WASHINGTON – U.S. Senator Chris Murphy (D-Conn.), a member of the U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee, spoke on the floor of the U.S. Senate on Monday to continue sounding the alarm over Senate Republicans’ efforts to repeal the Affordable Care Act and take health care away from millions. Murphy emphasized the devastating impact of the Graham-Cassidy bill, which would cut federal health care spending to Connecticut by $7 billion from 2020-2026, eliminate protections for those with preexisting conditions, repeal the individual mandate, and make deep cuts to Medicaid. Murphy criticized Senate Republicans for abandoning the bipartisan process the HELP Committee committed to just several weeks ago, and for attempting to push a bill without sufficient debate, hearings, or analysis from the nonpartisan Congressional Budget Office (CBO). Click here to view video of Murphy’s remarks.

“Graham-Cassidy is being rushed through in the dead of night, with no time for Americans to review it. Proponents of this bill are trying to contend that it still protects people with preexisting conditions. It does not. Rates will skyrocket for sick people or anybody who has ever been sick. 32 million people are going to lose insurance,” said Murphy. “That is a humanitarian catastrophe, and nobody knows it because this bill is being pushed through without any debate, without any CBO score.”

Murphy continued, “We are ready to sit down, once again, and try to work something out that gets Democrats and Republicans together on this and that does what the American people want us to do – keep what works in the Affordable Care Act and improve what does not work.” 

Full text of Murphy’s remarks is below:

Mr. President, let me associate myself with the remarks of the senator from Massachusetts. There is a lot of work we need to do this week; she is right. There are health care crises right around the corner for millions of kids and families that we could be working on solving right now. As the senator knows, both Connecticut and Massachusetts are still being wrecked by an opioid crisis – one that in my state is getting worse by the year, not better. We could be working together on that. 

We have brothers and sisters all throughout the United States who are right now in crisis because of devastating storms that have hit. We could be working together on trying to provide a meaningful response, and we aren't. Yet, again, we are back now talking about Trumpcare redux. This is version 10, version 11. I think there have been three versions already this week. This one is really the most dangerous version yet.

CBO just released a scaled-down analysis, noting that there was no way they would be able to provide a full analysis given the compressed schedule, given the need to pass this by the end of this week because of Republicans' desire to make sure that not a single Democrat is included in the negotiation. They gave us some hints as to what their score would say once it was fully completed.

Federal spending on Medicaid would be reduced by $1 trillion over the course of this decade. There is simply no way to rip $1 trillion out of the Medicaid system – the Medicaid system, by the way, as all my colleagues know, that provides insurance to the disabled, to children, and to the elderly – without millions of people losing access to health care, people who have nowhere else to go. 

CBO unsurprisingly says that the number of people with comprehensive health insurance would be reduced by millions, and they predict that states would allow insurers to set premiums on the basis of an individuals' health status. None of that is news to people who have read this piece of legislation.

I want to talk for a second about why CBO comes to those conclusions and why this is the most dangerous version of the bill yet.

In this bill is a massive reordering of the American health care system. The health care exchanges, which right now insure millions of Americans across the country, are essentially eliminated under this bill because the whole reason they existed was to funnel tax credits that are attached to individuals based on their income to help them buy insurance. Those tax credits go away under this proposal; thus, the exchanges go away.

Medicaid as an entitlement is ended by this bill. No longer will you as an individual have a payment from the federal government attached to you because of your income or your health status or your disability. States will now get a block sum of money to do essentially what they wish, which may or may not cover the same number of people today covered under Medicaid.

While proponents of this bill are trying to contend that it still protects people with preexisting conditions, no one is buying it, no one is believing it, because on the face of the text, it does not. It is important to explain why that is. 

While technically it is up to the states as to whether they protect people with preexisting conditions, under this new version, states can just sign a form that allows them to permit insurers to price based on medical acuity again – meaning charge sick people more. They will have to exercise that option under this version of Trumpcare. They will be forced to exercise that option because what is also eliminated by this version of Trumpcare is the requirement that healthy individuals buy insurance. You cannot require insurance companies to charge sick people the same as healthy people if you don't provide incentives for healthy people to sign up. There is no incentive, at least under the latest version of the bill that I read. Thus, anybody who has taken a semester's worth of education on insurance practice will tell you that states will be faced with two choices: one, reimpose their own individual mandate – and I am going to guarantee you that based on the vitriol that has been launched against the individual mandate from Republicans in this chamber and the House of Representatives over the past 6 years, most states will probably not take on their Republican senators and congressional delegation by passing their individual mandate. Or, they will be forced to drop the protection for people with preexisting conditions. 

CBO and JCT [Joint Committee on Taxation] anticipate that many states – I would argue the majority of states – will have to drop that protection for people with preexisting conditions because they will not pass an individual mandate. Thus, rates will skyrocket for sick people or anybody who has ever been sick, making insurance inaccessible for Americans who have had a cancer diagnosis or an addiction diagnosis or a mental illness diagnosis.

