lie. it wasn't rushed through here. it didn't get the express train through the united states senate. it set a record for discussion, deliberation, debate, and a process that included comments and input and thoughts and testimony from americans across the country. not just red states, not just blue states, but all americans. and it was justifiable. it was absolutely justifiable. i wasn't here. i was at home in newark. i was mayor of a city. and this debate went on and on and on and captured the attention of the nation. something i have never seen before and i haven't seen since.
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the president of the united states then barack obama -- this to me was stunning. it caught my attention -- on national tv cameras. sure it was c-span. not what i turn to first when i am home relaxing on my couch, but the president of the united states invited congress in. republicans. some of the smartest minds. i've served here three and a half years now. some of the smartest minds i have met here in this country are here in the senate on the republican side. he invited the congress in to discuss and debate with him on live tv health care. i don't know if reagan did that. i don't know if bill clinton did that. i can't remember that they did. so here was something that was done fully in the light, vetted, debated, deliberated, discussed
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in open air. and the hearing numbers are incredible. i have been here three and a half years, and i have never seen anything like it. in the senate's so-called help committee, health, education, labor, pensions, they held 13 bipartisan roundtables. 13 bipartisan hearings. 20 bipartisan walk throughs and they considered 300 amendments. this is the thing i didn't know till i got to the senate because of all the rhetoric on 24-hour cable news. this wasn't a pure democratic bill. they actually accepted over 160 amendments from republicans. the stories i've heard from people on both sides of the aisle is that they were bending
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over backwards trying to pick up one republican vote. and so they -- it incurred and took on amendments and actually shaped the bill. republican ideas on to this health care bill. 160 amendments. but stop. that's only in the help committee. in the senate finance committee, they held 17 bipartisan round roundtables. they held summits and hearings. 13-member meetings and walkthroughs. 38 meetings and negotiations, bipartisan. they held a markup. i've been to lots of markups. i've never seen them last or scarcely can think of times they lasted more than a day but they held in the finance committee a seven-day markup on the bill. that seven-day markup, talk about records, that seven-day markup was the longest markup on
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a bill in 20 years. that was the process. a bill effecting that fundamental american ideal that this nation, not a monarchy, the oldest constitutional democracy on the planet earth that aofficialed ideals -- that affirmed ideals that put into the ether of earth for the first time this constitution talking about life, liberty, and the pursuit of happiness, that this health care bill involved such debate and discussion, and the nation participated. policy experts, market experts, medical professionals, health nonprofits, insurers, hospitals,
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americans all got to put forward their input, their ideas. sure, not all of them were accepted but into the mix went everything. and so this should be shocking to the conscienceness of all people, of good conshens that aren't reflexively partisan but look at the history of this country, history that is proud, history that should be shameful about how things got done in matters of war and peace, in matters of foreign policy and domestic, in matters that made it possible for me to stand on the senate floor like integrate and civil rights. there was a process. and somehow in the last three and a half years in the name of
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what? a vicious brand of partisanship? that somehow undercuts not just the voice of democrats, not just the voice of policy expert, not just the voice of hospital expert, not just the voice of medical professionals, doesn't just undercut their involvement in the process but it is an insult to the history and the traditions of this body. this was not the constitutional intent that something as important as health care should be done in a back room where a small handful of senators are trying to hammer out amongst themselves a piece of legislation that's going to affect tens of millions of americans and change our economy and change our communities. there is honor in this place
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that isn't on tv. there are good folks on both sides of the aisle. i've gotten to know them. i consider folks my friends. i know their hearts. this does not sit well the way this is being handled. i know it. and this is one of those moments of history that somebody needs to raise their hand and say you know what? i may even like that bill that came out of that back room. i may like that bill that was hammered out by 12 republicans but this process is wrong. it is an insult to our history. i wouldn't want this done to me. this is the moment. it's a test. history will look back and see what this body did at this moment in history. i fear we're going to fail the test.
