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tv   U.S. Senate Democrats Debate Graham- Cassidy Health Care Bill  CSPAN  September 18, 2017 6:59pm-9:00pm EDT

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games with cost-sharing reduction subsidies. these are subsidies to insurance companies that take on individuals with expensive health histories. these insurance companies are given support by subsidy so that they can keep the premium cost for these individuals under control. these cost-sharing reduction subsidies help seven million americans afford their copayments and deductibles under health insurance policies. the current trump administration has repeatedly threatened to stop the payments. and as a result, individual market premiums keep going up because of the uncertainty of whether the government is going to keep its promise to make these cost reduction subsidies. i remember the commissioner from the state of south carolina, and he told us, i say to the senator from oregon who is our ranking senator on the finance committee, i'm going to announce a 30% increase in health insurance premiums.
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if i knew that these cost-sharing reduction subsidies were coming, it would be 10%. i can eliminate 20% of the anticipated increase in premium cost if these subsidies came through. well, it's pretty clear to me, this is sound policy on a bipartisan basis that would have a dramatic impact in reducing the costs of the subsidy -- the cost of premiums to many individuals. that came through loud and clear in every meeting we had with senators murray and senator alexander. the second thing they talked about was state reinsurance. and i don't understand that as well as some, but it has worked in states where the state picks up a share of the liability for health insurance between certain dollar amounts, and so the private insurance companies don't end up with that burden. because of this reinsurance, they are able to keep premium costs down. the third thing is to provide states with more flexibility without undermining some really
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fundamental issues, without undermining, for example, preexisting condition protection which we currently have. i left those meetings feeling encouraged. after seven months of bitter political rhetoric which led to nothing on the floor of the senate, we were finally sitting down on a bipartisan basis with people, democrats and republicans, from all across our country with specific suggestions that could help our health care system. that to me is the way to move forward. that to me is the lesson learned from much wasted time so far this year. but unfortunately, that whole effort may be derailed. senators cassidy and graham have come up with a legislative alternative that they want to move forward. unfortunately, this measure that they have proposed has not been scored by the congressional budget office or carefully measured to find out what impact it would have on the american
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health care system, which accounts for one-sixth of the american national economy. here is what we know about the cassidy and graham proposal. what they are suggesting is basically eliminating the subsidies that help individuals pay for private health insurance and bringing to a halt the medicaid expansion which has covered millions of americans and given them health insurance. what they say instead is something that's been said many times on the floor. well, we'll just give all the money to the governors and they'll significant -- figure it out. they'll figure out how to save money in their states. it turns out that governors of both political parties warn us, if you're going to give us a set amount of money as the cost of health care continues to go up, don't expect us to cover as many people or to provide as good of coverage if we do it on a state-by-state basis. so who supports this new cassidy-graham approach and who opposes it? every single medical advocacy
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group, the hospitals, the doctors, the nurses all across america oppose this cassidy-graham approach as well as the medical advocacy groups because they understand that their approach would allow discrimination against individuals insured based on a history of preexisting conditions. going back to the bad old days before we passed the affordable care act. the cassidy-graham approach, which they brought to us, doesn't add up. if you take $300 or $400 billion out of this health care system, dump it in the laps of governors around this country and say good luck, do it on a local basis, i'm sure it will work out, they will quickly tell you, as they have in the meetings we have had, the bipartisan meetings, it will not work, it does not compute. it may be able to check the box for some that they repealed the affordable care act, but they certainly didn't replace it with anything of equal or better value. the opposite is true.
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and that's why i think we ought to think twice. there is a mad dash now in the last 12 days to do many things. from a political viewpoint, there is a limited opportunity for this repeal effort. that 12-day period is a limited window under the senate rules of reconciliation. it's a mistake as far as i'm concerned for us to move toward cassidy-graham, concepts which have been roundly opposed in my state and across the nation, concepts that have failed on the floor of the senate. let us roll up our sleeves and do three things that do make sense. let's reauthorize the children's health insurance program. let's make sure those kids and the pregnant moms are going to have the basic coverage that they have enjoyed for almost 20 years. let's also reauthorize the community health centers. we know they work. we know that when people have a medical home, they are less likely to let medical conditions get worse and more expensive. that to me is a good investment to make sure they continue. and finally, let's turn toward a
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real bipartisan effort, a measure that can emerge soon, i hope within days, from senators murray and alexander on a bipartisan basis. i know they're still working on it. they vice president reached a final agreement on what they're doing, but i hope all of us in both political parties will encourage them to do the right thing. do you remember when john mccain came to the floor after he had been diagnosed with cancer that he's battling now? he came here and cast a crucial vote to proceed to debate, this whole issue of health care. and then he asked to speak for 15 minutes. i stayed in my chair. i wanted to hear it. and he reminded us of the importance of doing things on a bipartisan basis and doing them thoughtfully when it comes to something as important as health care. let us keep that speech by john mccain, that lesson in mind. let us resist as cassidy -- this cassidy-graham approach which has no support when it comes to the medical community and