This bill is a massive reorientation of the American health care system, the elimination of Medicaid as we know it, the end of the health care insurance exchanges, the end of the tax credits to help people buy health care insurance, and the end of the mandatory national protections for people against abusive insurance practices. We are potentially going to vote on this later this week without a CBO score, with one hearing, with no markups.

I don't care how mad my Republican friends were about how the Affordable Care Act was passed. That was done in an open process, with dozens of hearings, with markups in every committee, with 30 days of debate on the floor of the U.S. Senate, with hundreds of Republican amendments that were offered and adopted as part of the affordable health care act, with over a year of public input and debate about the pros and cons of the proposal.

None of that is happening on Graham-Cassidy. This is being rushed through in the dead of night, with no time for Americans to review it, no time for members of this body to look at it, and no ability for any senator in the Democratic party to be able to have any input into the final product. This is nothing like what happened on the Affordable Care Act. No matter how mad you are that in the end you couldn't vote for it, Republicans had plenty of opportunity to have a say. The American people had plenty of opportunity to take a look at it. That is not happening with Graham-Cassidy. 

Because there is no CBO score, we have to rely on outside independent groups to size up the potential disaster of this bill. The Center for American Progress – which admittedly is a left-leaning organization but is one of the few that have taken the time to take a look at the text and what it will mean – came to the conclusion that 32 million people would lose coverage. The Commonwealth Fund, which is not a political organization, which is an independent, nonpartisan health care think tank, essentially came to the same conclusion, saying that after 2026, 32 million people would lose coverage. The Commonwealth Fund says that 15 to 18 million people could become uninsured by 2019.

I have had this chart up here for 3 or 4 months, and I have had to adjust it over and over again because it started out with 23 million people losing insurance as we analyzed the first Republican repeal bill. Then, when the new version came in, you can see I had to write in 22 million people because the amended version that we were going to vote on right before the break was 1 million better. I had to redo my chart based upon this analysis of Graham-Cassidy, resulting in 32 million people losing insurance. Thirty-two million people. It is hard to understand how many people – 32 million people – will be losing insurance over the course of 10 years. That is the total population of Alaska, Delaware, Hawaii, Idaho, Kansas, Maine, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, South Dakota, West Virginia. We had to cross out Rhode Island, but then we had to add Mississippi, Arkansas, Vermont, Wyoming, and Utah. 

Forgive me, I had to do my own artist's rendering of these states because the data is coming in so fast and the vote is coming so quickly, I didn't have time to have this chart made up again. 

That is 32 million people. Think about that. Over 10 years, the equivalent population of all of these states – what is that, 17 States, 19 States – all losing health care at the same time. That is a humanitarian catastrophe, and nobody knows it because this bill is being pushed through without any debate, without any CBO score. That is what could happen if this passes.

It is no surprise that basically everybody in the American health care system opposes this piece of legislation. The proponents cannot find a single verifier inside the medical community for this piece of legislation. 

This morning, I heard Senator Graham say, “Well, that is to be expected. You know, we are making a big reform, and anytime you are making a big reform, the status quo players aren't going to like the result.”

Well, that is a little unfair because the status quo for groups like the American Heart Association or the Juvenile Diabetes Research Foundation or the American Cancer Society, the status quo for them is that their members – people who have cancer or juvenile diabetes or heart disease - don't go bankrupt any longer because they can't afford insurance. So, yes, they are kind of upset that 32 million people are going to lose insurance – many of their members – and that we are going to go back to the day in which if you are sick, if you have cancer, in most states, you can be charged more. So, yes, people are protective of the status quo, the part of the status quo that makes sure that sick people or people who have ever been sick don't lose insurance.

I think it is actually worthwhile for just a second – bear with me – to just give a quick sense as to how many people in the medical community oppose this bill. Here is just a beginning list: AARP, the School Superintendents Association, America's Health Care Plans, the ALS Association, America's Essential Hospitals, America's Pediatric Dentists, the American Academy of Pediatrics, the American Academy of Family Physicians, the American Association on Health and Disability, the American Cancer Society, the American Dental Association, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Diabetes Association, the American Federation of Teachers, the American Heart Association, the American Hospital Association, the American Lung Association, the American Osteopathic Association, the American Medical Association, the American Public Health Association, the American Psychiatric Association, the American Psychological Association, the Arthritis Foundation, the Big Cities Health Coalition, Blue Cross Blue Shield, the Children's Hospital Association, the Center for Medicare Advocacy, the Cystic Fibrosis Foundation, the Endocrine Society, Family Voices, the Federation of American Hospitals, the HIV Medicine Association, the Human Rights Campaign, the Juvenile Diabetes Research Foundation, the Leukemia and Lymphoma Society, the Lutheran Services in America, Main Street Alliance, March of Dimes, the Medicare Rights Center, the National Association of County and City Health Officials, the National Association of School Nurses, the National Alliance of State & Territorial AIDS Directors, the National Coalition for Cancer Survivorship, the National Health Council, the National Multiple Sclerosis Society, the National Organization for Rare Diseases, the National Partnership for Women and Families, Planned Parenthood, the Arc of Connecticut, the Arc of the United States, the Trust for America's Health, and 47 religious organizations representing various denominations, including Muslim Health Professionals, Alliance of Baptists, Methodist Federation for Social Action, the National Council of Jewish Women, the Presbyterian Church of the United States, the United Church of Christ, and the United Methodist Church. 