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but what's even more painful than that, for me is not just the sadness or the anguish i feel about a body contorting its extra divisions -- traditions, breaking its way. what even hurts me more than that subpoena what -- more than that is what they're going to be pushing through. you saw it in the house. instead of this body coming together and literally there is agreement on this. all of us believe the affordable care act needs to be improved. i've had it in conversations formal and informal that we could build upon the affordable care act. we could correct for its deficiencies and we could build upon its extraordinary
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successes. i see those extraordinary successes in my state. i have republicans and democrats who are now fearful about the consequences should a bill like the house republican health care bill be made law. folks who fear for their families, fear for their children, who don't want to go back to a nation that we had before it, with the number one reason for bankruptcy was not to be able to afford your medical bills, where people with preexisting conditions were denied insurance, when mental health care wasn't on parity with physical health care. i can go through all the things i've seen make a huge difference in new jersey, in communities
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rural and urban for americans. and i want to highlight some of those right now, some of those questions that people are asking at home about what happens if a bill like the house bill becomes law. if they take that bill here in the senate and push it through, have is back to the house, these bills, a subverted process, go to that process called reconciliation, there's questions that are being asked. here's one. what happens to a mother who's pregnant with, say, her second child who suddenly loses medicaid coverage. understand, a very large percentage of the children born in the united states of america are born covered by medicaid,
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which we already see in this house bill as being gutted. the biggest rollback in the safety net in our country in my lifetime and more. what happens to that mother who's pregnant with her second child, loses her medicaid coverage and her parental care -- prenatal care, she loses her prenatal care along with it? what happens to that american citizen? what happens to that baby? well, we know that according to the united states department of health and human services, babies born to mothers who receive no prenatal care are five times more likely to die than those whose mothers did not receive -- did receive prenatal care. five times. and tragically women without prenatal care are three to four times more likely to suffer maternal mortality. that means dying in childbirth,
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than women with prenatal care. and these rates significantly increase for women of color. what happens to the tens of thousands of mothers who may lose access to maternity services? and what happens to the already dismal infant mortality rate and maternal mortality rates in our country if this plan goes through? that is a legitimate question. the data is clear. you restrict access to prenatal care, you endanger children, americans. you endanger mothers. but let's keep asking those questions. what happens to the health care worker who works 60 hours a week taking care of others but loses their own health care coverage and then is unable to afford getting screened themselves,
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preventive screenings for cancer. let's say ovarian cancer. what happens to them? we don't have to imagine what happens when millions of americans forego preventive screenings. we have factual data on what happens should access to those preventive screenings like what happened with the house health care bill, what happened? the american cancer society tells us clearly that inadequate health coverage is a preventive to early care and optimum treatment. they find patients with stage 2colo dtion rectal -- stage 2 colorecta cancer that have it detected had higher survival rates. in fact, they point out that people with stage 2 colorectal cancer with adequate insurance
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have better survival rates than people with stage 2 -- stage 1 colorectal cancer that have no health coverage. in other words, the american cancer society shows that access leads to survival and denial leads to higher rates of death. a recent cancer study found and i quote right now the number of americans whose cancers were diagnosed at the earliest stage when it's most likely to be cured increased after obamacare went into effect and more citizens had access to health coverage. you take away the expanded coverage that was found through obamacare. you did he crease pre-- you decrease preventive screenings. you decrease early detection as indicated by the american cancer
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society death rates go up. another question in general. what happens to cancer rates in america when these gains are reversed? what happens when these gains are reversed? what happens to the father of two who's diagnosed with a rare cancer who can't afford the additional estimated $82,000 his cancer treatment goes up if this bill, like the republican house bill, passes. that's what's estimated. $82,000 would his cancer treatments go up. what happens when he can't afford that care, when he's forced to choose between his family's home, for example, and treating his cancer? well, this is what we know. these are the facts, that from 2010 to 2016 personal bankruptcy filings have dropped close to 50% in the united states of america. one of the collateral benefits of obamacare, 50% drop in
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personal bankruptcy filings with experts agreeing that the affordable care act played an important role in this significant decrease. a group of economists has estimated that the house republican bill would cost the average enrollee more than $1,500 more per year than the current system. this is despite the fact that surveys have found that the majority of americans had less than $1,000 in savings. with only one study finding -- excuse me -- with one study finding that 63% of americans don't have the savings to cover a $500 emergency. remember what senator murphy showed. that's a bill that gives massive tax cuts to the wealthiest of americans shifting the cost burden so that the average enrollee now under this bill is going to see a $1,500 more per
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year payments, when the average american doesn't have the savings to cover a $500 emergency. let me -- that's another question that folks are asking. what happens to a family whose child with a disability loses their access to home and support services, to physical and speech therapy? that they receive through medicaid if the republican plan goes forward? i was in a hospital today with such parents, telling me about children who the only way they got the coverage was because of the expanded medicaid. and now what happens under the republican plan? we know that medicaid is a critical lifeline for people and families with disabilities, providing access to things like rehabilitative therapies, that help children meet developmental goals. one of the incredible women, young girls i met today because of developmental therapy, she
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went from not being able to walk to now continue to do the things that her normal teenaged peers and her twin sister is able to do. we know that today, 15% of kids are growing up with a developmental disability, and in new jersey, one in 41 children live with autism. but this plan we saw pass in the house threatens to make it more difficult for children with disabilities to receive the care they need, to go to school and to live healthy lives. losing coverage can mean the difference between a child with a disability achieving a developmental milestone or falling further behind, and unfortunately in the republican bill that passed the house that's exactly what will happen if it should become law. if that bill passes, what happens to older americans who don't get qualified for medicare but still need access to critical health services?
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well, we know that because insurance companies would likely be allowed to change older americans to much higher premiums, premiums under the republican plan. remember, it used to be capped. the costs for older americans used to be capped. it's now being estimated that americans between the ages of 55 to 64 would pay some of the highest increases. it seems to me that wave would be $5,200 more per year. standard and poor's -- standard & poor's actually estimated that premiums for a 64-year-old could increase by 30% under the republican bill that passed the house. the congressional budget office noted in their report on the house republican health care plan that, and i quote, although the agencies expect that the legislation would increase the number of uninsured broadly, the increase would be
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disproportionately large among older people with lower income, particularly between people between 50 and 64 years of age with incomes of less than 200% of the federal poverty level. think about that for a second. executives in insurance companies, the richest would get tax breaks into the hundreds of thousands of dollars but the poorest folks, elderly in our community, according to the c.b.o., would see their costs go up considerably. the new jersey hospital association noted that, and i quote for them, under current law, a 64-year-old making $26,500 a year will pay an average of $1,700 in annual premiums. under the ahca, the republican plan in the house, that same individual making just above
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minimum wage, they will pay under their plan $13,600 -- between $13,600 and $16,100 in premiums. that's the increase for older americans, working americans. that's the increase. we know that if more older americans lose their health coverage and in turn enter medicare in worse health, our entire medicare system is made weaker and less solvent. and if this bill passes, what happens to older americans who have already spent their life savings in nursing homes? well, we know right now elder americans that are in nursing homes that medicaid actually covers the costs of two out of three of those individuals.