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instead work on the bipartisan approach, alexander and murray, together with the finance committee which i know senator wyden is going to address next, so that we can have a bipartisan solution. the american people sent us here to solve problems, not create them. cassidy-graham creates problems. let's find solutions that solve problems. mr. president, i yield the floor. the presiding officer: the senator from oregon. mr. wyden: mr. president, before he leaves the floor, i just want to draw attention to the central point that the senator from illinois has been making tonight. he has been focused on what the duties of the american people are all about, which is to make their lives better, and particularly to improve the quality of their health care, which is a lifeline for millions of families. now, instead of looking at bipartisan approach to make the
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lives of our people better. chairman hatch and i introduced the children's health bill today. nine million youngsters of that program get better help instead of focusing on that that my colleague from illinois has said we are going to be looking at a bill that will hurt our people. we'll give them worse health care. we'll go backward with respect to the march in our country to make sure that we recognize that all our people, all our people deserve quality and affordable health care, and i particularly appreciate my colleague pointing out the contrast between where we ought to go with a bipartisan proposal like the children's health plan and where we shouldn't go, which is the graham-cassidy-heller proposal that is going to go backwards with respect to the health care needs of our people. the fact is, mr. president,
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graham-cassidy-heller has been exposed to sunlight for just a few days, but it's already clear this legislation is a bad deal for the american people. now, senator cassidy has introduced health care bills before. earlier this year, he introduced a bill with our colleague from maine, senator collins, an alternative to what the senate republican leadership put on offer. now, i had my concerns with that proposal that the first thing i want the senate to understand is this cassidy bill, this cassidy bill that we will soon be considering is much, much worse. the reason i say that is this bill lowers the bar, mr. president, lowers the bar for legislation that has been hastily written and ill
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considered, and i want to be clear this cassidy bill will flunk the jimmy kimmel test of not hurting kids in america with preexisting conditions. now, to make matters worse, just this evening, mr. president, i have been informed that the senate finance committee will shortly announce a hearing, a hearing for next monday on the graham-cassidy-heller proposal. contrary to the norms of senate -- of the senate finance committee, i was not consulted in this matter as ranking democrat. mr. president, i am all for debating major legislation, but talking about a piece of legislation that will not have the congressional budget office, our independent arbiter of these matters, give us their thoughts
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on coverage or premium matters less than 48 hours before a vote is scheduled to happen is a sham process that makes a mockery of the very eloquent words of our colleague from arizona, mr. mccain, who appealed for the regular way in which the senate handles legislation. that means senators won't know how many millions of americans are going to wake up not knowing if they have health care, how many seniors would get kicked out of a nursing home or see their core health care needs not met. how much will americans' premiums go up? senate republicans have no answers on any of these matters. what graham-cassidy-heller does
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do is give a super block grant blank check, a super block grant blank check to the states. they can do whatever they want, whatever they want in terms of americans' health care. and it guts the funding for those block grants over a very short period of time. that's going to mean a whale of a lot of pain for vulnerable people and an open door to some of the worst abuses of insurance companies, abuses we thought we had gotten rid of, democrats and republicans, thought we had gotten rid of them. back when i introduced a bill with seven democrats and seven republicans. now we're talking about bringing them back. this bill amounts to the largest health care devolution, moving
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power without any accountability at all to the states. now, the bill, if i might for a few minutes get into some of the specifics, does especially serious damage to medicaid. in fact, it really hollows out the medicaid program. this year's debate over health care made one thing quite clear. medicaid matters. it pays for the health care of our most vulnerable and serves as a safety net for those who might not think they're ever going to need it. it covers nursing home care for older people who spend down hard-earned savings. it pays for critically needed addiction treatment services for those who struggle with opioids. we know that that's what millions of americans are facing now. and it helps americans with disabilities and kids with
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special needs live a healthier, more productive life in their communities rather than in an institution. and that is just a little bit of the good medicaid does for folks from portland, oregon, to portland, maine. under the graham-cassidy-heller proposal, that's gone, simply gone. the plan ends medicaid coverage that 11 million americans count on right now. it guts medicaid and guts hundreds of millions of dollars of support from the federal government. so in effect what it's like is telling the states good luck. it's telling them, well, you can make the hard decisions about which americans are going to get adequate health care and which are going to be those unfortunate souls who go without. my view is this is going to lead
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to destitution for older americans who count on medicaid for nursing home care, and it also represents a massive transfer of dollars from states that expanded medicaid to states that chose not to. history tells us that the most vulnerable americans without a voice or a powerful lobby are the ones that are going to be the worst off. now, i have heard my colleagues, senator cassidy in particular, claim that this bill is modeled on the children's health insurance plan, which is a block granted program, and that means all supporters of chip should support graham-cassidy-heller. nothing could be further from the truth. the children's health insurance program has been an extraordinarily successful program for more than 20 years,
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now covering nine million youngsters. part of that success is due to its reliance on a strong medicaid program. if medicaid and the rest of the health care system is block granted and slashed by hundreds of billions of dollars, the pillars that support a successful children's health insurance plan will crumble. they'll lose their structural support. a vote in favor of graham-cassidy is a vote to demolish successful health care programs, like the children's health insurance plan and its promise of affordable health care for millions of kids and their families. now, there's one more step that the graham-cassidy-heller bill takes that is different from previous versions.