That’s sort of the tip of the iceberg. You are not really in good company if you are supportive of this bill when every single medical association, every single patient advocacy organization, every single hospital association, every single insurer thinks that you are wrong. You would like to think there might be a couple of these groups who would think it was a good thing to pass a bill that uninsures potentially 32 million – maybe 25 million, maybe 22 million – and jeopardizes preexisting protections for millions of Americans.

What is so bonkers about this is that we were this close to getting a bipartisan agreement. It is not as if there wasn't another path. I sit on the HELP Committee. I had half a dozen conversations with Senator Alexander and Senator Murray. I know we were 80 percent of the way there on passing a bipartisan package of reforms – at least out of the HELP Committee – that would have kept what was working in the Affordable Care Act and tried to fix what wasn't working. 

I saw Leader McConnell's tweet from earlier today in which he said that Senate Democrats have two thoughts on how to fix Obamacare – one, do nothing; two, a fully government-run system that would take away even more of their decisions.

That is not true. That is not true, and everybody here knows that it is not true. Why? Because Senate Democrats were sitting down and talking with Senate Republicans. We were at the table just a week ago, trying to come up with a package of reforms. So to say that the Democrats want only a single-payer health care system or what we have today is not true, and everybody knows that is not true.

I am certainly raw at the fact that Republicans walked away from that negotiating table when we were so close. I do not think that was in the best traditions of the U.S. Senate, but I am ready to sit back down at the table. I know that Patty Murray is ready to sit back down at the table if this process blows up, as every previous attempt at repealing the Affordable Care Act with a thoughtless alternative has blown up.

My constituents are not happy with the American health care system. They like a lot of the things the Affordable Care Act did, but they acknowledge there are still lots of problems that need to be solved. Amongst those constituents in my state who like what the Affordable Care Act has done but who still want to see changes are Isabelle and Rylan.

Isabelle first wrote about her son to my office 2 days after the last election. This is Rylan, who was born with a congenital heart defect. He looked healthy when he was born. He and Isabelle had been scheduled for discharge from the hospital when Rylan went in for some routine testing, but he never came back. His parents kind of knew something was up, but when the doctors arrived back in their room, they told Isabelle and her husband that Rylan needed to be rushed to the hospital for emergency surgery because his body was not getting enough oxygen, and there was something wrong with his heart. He was diagnosed with several severe heart defects, and he required emergency open-heart surgery.

The first thing Isabelle thought was: how are we going to pay for this? Does insurance cover it?

She found out, much to her relief, that insurance did cover it, because insurance was required to cover things like hospitalizations under the Affordable Care Act and that they would not lose coverage, because no matter how big the bills got, the Affordable Care Act prohibited insurance companies from cutting her off.

Isabelle has been a warrior in preserving those protections in the Affordable Care Act, and I just want to leave you with an email that she sent me this week. 

She writes that she is exhausted and that she is so tired of having to fight over and over and over again for Rylan. She feels that no matter what she tries to do, this repeal is going to happen, regardless of Rylan's story, and that they are just going to be casualties of this political imperative to repeal the Affordable Care Act. 

In 3 weeks, Rylan is going to be going up to Boston for his big cardiac and neuro checkup. She wishes that their biggest fight were to keep him healthy and alive, but it is not. They are engaged in a political fight to try to stop the protections, which keep him alive and keep this family solvent, from being stolen from them.

This is not a game to Isabelle and to Rylan. This is not about politics. This is about this little boy's life. I am going to tell you that my state cannot hold this together if you cut federal funding for health care by 50 percent to Connecticut, as this bill would do – maybe more. What we are hearing is that money is going to be stolen from states that have implemented the Affordable Care Act in order to be delivered to the states of senators who have not yet committed to the bill on the Republican side. We cannot hold it together for Rylan in Connecticut if you take away half of our federal health care funding, if you take away the tax credits that help people buy insurance, if you take away the Medicaid that helps insure these kids, if you let insurers go back to the days in which they discriminated against these kids. It is not a game to Isabelle.

She writes: “Every time the repeal comes up – what is it, the third time or more – I feel sick with anxiety. How quickly the rug will be pulled from under us. How quickly the bricks will begin to fall.”

We are ready to work with you. We are ready to sit down, once again, and try to work something out that gets Democrats and Republicans together on this and that does what the American people want us to do – keep what works in the Affordable Care Act and improve what does not work.

Please give this up. You are ruining the lives of these families who, in addition to having to save their children's lives, are having to become full-time political activists to stop this from happening. We can do this together. We can deliver peace of mind to these families. It is not too late.

I yield the floor.

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