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in the piece that just ran this past weekend in "the new york times," and i quote, roughly one in three people now turning 65 will require nursing home care at some point during his or her life, one in three. over three-quarters of long stay nursing home residents will eventually be covered by medicaid. many american voters think medicaid is only for low-income adults and their children for people who aren't, quote-unquote, like them, but medicaid is not somebody else's insurance. it is insurance for all of our mothers and fathers and eventually for ourselves. i continue the quote. mr. trump and the republicans would lower spending on the frailest and most vulnerable people in our health care system. they would like most americans to believe that these cuts will not affect them. only their, quote-unquote,
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undeserving neighbors. but that hides the truth that draconian cuts to medicaid affect all of our families. they are a direct attack on our elderly, our disabled and our dignity. i want to wrap up with just this concluding thought. we know right now that we are at a turning point in our country, that the process that has made this deliberative body known throughout the land, throughout humanity, that this deliberative body is about to alter its traditions and have a bill that affects tens of millions of americans done and crafted in the back room without public input will be rushed to this floor. that's what the process is right now.
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it was martin luther king in a speech to the medical community for human rights in 1966 that said of all the formats of -- forms of inequality, injustice in health care is the most shocking and inhumane. this bill will perpetuate injustice in our nation. it will further the gulf between the haves and the have-nots, but it will not just target those most vulnerable, the elderly, the poor. it targets all of us. it targets our character as a country, our highest ideals, the very core of many of our faiths. to the least of these, the least of these, we cannot allow this legislation that will so hurt our country to be crafted in darkness behind closed doors, that subverts a tradition, a
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mighty tradition of the world's most deliberative body to be rushed through when it will cause so much damage to so many americans, and indeed the very soul of our country. mr. president, i yield the floor. mr. young: mr. president. the presiding officer: the senator from indiana. mr. young: i ask unanimous consent the senate be in a period of morning business, with senators permitted to speak therein. the presiding officer: without objection. mr. young: i ask unanimous consent that when the senate completes its business today, it adjourn until 10:00 a.m. tuesday, june 20. further, that following the prayer and pledge, the morning business be deemed expired, the journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day and morning business be closed. further, following leader remarks, the senate proceed to executive session and resume
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consideration of the mandelker nomination. that finally the vote on the long nomination be equally divided between the two leaders or their designees. the presiding officer: without objection. mr. young: if there is no further business to come before the senate, i ask that it stand adjourned under the previous order following the remarks of our democrat colleagues. the presiding officer: without objection. ms. baldwin: mr. president. the presiding officer: the senator from wisconsin. ms. baldwin: mr. president, i rise tonight to join my colleagues in our fight to protect the health and economic security of the american people. i'm here to express my deep concern, anguish, disgust with the fact that instead of working across party lines, working together to protect health care,
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instead the majority is writing secret legislation behind closed doors, legislation that is going to make the american people pay more for less care and take health care coverage away for millions of american families. i'm disgusted, mr. president, because this issue is very personal to me. when i was 9 years old, i got sick. i got really sick. i was hospitalized for three months. i eventually recovered, but when it came to health insurance, it was like i had a scarlet letter. my grandparents who raised me couldn't find a policy that would cover me, not from any
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insurer and not at any price. they had to pay for my health care out of their pockets, and they made incredible sacrifices to do so, all because i was a child who had been branded with those words preexisting condition. no parents or grandparents should have to lie awake at night worried that if their child has an illness or an injury, that they wouldn't have a way to pay to cover their care. no child should have to lie awake at night hearing the whispered tones of their parents downstairs wondering how they might pay the bills to care for
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an ill child. it's not right. it's not fair. and it's not fundamentally who we are. but that's exactly what people were wondering last night in america. and they will do so again tonight. families across this country will go to bed anxious, scared because of the partisan politics happening right here in washington. the politics that is moving forward with a plan that will make things worse and not better for the american people. this isn't just personal for me. it's personal for the wisconsin families that i worked for. i've listened to them, and i'm here to give them a voice.