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rather than reducing the tax credits that help americans get help, similar to earlier republican approaches -- again, this bill just chucks them out, gets rid of them. gone. that means asking states to use their federal health block grant for a whole host of competing health care priorities, forcing vulnerable -- in effect pitting vulnerable americans against each other and not having enough at the table to meet these critical needs of some of our most vulnerable people, people who day in and day out are walking on an economic tightrope trying to balance their food costs against their medical costs and their medical costs against the housing. graham-cassidy-heller is a recipe for disaster.
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this proposal again opens loopholes for insurance companies that as i described thought we had closed, thought we had finally closed the book on the days when health care wasn't just for the healthy and wealthy. that's what happened when we had discrimination against those with preexisting conditions. you had a preexisting condition and you were wealthy, just pay the bill. if you didn't have any preexisting conditions, nothing to worry about. but for the millions of people who finally got some peace of mind at night when we eliminated discrimination against those with preexisting conditions, this brings back that ugly prospect, that ugly prospect that a key consumer protection, the protection that bars discrimination against those who have preexisting conditions is
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just tossed aside just as what looks to be setting aside the essential health benefits that all americans are entitled to receive. it was pretty obvious during the trumpcare debate that unraveling the consumer protections that our people count on today leads to the entire system falling apart and the vulnerable bear the brunt of the pain. mr. president, many of our friends and neighbors have spent their year raising their voices and showing up to stop bad health care legislation. thanks to their grassroots efforts, the partisan approach that i've described is being used here again has been stopped multiple times. so i wanted to come on the floor
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tonight to say once again to people in every community across our great country is that once again we need people power. once again we need them to stand up and say we don't want to turn back the clock on the health care needs of the most vulnerable, like seniors and the disabled and our kids. and once again we hope that they will speak out all across the country. i'm going to be having town hall meetings this upcoming weekend, mr. president, after the jewish holiday. you can be sure i'm going to hear a lot from the people of oregon about this. and i'm very hopeful that once again people power around america is going to come forward
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and say to those who are talking about supporting graham-cassidy-heller that this is a mistake, that they don't want to turn back the clock with respect to health care. they want to move forward. instead of turning back the clock, what they're looking for is leadership, for example, that will hold down their prescription drug costs. i've introduced legislation to require that these companies publicly justify raising their prices. we've had senators introduce a host of bills. that's what we ought to be doing is talking about how we're going to improve american health care. my colleague from illinois mentioned the children's health insurance plan that chairman hatch and i have worked with our finance colleagues to get introduced. the community health center program. i could go on and on about
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opportunities for bipartisanship to take the country in the right direction rather than in the wrong direction. instead it doesn't look like that's going to be on offer any time soon. what's going to be on offer is a proposal that turns back the clock, guts medicaid, harms seniors, harms the vulnerable, and i think would be a major mistake. my bottom line has long been that for changes to the health care system to be sustainable and lasting, they have to be bipartisan. that's why i mentioned the effort that i was involved in. several of my colleagues here who cosponsored the bill i'm talking about have been supportive of that for quite some time. so we know republicans and democrats know how to write
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bipartisan legislation, but what graham-cassidy-heller bill seeks to do is just the opposite, to use the most deeply partisan process the senate knows called reconciliation. it's basically our way or the highway, not interested in trying to find common ground. and i just point out it didn't end too well earlier when we talked about health care. and i came to the floor tonight to make the case that we cannot let partisan reconciliation tactics win on this key issue. we ought to be working together to improve health care on a bipartisan basis in a way that helps people all across the country. and i have mentioned, mr. president, and this is
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particularly important to me, a number of bills that colleagues on both sides of the aisle have worked on that would help improve the lives of the american people. graham-cassidy-heller does not meet that test. i hope my colleagues will reject it. and i hope that all across the country from one corner of america to every other, that people will step up and they'll say, as i've said on this floor, the political change doesn't start in washington, d.c. and then trickle down. it's bottoms up. it's bottoms up as people come forward and say that's not the way to go and say here's a way that really would make sense and make our lives better. mr. president, i yield the floor. i would note the absence of a quorum. the presiding officer: the clerk will call the roll.
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quorum call:
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quorum call:
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mr. lankford: mr. president. the presiding officer: the senator from oklahoma. mr. lankford: i ask unanimous consent the quorum call be vitiated. the presiding officer: is there objection? without objection. mr. lankford: 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. lankford: i ask unanimous consent the senate proceed to the immediate consideration of calendar number 37, s. 188. the presiding officer: the clerk will report. the clerk: calendar number 37, s. 188, a bill to prohibit the
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use of federal funds for the costs of painting portraits of officers and employees of the federal government. the presiding officer: is there objection to proceeding to the measure? without objection. mr. lankford: i ask unanimous consent the bill be considered read a third time and passed and that the motion to reconsider be considered made and laid upon the table. the presiding officer: without objection. mr. lankford: i ask unanimous consent the senate now proceed to the en bloc consideration of the following senate resolutions which were submitted earlier today. s. res. 260, s. res. 261, s. res. 262. the presiding officer: is there objection to proceeding to the resolutions en bloc? without objection. mr. lankford: i ask unanimous consent that the resolutions be agreed to, the preambles be agreed to, that the motions to reconsider be considered made and laid upon the table, all en bloc. the presiding officer: without objection. mr. lankford: mr. president, i ask unanimous consent that when the senate completes its business today, it adjourn until 10:00 a.m. tuesday,
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september 19. 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 consideration of the francisco nomination, with the time until the cloture vote equally divided between the two leaders or their designees. further, if cloture is invoked, all postcloture time expire at 12:15 p.m., and the senate vote on confirmation of the francisco nomination with no intervening action or debate. finally, following disposition of the francisco nomination, the senate recess until 2:15 p.m. to allow for the weekly conference meetings. the presiding officer: is there objection? without objection. mr. lankford: if there is no further business to come before the senate, i ask that it stand add jushed adjourned -- adjourned under the previous order, following the remarks of our democratic colleagues. the presiding officer: without objection.
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ms. warren: mr. president. the presiding officer: the senator from massachusetts. ms. warren: mr. president, i request unanimous consent to speak. the presiding officer: the senate is recognized. ms. warren: it has been just over three weeks since the senate voted down three different versions to bring down the affordable care act. each of these bills would have stricken coverage for tens of millions of americans and raised costs for millions more. during the seven weeks that followed those votes, no one has clamored for another try. phones have not rung off the hook for republicans to go one more round in their effort to rip up the medicaid program. letters and e-mail aren't pouring in asking for legislation to help jack up the costs for people with preexisting conditions. tweets and facebook posts don't demand that insurers get the chance to drop coverage for mental health issues and addiction treatment. instead, the families i have spoken with have told me, often through tears, that they are so
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relieved that republicans stepped back from the brink and came to their senses. they are breathing just a little bit easier knowing that medicaid will be there for their elderly parent in a nursing home or a neighbor down the street who uses a wheelchair. that tight, anxious, terrifying feeling in their chest has eased up because they don't have to worry about losing the health insurance that helps pay for their asthma medication or their children's heart surgery. but here we are again, back on the floor of the united states senate, engaged in a terribleaged familiar ritual -- begging the republicans not to gut our health insurance system for the sake of political games. if the american people want these cruel repeal bills to be thrown in the garbage where they belong, then what are we doing here? well, senate republicans are pretty desperate. this month, they learned from the senate parliamentarian --
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that's the independent umpire here in the senate who gets the final say on how the procedural rules work -- that the legislative instructions they passed back in january to kick off their whole effort to repeal the affordable care act, will expire on september 30, and once that happens, republicans would have to start over with a new set of instructions if they want to be able to use the special senate rules that allow them to jam this bill through without a single democratic vote. so the republicans have dug through the trash and pulled out an old draft of a bill that they think could get the job done. it's called a cassidy-graham proposal, named after the republican senators who put it together. you might think, after months and months and months of failed attempts, the republicans would have something new to offer. you might think that after their last three terrible repeal bills went up in flames, the republicans would propose something more reasonable this time around.
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you might think that, but no. this is just the same terrible set of policies with a fresh coat of paint and a new name. the cassidy-graham proposal completely eliminates the parts of the a.c.a. that help families afford health insurance. you think nurns is -- insurance is expensive right now? just wait for cassidy-graham. need help paying for your chemotherapy or surgery? good luck. cassidy-graham says you're on your own. and what about all the people who count on medicaid to help out, people with health insurance but who have a baby that was born eight weeks too early and who now needs breathing equipment and special therapists? people who worked hard all their lives but who couldn't save enough to make it through decades in a nursing home, people who use a wheelchair or need a home health aide to come by so they can live independently. what happens to them? well, with massive cuts to medicaid, the latest republican proposal turns america's back on
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babies, on seniors, on people with disabilities, on our families and our friends and our neighbors who need our help. i could go on and on about this, but let's get one thing straight about this latest republican plan. it is not more reasonable. it is not more moderate. it is not bipartisan, and it is definitely not something that families in this country want. it's just another version of the same old cruel, heartless, shameless plan that republicans have spent the last eight months trying to jam down the throats of the american people. don't take my word for it. doctors groups, including the american academy of pediatrics, the american academy of family physicians and a bunch of other medical specialties hold the -- pulled the fire alarm last week when cassidy and graham released their proposal. they sent congress a letter saying it could cost millions of
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americans their health care coverage. they begged republicans not to start down this road again. instead, the doctors asked congress to do something that makes a whole lot more sense. focus on ways to improve health insurance markets in this country, starting with the discussions that have taken place in the help committee over the last two weeks. that's because there's another important end of september deadline coming up, the date when insurance companies have to set their prices for next year's insurance premiums. now, over the last couple of weeks, the two senators who run the help committee, senator alexander on the republican side, and senator murray on the democratic side, have held a series of hearings on policies that we could pass before the end of september to help lower premiums and make sure that when you buy health insurance, you