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it's personal for jim from appleton, wisconsin, and for jim's daughter who has multiple sclerosis. jim told me that his family needs strong protections for people with preexisting conditions so his daughter can continue to receive treatment that her family can afford. this is personal for greg from stoddard, wisconsin, who has no idea how he and other older wisconsinites will be able to afford higher costs for their health care and for greg's two sons, both of whom have diabetes and are already struggling with scrobting prices for inches lynn. this is personal for barbara from madison who is deeply
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concerned about cuts to medicaid because barbara's son has a disability, and he relies on medicaid to work and to live independently, and this is personal for chelsea from shelby, wisconsin, whose daughter zoe was born with a congenital heart defect. right now, zoe is guaranteed access to coverage without being denied or charged more because of her preexisting condition. chelsea wrote to me and said i'm pleading to you as a mother to fight for the kids in wisconsin with preexisting conditions that are counting on you to protect that right. mr. president, there's the -- does the congressional majority really care more about finding
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50 votes for a secret plan than it does about the health and well-being of zoe? sad did i, it appears they do. it appears they're more concerned with finding 50 votes for any legislation, no matter how harmful it is, just so they can notch up another partisan victory and so they can move on to other things on their political agenda. well, they're not listening to american families or wisconsin families who will be left behi behind. mr. president, i want to tell you what the consequences are going to be when washington doesn't listen to wisconsinites like jim and his daughter from appleton or gregg and his two sons from stoddard or moms like
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barbara from madison and chelsea from shelby. the consequences of that things are going to get worse, like they do under the house-passed republican plan. if you're older, you're going to pay an age tax. a 64-year-old in wisconsin could have to pay increases in excess of $10,000 more in premiums. if you have a preexisting condition like i do or like almost 2.5 million wisconsinites do, the guaranteed protections and care that you have today may not be here tomorrow. if you live in rural wisconsin, this plan will only make it harder to access affordable quality health care.
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for some living in northern wisconsin, this plan could cost them up to $6,000 more a year than they pay today. our rural hospitals are already struggling to keep their doors open, and this plan could make those challenges even worse. by the way, rural hospitals are often the lifeblood of their communities, the largest employers in many counties in which they exist. so if rural hospitals, even a few of them, are forced to close, they not only make it harder for people to gain health care, it also means that people lose their jobs. if you rely on medicaid for nursing home care or, like barbara, you have a disabled child who relies on medicaid to
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live independently in the community, the house-passed bill cuts medicaid and puts that care at risk. if you are one of the 35,000 veterans in wisconsin or nearly 2 million veterans across the country who rely on medicaid for their health care coverage, your care will be at risk. the house republican proposal will dramatically both increase and shift health care costs onto wisconsin taxpayers and onto the shoulders of families for things like substance abuse treatment and mental health services. it will make it harder in our state's fight and america's fight against the opioid crisis and could make the epidemic our country is facing even worse.
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put simply, this plan will hand over more control to insurance companies, weaken health insurance protections, raise costs, and provide less care for the american people. the american people cannot afford to sell a home or take out a second mortgage or home equity loan or spend their life savings or max out their credit cards or go bankrupt just to get the health care they need. it's not right, it's not fair, and it's not who we are. mr. president, it's time to stop this partisan nonsense. the people of wisconsin did not send me to the united states senate to take people's health care away. they sent me to fight for people like jim and gregg and barbara
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and chelsea and their children. let's listen to these wisconsi wisconsinites. let's take repeal off the table, and let's work in a bipartisan way. let's work together to improve the health care that people have today and make it more affordable, not more costly. let's work in a bipartisan way. let's work together to make things better, not pursue partisan plans to make things worse. i call on my colleagues on the other side of the aisle to come out from behind their closed doors, to join us in this fight to stop leaving people behind and start helping them get ahead.
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mr. president, i yield the floor. mr. merkley: mr. president? the presiding officer: the senator from oregon. mr. merkley: mr. president, i appreciate the remarks from my colleague from wisconsin, who came here to champion the citizens of her state but the citizens of all of america. and as she spoke so passionately about the need to make sure that we have affordable, quality health care, that is really the theme of what we're talking about. that is the value we're talking about, that in this great, beautiful, wonderful nation of the united states of america, everyone should have access to affordable, quality health care. now, there's some colleagues here who don't share that value. oh, they consider health care to be a privilege for the wealthy. health care for the wealthy. health care for the healthy. but not health care for all americans. they say, can't afford health care? too bad.
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they have a plan, 13 republicans meeting in secret, the secret 13, even meeting in a room that the hallway is not accessible to press because they're afraid to have the cameras showing them going into the room and out of the room. if you're ashamed to see yourself going in and out of a room, your constituents to see that, shouldn't you be ashamed of what you're concocting? shouldn't you really wonder about whether you're doing the right thing. to say to your constituents, i'm not going to show you the bill because i know you won't like it, i'm going to keep it secret, and i'm going to bring it out the last minute, i'm going to employ a tactic that doesn't belong in the u.s. senate. this is supposed to be a deliberative body, once called the world's greatest deliberative body. but now it's the body under this leadership of zero deliberation, zero committee meetings, zero
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markups, zero chance for the public to weigh in, zero chance to hear the experts and take their insights into account. well, that has to change. we need three of our colleagues who believe in this nation, who believe in the constitution written with those beautiful three words "we the people." they need to stop thinking about we the power and we the privileged -- we the powerful and we the privileged. they need to stop thinking about how do we help our friends and our friends in the corporate suites of america. how do you help struggling americans? franklin roosevelt said the test of our progress should not be whether we do more, add to the abundance of those who have much, but whether we do enough for those who have little. the philosophy of this bill that the secret 13 are cooking up is
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about giving more to the abundance of those who have much and taking away from those who have little. i.t. the opposite -- it's the opposite. it's government by and for the wealthy and government by and for the powerful and government by and for the privileged. have they forgotten the first three words of our constitution? have they forgotten that the philosophy was that, as jefferson put it, that we would have outcomes that would reflect the will of the people? you are afraid -- if you are afraid to share the bill with the people of america, you're certainly not pursuing the will of the people of the united states of america. what is really in this bill? well, on the one hand, we understand that it's going to take health care away from millions of americans. they're saying they might do it a little more slowly than the trumpcare bill did, now that the trumpcare bill -- the president himself said it was mean.