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get coverage that actually means something. i sit on this committee, and like most of my colleagues on both sides of the aisle, i have been to each of the four hearings that we have held on this issue. senators alexander and murray have also opened up the discussion to every single senator so that even those not assigned to the committee can come and meet the witnesses and talk about how to make health care better. we have traded ideas, we have talked to governors, we have talked to state insurance commissioners, we have talked to doctors and to patients. and look, not everyone sees things exactly the same way. we have argued back and forth and put a lot of different ideas on the table, but we have spent hours talking about how to improve health care in this country. we have 12 days left before the end of september. it's not always this simple, but this time there really is a clear tradeoff. we can either use those 12 days
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to let republicans burn down health care in this country, or we can use those 12 days to pass a bill that would stabilize health care coverage for millions of americans. the republicans are hoping to slip below the radar screen, to sneak the repeal of health care coverage across the finish line just when we let down our guard. well, i have news for the republicans who want to go down this road. i see you. the american people see you, and we will fight you every step of the way, for as long as it takes, for as many rounds as you want to go, to stop your ugly bill in its tracks. we will not give up on the families who are counting on us to defend their health care. we will not back down. we will not blink. here's the thing that republicans just don't seem to realize. we aren't tired. we don't get tired when we're
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fighting for kids on ventilators. we don't lose heart when we're lining up on the side of moms with breast cancer or grandparents with alzheimer's. we never, ever run out of steam when we're fighting for people's lives. we're here today and tomorrow and every day, and we will fight back as hard as we need to for as long as it takes to defeat every single attempt to take away health care from millions of families in this country. thank you, mr. president. i yield the floor. a senator: mr. president. the presiding officer: the senator from wisconsin. ms. baldwin: mr. president, i rise to join my colleagues in expressing actually a combination of outrage and heart break that washington is
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still working on yet another partisan plan to take health coverage away and guaranteed protections away from families across this country. this is despite a clear message from americans and from wisconsinites sent to congress that they want us to work across the party aisle to make things better and not worse. this latest repeal plan totally ignores that message. this plan would make things far worse, not better. it would make things worse by allowing insurers to charge older americans an age tax. that's a worry that greg from stoddard, wisconsin, has shared
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with me. greg told me that he and his family can't afford for things to get worse. he has no idea how he and other older wisconsinites will be able to afford higher costs for health care. and greg's sons, both of them have diabetes, and they're already struggling with the skyrocketing costs of insulin. it would make things worse by dramatically weakening guaranteed protections for those with preexisting conditions, allowing insurers to cut coverage for essential health benefits, and charge more for needed care. now, as someone who was branded with those words "preexisting condition" as a child, i understand how this repeal would
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hurt wisconsin families and families throughout america. it would make things worse by eliminating the premium tax credits and cost-sharing reduction payments that help thousands, thousands of wisconsinites afford health coverage. and estimates show that this particular plan offered in the senate could significantly cut funding for my home state of wisconsin by almost $3 billion in the year 2027. on top of this latest repeal plan, it has to be added that the trump administration continues to play dangerous political games, to engage in sabotage against the affordable care act, and wisconsin's health
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care system. and it does so at the expense of families seeking affordable insurance. you know, instead of working to lower health care costs, the trump administration continues to threaten to withhold the critical cost-sharing reduction payments that help reduce deductibles and out-of-pocket costs for wisconsin families. instead of giving health care providers certainty and working to stabilize the health care marketplace, the trump administration is laying the groundwork for higher premiums next year. in addition, just last week the administration slashed funding to states for their outreach in education efforts to help more people sign up for health care.
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wisconsin's trusted navigator programs had their funding cut without explanation by almost 50% despite a long record of actually exceeding their enrollment goals. this would mean fewer people in rural wisconsin would receive the support and assistance they need to obtain affordable health care coverage. instead of making things worse, we should be making things better by getting the job done on bipartisan solutions that lower costs, that expand coverage, and make health care more affordable. the senate committee on health, education, labor and pensions, the help committee, is trying to do just that, mr. president. chairman alexander and ranking member murray have shown great
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leadership in bringing us together to work across party lines and solutions that work for the american people. our committee has heard from leaders from across the country. these are leaders and experts who play different roles in the health care system, and they're telling us how we can work together to make things better. we've had a set of four hearings over the last two weeks, and throughout these hearings, we've received a consistent message. that message is that now is the time to work together to stabilize the health insurance market and to make health care more affordable. i believe we need to be doing more to increase the enrollment of younger and healthier adults in the marketplace. we should be exploring bipartisan solutions to increase
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outreach and coverage for those over 6.1 million young adults who are still uninsured. slashing the funding for outreach in education and assistance to them will further destabilize the market and would lead to higher costs for everyone. it is past time to stop this partisan nonsense. i urge my colleagues on the other side of the aisle to do just that. by ending these partisan attempts to take people's health care away and make them pay more for less care. the people of wisconsin, frankly the people across this country, have sent a clear message. they've sent a clear message that they don't want us to take people's health care away and
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they've sent a clear message that they want us to work together, to work across the party line, to make things better, not worse. and i believe that if parties can look past this partisan debate, if we can do the people's business, then we can feigned common ground -- we can find common ground. let's do that by getting the job done on bipartisan solutions that stabilize and strengthen the health care marketplace. let's do that by getting the job done on solutions that would lower health costs for all american families. thank you and i yield back.
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ms. baldwin: mr. president? the presiding officer: the senator from wisconsin. ms. baldwin: i would note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
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mr. merkley: mr. president? the presiding officer: the senator from oregon. mr. merkley: mr. president, i ask that the quorum call be lifted. the presiding officer: without objection. mr. merkley: thank you, mr. president. yogi berra once said it's like deja vu all over again. here we are feeling the echoes
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of the recent debates over health care, yet another republican plan to dismantle health care, the peace of mind of millions of americans coming to the floor. what we've seen in the previous plans, we've seen the house bill that was going to wipe out health care for 24 million people. we saw the bill that the -- that came over from the senate in june, wipe out health care for 22 million people. then we saw the republicans improved version for that wiping out health care for 32 million people. now july of this year yet another plan, back to 22 million. millions and millions of people losing their health care. and now we have one more last-ditch effort to destroy health care for ordinary americans, for rural americans, for working americans.
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it's just wrong, and i'm going to explain some of the reasons that all of us should be outraged by this bill, this bill, this new bill. this new bill which says need yachtly -- immediately the individual mandate and accompanying mandate -- company mandate are wiped out. what does that do? it means instantly in 2018 and 2019 it's a destructive, race to the bottom insurance pools. if there's no pool, no mandate, then only those who are sicker sign up. those who are sicker are more expensive. so then more people drop out of the health care pool and the pool becomes even more expensive. it just shoots right out of sight. so we're not talking just about damage that would be done in 2020. we're talking about damage that would be done next year and the year after. what happens when the insurance companies say there's only two
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years left on this and the health care pool has a big hole in it, healthy people are gushing out and only the sickest people remain? they're going to drop out of providing coverage. so suddenly we have hundreds of counties across the nation with no health care provision for those that are currently in the health care marketplace. we've been through this conversation. we've been through the ted cruz fake insurance bill. and it was voted down by this body with a substantial bipartisan majority. this is a repeat of that saying let's destroy those insurance pools. what else does this bill destroy? well, in 2020 it destroys the tax credits. let's say you were fortunate enough to have the pool survive 2018 and 2019 and you have tax credits to enable you to buy
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insurance and there's still a provider during those two years. but then comes 2020 and there's no tax credits with which to buy insurance of the so now you are -- insurance. so now you are thrown out of health care. no remedy provided in this bill. and is it possible that you're going to get covered by the medicaid program in your state? well, not likely because medicaid in most straits provides -- most states provides insurance for poorer americans, not for the folks who are getting the tax credits and the exchange. no, they are out of luck. and what else do we have? the elimination of essential benefits. essential benefits no longer required. we have some history with this here in our country. we've had those fake insurance policies that you buy that cost virtually nothing and then you
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get sick and discover that your trip to the emergency room isn't covered. you discover your hospitalization is not covered. then your child gets injured. they break a bone. you discover the x-rays are not covered. and the lab tests are not covered. these are the fake insurance policies that don't belong anywhere because they are simply a fraud. this is the scam. why are we returning to a vote on fake insurance? we also have this vision of this fake insurance where you have a policy that costs us virtually nothing and then covers nothing. so it's sold to the -- to those who are vulnerable to the sales
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pitch of the scam man. and what else does this do? well, right now we have this very complicated health care system. this is a big improvement over what we had eight years ago, but it is still complicated. we have medicaid and we have medicare. we have on-exchange, we have off-exchange. we have special insurance for the workplace called workers' compensation. we have special insurance for children called children's health insurance program. we have workplace policies that are very good benefits covered by the company, and we have workplace policies that are very poor policies. we have workplace policies that are paid for by the company and those that the individual has to buy into the workplace policy. and we have policies that cover just the worker and ones that
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cover the family. what do you do as you navigate this incredibly complex array? this is continuous, stressful journey for americans. maybe you have a job that doesn't pay very much and you're able to be on the oregon health plan for similar medicaid programs across the country and then you earn a little bit more, or your spouse earns a little bit more. suddenly you don't qualify. how do you get on to the exchange in the middle of the year? how do you work out that tax credits for the end of the year? or maybe your next job provides some insurance for you but not your children. how do you get your children signed up? very, very stressful situation, this complicated, overlapping health care that requires continuous attention just for people to make sure that if their loved one is sick, if their child is injured, that they will get the care they need when that happens, that the
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family won't end up bankrupt. this is a pursuit of peace of mind. what does this bill do? it makes our already complicated system even more indicated -- even more complicated. it says in this bill, we want to have 50 different systems for 50 different states. so much for focusing on a simpler system, where we can work to drive out any fraud or inefficiencies or abuse. no, now we have 50 systems pursuing different forms of fraud and waste and abuse. now, we should be going in the other direction towards simplicity, towards a world in which just by virtue of being an american you know you're covered. you don't have to worry about that transition from job to job, or that change as you go from one income to another income, or the dynamics that occur should you get married or get divorced.