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and he used the derogative slow gang that i won't repeat on this floor, a derogative slogan to say how terrible it was. why did the president call it mean? because it was taking away health care from an estimated 23 million people. my colleagues we understand are going to do it a little more slowly, inflict that damage a little -- over a number of extra years. does that make it right to hurt people? does that make it right? and in the meantime, they're going to hand out an insurance bag of goodies-- or a bag of goodies to the health insurers of $127 billion. strip health care over here, give goodies to the insurance companies over here. and what happens to those who are in long-term care in nursing homes? you know, 60%, more than six out of ten americans, who are in long-term care are there because
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they're paid through medicaid. and they have to pay down all their income and their wealth before they can use medicaid. this is the last resort, the last thing they have. medicaid comes to the rescue. visited a couple nursing homes over the weekend, one in an urban asian one in -- in an urban area, one in a rural amendment. i encourage my colleagues, go visit a nursing home. talk to the men and women who are there. they are so thankful that they have that care. one woman said to me, she said, medicaid is how i'm paid for. her name is deborah. deborah said, medicaid is how i can afford to be here. she said, they take it away, i'm out on the street. and being on the trea street isa problem because my legs don't work. so picture that individual thrown into the street. she's in her wheelchair because her legs don't work. where is she going to sleep? how is she going to feed
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herself? where is she going to bathe? then i went to a nursing home in rural oregon, and this was down in the south, klamath county. at that us i nursing home, theyd me about 100% of their patients are paid for by medicaid. imagine that entire hall individuals swept out, tossed out. and why? well, what else do we have in this bill? we have -- oh, get rid of -- giving tax deductions, gifts to the health insurance executives. first we have gifts to the health insurers and then another $18 billion to the health insurance executives. then my colleagues say, let's make insurance cheaper by getting rid of the essential benefits, that way people can have an insurance policy for less, but unfortunately i.t. not worth the -- but unfortunately it's not worth the paper it's written on.
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we've been there. there's a reason for why you set a floor for what the benefits are. so when you get sick, you can get an operation when you break a leg, you are actually get it set. when you need treatment for a disease, you can get the treatment. these are the fundamentals. they're not the fancy end of the health care. it is not the fancy end that you might find with some executive health care packages. i.t. the basics -- it's the basics, the essential basics. my colleagues want to strip that away. on the other hand, they say, hey, we've got so much money, we can give tax giveaways to the prescription drug makers, $29 billion to the prescription drug makers. well, and then they want to destroy the rural health care clinics and hospitals.
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i was in four of my rural counties this weekend. i was in klamath and lake, i was in grant and wheeler. i held town halls. people came out and spoke to me. and these folks said, you know, our rural clinics are the heart of our community, and they're what allow people to live here with confidence, that they can get the health care they need, instead of having to go to some city hundreds of miles away. or maybe not even be able to get care at all on a timely basis. and they love their hospitals that provide care in the bit larger communities in rural oregon. and the heads of these hospitals and the heads of these clinics, what do they say? they say that without the affordable care act and the vast decrease in uncompensated coverage, they'd have to fire a whole lot of employees and provide a whole lot less health care.
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one doctor from a clinic in the northeast clinic of the state came to me and said, we doubled -- roughly doubled the amount of health care we're able to provide, and we are so remote, it's so important to be able to have that nearby. so why do my colleagues really dislike health care in rural america? why do they want to undermine it? well, they can give away more money to medical device makers. $20 billion to medical device makers. and all of this is before we look back that they are giving more than $200 billion away to the richest americans. so over here, let's strip the essential benefits, let's destroy the health clinics, let's undermine the rural hospitals. let's make it challenging for those with preexisting conditions. let's take those in nursing homes and make sure that they're not able to be in nursing homes
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and magically maybe they will get cared for some other way. so we can give tax giveaways to the health insurers, tax gifts to the insurance executives, tax goodies to the prescription drug makers, and special tax provisions to the medical device makers, and then give $200 billion to the richest americans. isn't that the opposite of the test of our progress, that here in the united states of america, under a system of government that is supposed to be of the people, by the people, for the people, this bill is by the privileged and powerful, for the privileged and powerful. and not just that, but let's really hurt ordinary working people and struggling americans in the process right where it really gets them, right here at the fundamental part of the peace of mind that they get from
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knowing that currently they have access to health care. now, i don't know that anything is quite so disturbing as worry about the fact that your loved -- that if your loved one gets sick, will he or she be able to get the care that she needs? if your loved one gets sick, will he or she go broke? and what about your neighbor? and what about your extended family? this republican bill is all about creating stress and anxiety and bad outcomes for ordinary working americans, ordinary working class americans, ordinary struggling americans. they didn't send us here to the senate to do this. that's why the secret 13 are meeting in secret. that's why they don't want to meet in a room that has a hallway that the reporters can be in. that's why they don't want to
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answer questions in the hallway about whether they will vote to proceed to a bill without legislate the people of america weigh in on it. shouldn't everyone here be willing to answer that question? are you willing to vote to move to a bill that has had no public process? aren't you working for the people of america? or like this bill says that you're writing, you're just working for the companies and the rich, that's it, and too bad for everyone else. erin in portland wrote because she has been diagnosed with diabetes. she is terrified that if trumpcare goes through, her condition will be considered a preexisting condition and she won't be able to afford the coverage that she needs, and she says, quote, although through committed lifestyle changes and family support, i have done well managing this condition, the diabetes, i will be marked as high risk along with my age.