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no, just by virtue of being an american, you're covered. that's the way the whole developed world does it. they make it easy -- except here; we make it complicated. and this bill is determined to make it much more complicated. much more fractured, much more stressful. so let's not do that. let's apply a little common sense and recognize none of us would run a business determined to make the workplace more stressful, more fractured, less efficient, more filled with fraud. but that is what this bill does. so let's say no. let's have a huge, bipartisan response to say, absolutely not. now, it's grassroots america that defeated those previous diabolical plans to wipe out
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health care for millions of americans. they filled the streets. grassroot america overflowed our in-boxes, they flooded our phones and once again we need the common sense of working america, of grassroots america to weigh in and say how wrong this proposed bill is. during the debate previously i kept noting that this was like a monster that you can only put away by driving a stake through its heart. and each time we attempted to have that debate on the floor and defeated the bill, i thought, well, perhaps we've finally put this monster six feet under. but now it's back in all its ruthless tooth-and-fanning fury
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ready to destroy peace of mind and health care for our citizens. so let's take a vote in this senate that will do what we had hoped we'd done before and truly drive a stake through the heart of this trumpcare proposition. let's stand up in partnership with our citizens. oh, i know this room is full of really wealthy americans who have never worried about health care. when i was first campaigning for the u.s. senate, i met with one of those really wealthy americans in new york city who said to me, i don't know why you're saying you're fighting for better health care. everybody in america has good health care. that's because that individual lived in a bubble where he was surrounded by everyone he knew having good health care because they worked for really wealthy firms in new york city.
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they are so dramatically disconnected from the reality of working americans. i'll tell you what's going on in my neighborhood, my blue-collar neighborhood, the same neighborhood my children went to. it is getting tougher. it is getting tougher to find a full-time job. it is getting tougher to find a living-wage job. it is getting tougher to be able to save and help your child pursue their dreams. it is tougher to be able to help your family perhaps go on a vacation, even a simple vacation. and it's certainly tougher to buy a home. in fact, many people in my neighborhood feel the only way they're going to be able to buy a home is to inherit it from their parents. but i'll it will you, there's one thing -- but i'll tell you,
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there's one thing that got easier in the last eight years against that. one thing. and that was that we provided expansion of medicaid to cover a lot more people, and we created a marketplace for insurance where working people could use tax credits to be able to buy care, to easily compare policies. we made it a big step forward in one single area, one area, and now my colleagues from their gated communities and their seven-digit wealth want to come and destroy the one thing that we did for working americans. if president trump cared one wit about a working american, he'd be ringing up the majority leader of this chamber right now and saying, what are you doing? i campaigned saying i was going to stand with workers. this bill attacks them.
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what are you doing? he'd be calling up and saying, i called that house bill mean. that house bill, which eliminated health care for 23 million americans, the final bill you i called it mean and heartless. this is meaner. this is even more heartless. but we shouldn't need the insights of president trump to be able to understand the damage that this does to ordinary americans. you can see it plain as day right there on the page -- on the pages of this bill. so, colleagues, read the bill. talk to your health care experts and drive a stake through this health care monster. thank you, mr. president. i note the absence of a quorum.