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and ellen from medford writes, southern part of our state. she writes and tells me that she has the challenge that her baby daughter was in a catastrophic accident just days before her second birthday. her husband had just switched jobs and didn't have health insurance yet, but fortunately medicaid, that would be the oregon health plan, was there for them, and her daughter got the lifesaving care she needed. that's anxiety for an ordinary person. do you have health coverage when you're switching jobs? is it once health insurance you can afford? just as my colleagues want to strip health care from ellen in medford so they can cut $800 billion from medicaid overall so they can give tax
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giveaways to powerful corporations and the richest americans, just wrong, morally wrong. wrong in every possible way. is my colleague ready to speak from pennsylvania? no. so maryland from ontario says she is living with two auto immune diseases, give to pronounce, so i won't. she was diagnosed before the a.c.a. became law. but rather than be denied coverage outright by her insurance coverage, she was told she could be covered if she paid a monthly premium of about $1,000 with a $20,000 deductible, $20,000 deductible. needless to say that wasn't helpful to her.
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marilyn went five years without insurance, and she ended up being very sick. she had to borrow against her home, leveraged her home. she had to deplete her retirement savings. she had to make payments on $64,000 worth of credit card debt run up in order to cover her health care. and then the a.c.a. came along and marilyn was able to afford insurance. she got community pricing. despite her preexisting condition, she paid the same price as everyone else. that is so important to peace of mind about health care. just saying that you will have access to health care, a favorite phrase that my colleagues have used, access, if you can pay extraordinarily high prices that i know you won't be able to pay. that's not access. that's teasing people. that's cruelty to say oh, we'll make sure you have access. as long as you're a millionaire,
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you pay a ton every month. we have taken care of you. you have got access. no. that is not access. affordability is critical to having a functioning health care system. and marilyn will probably be priced out of the moct again with the republican strategy. or how about lisa in corvallis? a single parent of three children, two with serious medical conditions that have placed them on permanent disability. lisa has faced some hard times. i will let her words speak for themselves. she says, and i quote, our family was very fortunate and eternally grateful that the a.c.a. passed while i held that job because in 2015, my middle child was hospitalized for the first of four times in the last two years. and in march, 2016, i developed
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a serious heart condition which my doctor attributes in part to stress. she goes on to say, and i quote, in june, 2016, my employer declined to renew my contract, and if it weren't for the a.c.a., i would have been out of a job and completely without medical coverage, this time with a serious and expensive preexisting condition. the stories are coming in through the e-mails. they're coming in through my town halls. they're calling in over the phones. they are letting us all know and not just in states represented by folks on this side of the aisle. every senator here is getting these letters. so i say to my fellow senators, read these letters. read these letters from your constituents. i know that your constituents are in the same position my constituents are in.
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and be a champion for them. be a champion for struggling families, for working families, for middle-class families. honor the role and responsibility of representing all the people of your state, not simply powerful companies and your richest constituents, but all your citizens. that was the vision on which our country was founded, and that is the spirit which franklin roosevelt saying this test of our progress is not whether we give more to the abun dance -- abundance of those who have most but enough to those who have little. enough means affordable, accessible health care for every single person in america. tearing that down is wrong morally and wrong to do it
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secretly and wrong in terms of the enormous damage that it will cost. thank you, mr. president. i'm pleased to see my colleague is here from pennsylvania who has been a champion for working americans. every day he serves in this chamber, and he particularly makes sure that all of us are thinking about the impact on children. there is so much of this secret republican plan that will hurt the children of america. i appreciate the insights he shares with all of us and urges all of us to ponder and do better on each time we consider legislation. i yield the floor. mr. casey: mr. president. the presiding officer: the senator from pennsylvania. mr. casey: thank you, mr. president. i want to thank my colleague from oregon for bringing the passion and the determination that he brings to his work, especially when it comes to health care. i spoke earlier tonight,
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mr. president, about the potential impact of a senate bill, but unfortunately the impact that we know of already with regard to the house bill, the house bill legislation that passed and legislation that we can analyze as it relates to the impact on children, especially children with disabilities. of course, when it comes to health care generally but in particular medicaid and what medicaid provides the children, we know the impact of nationwide, i know just from my home state of pennsylvania, we have 1.1 million children that are covered by medicaid. i'm very concerned about any effort that would undermine or ultimately extinguish the ability of americans and especially children to have the benefit of medicaid expassengers, but of course the medicaid program itself.
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it's especially insulting when some would support cuts to the medicaid program that would undermine or even threaten to undermine health care for children with disabilities. i spoke earlier of two children in particular. i will come back to children in a moment, but i wanted to go to the other end of the age scale, older americans. so many people think of health care for people over the age of 65 to be solely limited to medicare and not medicaid, but of course we know that medicaid plays a role as well. one of the parts of our health care infrastructure that may not be as well known as the impact that medicaid has on supporting aging older adults in particular with regard to supports and
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services. we know that medicaid is critical to support aging older adults, providing them dignity and choice as they age. medicaid covers long-term care -- or i should say long-term services, supports for low-income older adults and adults with disabilities, including nursing home and community-based programs. generally health insurance does not cover long-term supports and service costs. medicare costs for those services can be limited and private long-term care insurance is unaffordable for many americans. so spending on long-term supports and services for older citizens accounts for almost two-thirds of all medicaid spending. i said medicaid, not medicare. a lot of people don't know that
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we spend that much in terms of long-term supports and services. to give this perspective, these numbers, in 2016, the median annual cost for a year of home health aid services was over $46,000. for home health aid services. the immediate cost for a semi private room in a nursing facility was $82,000, a much greater cost. so we know the impact of those -- those numbers. about a third of people turning 65 will require nursing home care at some point during their life. so these are big costs, and we have to make sure as we move forward we can provide this kind of care for aging adults.
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if you're going to a nursing home and you spend down, the only option for you in most instances is medicaid. we know that just in about a one-year time frame between july of 2015 and june of 2016, in pennsylvania, 123,000 pennsylvanians aged 55 and olde, received long-term care -- or long-term supports and services through medicaid. one group of about 85,000 pennsylvanians receive those services a at nursing home. another group, about 50,000 pennsylvania's 55 and older receive medicaid home and community-based services. so lots of -- lots of numbers there. lots of data. but the key thing is the, we know -- but the key thing is, we
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know the great dependence that folks have on the medicaid program, in addition to the obvious -- the obvious benefits provided by medicare. so cuts or per capita caps on medicaid would have a devastating impact on older americans. and i know the discussion now in the closed-door, secret discussions that are taking place here in the senate between and among only a small group of republicans so far -- we know that those kinds of discussions are taking place. what will they do with regard to medicaid? will they cut it outright or will they put a per capita cap on it, or will they send it back to the states and tell the governors and state legislatures they have to balance their budget. it is up to you to provide most of the medicaid services the federal government is getting out -- most of the medicaid
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services. the federal government is getting out of that, which or at least transferring substantial responsibility to the states. so we have to be vigilant about that and make sure we do everything we can to put the interests in the priority -- the from the of older americans and the priority of taking care of them at the front of the agenda. research also shows that medicaid dollars also plays a role in supporting a lot of good-paying jobs in a state like pennsylvania. we're told that over a quarter of a million jobs in the long-term care field -- meaning long-term supports and services -- are pennsylvania jobs right now. and so any change there could be an adverse job impact. the commonwealth fund and george washington's mill ken institute released a report projecting 942,000 fewer jobs in 2026, and that nearly every state would
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experience an economic downturn if the republican bill were to become law. based upon the house bill, as we know it and we were told most recently by a republican senator that the senate bill will reflect the house bill about 80%. so we have a sense of the outlines of the senate bill, if not all the details yet. in pennsylvania, the report -- this same report by george washington university's milken institute said that just in pennsylvania the job impact would be 85,000 fewer jobs by 2026. and of those 85,000, more than 50,000 -- more than 52,000 of those jobs would be health care jobs that would be lost, if the republican bill were to be
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enacted into law. so we get a sense of the job impact, we get a sense of the health care impact when it comes to cuts to medicaid that are substantial. as we know, the congressional budget office told us that in the decade, were the house bill to be enacted into law, in that decade, 14 million folks on medicaid would lose their coverage. that's on page 17 of the c.b.o. report. when we look at it by county in pennsylvania, you can see the impact in this age category of 55 and up. for example, allegheny county, our second-large i think county by pop -- our second-largest county by population, over 10,000 pennsylvanians over the age of 55 receive care in a nursing home. that provided a large number of
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payments. huge impact on the care that people will receive. i won't go through every county but to give you a sense of it cambria county, a much smaller county by population, where johnstown is, 1,100 individuals in cambria county aged 55 and older receive care in a nursing home or at home because of medicaid. that's what a third -- that's about a $36 million impact on that county. my home county, lackawanna county, where scranton is located, 2,500 pennsylvanians over 55 receiving nurse being home care or home care because of medicaid. a $96 million impact just in lackawanna county. so i won't go through all the counties, buck see the impact on both -- but you can see the impact on both care when it
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comes to medicaid and long-term supports and services. we talked earlier about medicaid and the impact on children. i don't think it's been at all clear until recently the reach and the scope of medicaid when it comes to children. 40% of every child in the country is covered by medicaid. i mentioned earlier tonight -- i'll say it again -- 60% of all children with disabilities ranging from autism to traumatic brain injury -- and a lot of disabilitiedisabilities on thatn between, 60% of children with disabilities rely on medicaid. i said that the republican plan at a minimum, at the bare minimum, should guarantee -- guarantee -- that every child with a disability who has medicaid coverage today would in fact have that coverage going forward, for whatever time they