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the presiding officer: the clerk will call the roll. quorum call:
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quorum call:
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quorum call:
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quorum call:
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mr. booker: mr. president. the presiding officer: the senator from new jersey. mr. booker: thank you very much. i'm grateful for the senator from georgia for a few moments to speak on the floor this evening. the presiding officer: we have a quorum call. mr. booker: oh, forgive me. i'd like to note the absence of
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a quorum. the presiding officer: without objection. mr. booker: thank you very much. thank you very much. i've watched this as this body has reebtly really begun to work in a bipartisan fashion trying to stabilize the insurance market under the leader of senator alexander, the chairman of the health committee. there's been efforts going on. there's been a number of hearings held on what needs to be done to stabilize the affordable care act and strengthen the affordable care act. this is coming about because of a crisis. in january of this year, leading from december, we even had people like standard & poor's talking about how stable these exchanges were. we've seen over the last months many actions that have taken place threatening cost sharing,
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not advertising the markets, many actions taken by the trump administration has weak end the markets and put the markets in crisis. it's actually not the markets that are in crisis. it's fellow americans, people who want the same thing, whether they're republican or democrat, from the west or east or north or south or in the heart of our country, they want the same thing. they want affordable care that's quality. we've come a long way to where we are right now. under the affordable care act, we have increased the number of americans who have health insurance by over 20 million. we've been actually able to bend the cost curve. actually the affordable care act has taken us out of days that no american, very few want us to go back to, the days where people could deny you coverage based on a preexisting condition. the affordable care act created an essential set of benefits
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that, again, americans from both sides of the aisle think is really important. these essential benefits include things like health care for women having children. it's included things like putting a parity between mental health care and what might be called physical health care. there's been so many improvements in the affordable care act that i've heard about them from constituents all over my state as well as hearing the voices from all around the united states of america. difficult stories about people who have lifetime caps who because their child had an illness as a child, by the time that child was an adult, they couldn't find insurance. or people who are being denied insurance because of a preexisting condition, people who were declaring bankruptcy in this country at rates significantly higher than we're seeing now because they could not afford their health insurance. in fact, personal bankruptcy in
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our nation has been cut around 50%. these were all the gains we've achieved through the affordable care act. the expansion of health care to millions of more, the security of knowing that your health insurance won't be cut off because of a preexisting condition, knowing that when you're paying for health coverage it's going to carry essential benefits that every american should get. these gains and many more. and what's happened after the failure of trumpcare, after the failure of republican plans, what actually came out of that were something that was encouraging to me as a senator that's been here for three-plus years, to see some of the states people from our senate -- lamar alexander, senator murray -- come together and say, hey, we have a crisis in our country. some of these markets are losing stability. we should work together, put
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aside partisan differences, try to find a pathway forward to make sure that in some states millions of folks don't lose health insurance. and you heard, at least i did, some of the best commentary in this body. perhaps most notably a speech by john mccain who stood up and so strongly talked about regular order, talked about us doing things in the senate in a way that brought us together, that invited in the public, that had a wide berth of people participating in the crafting of policy, policy that affects nearly 20% of our economy, policy that affects hundreds of millions of americans, policy that is critical to the success of our nation. and i'm grateful that murray and alexander have been holding bipartisan hearings to try to stabilize the market periods.
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through this process over the past month, we've had bipartisan governors, governors from both parties, insurance commissioners, consumers, all had the opportunity to come in and begin to weigh in on different proposals and their impact on the health insurance marketplace. you see, this shows that we can work together to try to improve the affordable care act. not this idea that we throw it out, hurting not just a few people but literally tens of millions of americans. this is the way it should be done. the past proposals that have failed in this body were done the wrong way. people crafting legislation behind closed doors in a noninclusive manner, in a partisan manner, not holding hearings, not bringing experts in. that's not the way this body was meant to work. in fact, for those who
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criticize the affordable care act, for the affordable care act there were dozens and dozens and dozens of bipartisan hearings, over 100 amendments from the republican party were included in the ultimate legislation. it was a process that took months and months and months. the president of the united states even met with the republican senators and congress people to discuss and debate the legislation, and it was aired on c-span. this showed the best of who we are, that when we come together as a body and go through a process, good legislation -- not perfect legislation, but good legislation could advance us towards our principles. and those principles were principles that were discussed during the last presidential campaign by both candidates. donald trump himself, our president, said time and time again, i want us to have an insurance health system in which everyone is covered, in which
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everyone has affordable and quality health care. these values are not debatable, and i'm disappointed. i am frustrated, i am angry that we are here again while the bipartisan process is going on, and we're having as a great new jerseyian once said -- yogi berra -- we're having deja vu all over again. here we are now coming back this week, and we're hearing about another republican bill that has not gone through regular order, that has not had hearings, that has not had a bipartisan process, another bill is coming to the floor that people are whipping up votes, that we might have yet another dramatic moment in this body in which millions of americans are watching and holding their breath because their families,
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their children, their senior citizen parents are all being held in the balance about the decision that this body would make not going through regular order, not bringing in input from experts on legislation that hasn't even been scored by the congressional budget office. the c.b.o. hasn't scored this bill. we don't know what its total impact would be on the health coverage, on costs. we don't know how many people could lose their coverage exactly, how much premiums could scrooct -- skyrocket for the middle class and just how much and how medicaid would ultimately be gutted. this is the bill that's coming before us. this is the threat right now to our nation and to millions of people. we do know enough about this bill and that previous versions
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of the repeal plan that looked very similar to this bill give us many hints, more than hints, give us much evidence about what this bill would do and how this bill would again cause millions to lose their coverage, to have premiums again skyrocket. and for those that rely on medicaid, for everything from opioid addiction treatment to maternity care, the millions that rely on medicaid, they would suffer. let me go through some things that we know about this legislation that is being threatened to be brought to the senate floor, that now casts a shadow over the coverage earned and gained by millions of americans. this legislation would still take coverage away from millions of americans. we know that this destructive version, this partisan repeal
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plan will take coverage away from millions of people. experts are projecting that already that after ten years, this partisan repeal plan could cause over 30 million americans to lose their coverage. 30 million americans cast back into a world where one illness, where one injury could devastate their families, could send them into bankruptcy. that one illness, that one injury could have the worst of results, could cast us back to a time when so many americans were using emergency rooms and emergency room doctors as their primary care physicians, cast us back into a time when many americans were delaying seeing doctors because they couldn't afford to allowing preventable diseases or treatable diseas


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