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need it. because that's, i think, part of who we are as a country. when a child has a disability that is so substantial in terms of the impact on that child and his or her family and they have medicaid, nothing the united states senate should do should undermine that in any way. i would hope -- i would hope at a minimum that our republican colleagues would ensure that. i think it's -- i think it's insulting to even create doubt or uncertainty or create any degree of anxiety for a family to have to watch this proceeding, to watch this bill proceed had -- either the house bill that was passed or the senate bill which is in formation right i now -- for any family that has the benefit of medicaid and that has a child
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with a disability, to watch with uncertainty because of what might happen here, i think is an insult. we're a great country. we can make sure that children with disabilities that have the benefit that comes from the early periodic screening and diagnosis, the preventive care, the quality care that comes from the services provided by medicaid for kids with disabilities, we're a great country, we can pay for that and still be agrology economics -- still have a growing economy, still have the strongest g.d.p. in the world. we can do all of that and still take care of those children. but some, i guess, believe that the only way to prosperity is to say, well, we have to substantially cut back on medicaid to the point where 14 million americans lose their coverage over ten years, but don't -- but we still at the
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same time have to give tax cuts to the very wealthy. one estimate showed that the house -- the original house bill, the one that didn't get a vote but was substantially similar to the one that did get a vote, that that first bill gave to 400 americans a tax cut of some $7 million each. why -- how does that make the country stronger when you're cutting back on medicaid and giving gross, substantial tax cuts to people who already are worth hundreds of millions of dollars or maybe even billions of dollars? i don't see how that moves the country forward to shortchange folks on medicaid, especially -- especially if it were to adversely impact a child with a disability. so we mention all of those impacts, but i think it's
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especially devastating when it gets down to an individual, an individual family. i talked earlier about roane simpson, who mom wrote to me monthsing a. i had a -- wrote to me months ago. i had the chance to meet with him and his mom and dad last month in person. the idea that pam simpson or any parent would be at all uncertain or worried about what would happen here in the next couple of days or weeks is really -- i think is really an insult to who we are as a people. so i hope that those who are behind closed doors making decisions as we speak -- maybe they're gone for the day now, but i hope they'll be thinking about roane and his mom and their family.
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i mention the overall impact of medicaid on children. in particular, we know that the medicaid program, of course, in addition to covering those children with disabilities covers adults with disabilities as well. in my state, by one estimate, it's over 720,000 people. and across the country in 2015 there were 15 million people with disabilities who were medicaid beneficiaries. through medicaid, those 15 million people receive assistance with their health care. they get the benefit of durable medical equipment such as wheelchairs or assistive speaking devices. they get long-term care -- long-term supports for daily living, such as personal care attendants because of their disability. so medicaid is now one of the primary payers for health care
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for those with disabilities. it is also the primary payer for long-term supports and support's services that help those with disabilities survive. in many cases, these long-term supports and services also make it possible for a person with a disability to hold down a job, because of the support they get from medicaid. we know that in 2014 across the country the average spending for a person with a disability enrolled in medicaid was a little more than $19,000. now, in pennsylvania, a little more than $18,300. the average annual growth in enrollee spending for a person with a disability between 2000 and 2011 was 4.5%. so -- and in my state, it is a little more than that, almost 5.7%. we've seen the outline of a proposal that would limit that growth, that annual growth to
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about 2.4%. i hope -- i would hope that those who are working on the medicaid provisions would take into account the reality of what it costs to provide help to someone with a disability and not come up with some arbitrary number to cap or limit what an individual with a disability would have available to them, especially if, by way of medicaid or otherwise, they have -- they are dependent upon and have a right to expect that that kind of health care would continue to be provided. so we'll see what happens. i know that the -- those who are behind closed doors have a sense of those numbers. i hope that they would be very determined to make sure that no one with a disability is worse off as a result of their
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efforts. but that's the reality that people with disabilities live with. and i think, mr. president, when we consider what some families are up against right now, many families have just barely come out of the last recession. some families lost their homes, some families lost their homes and their jobs, or even if they lost a job and have since recovered because they are employed or partially recovered, sometimes the job they have isn't the job that they had prior to the recession. i can only imagine what it's like if you have the kind of economic stress that some live with, because they've lost a job or the job they have now doesn't pay what their old job paid. and on top of all that -- on top of all that, if your son or daughter or someone in your
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family has a disability and the only thing that's kept you above water or allowed you to get from one day to the next, to make ends meet, is the availability of medicaid, for that individual in your family who needs that kind of help. so we'll see what the bill drafters come up with, but every indication so far has been very negative and very much adverse to the interests of those families, those millions of families who depend upon medicaid for basic health care, especially the basic health care that would be connected to a disability, whether that disability is a physical disability of one kind or another or whether it's a disability because that child or that adult is on the autism spectrum or whether it's a


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