WASHINGTON —Before Senate Republicans are expected to release another draft of their reckless health care plan, U.S. Senator Chris Murphy (D-Conn.), a member of the U.S. Senate Health, Education, Labor, and Pensions Committee, spoke on the floor of the U.S. Senate on Wednesday highlighting the dangers of the Congressional Republican health care plan for Connecticut. Murphy told the story of Milford, Connecticut resident, Alison, who was diagnosed with a rare liver disease and is concerned that she will be denied health coverage based on her preexisting condition if the Republican bill passes. Click here to view video of Murphy’s remarks.
“As Republicans finish up this latest round of secret negotiations, I want to make sure that we remember what Republicans stated as their goals for this replacement. The goals were that the system would be better, but by every single metric, this proposal will result in worse health care for people. Fewer people will have insurance. Rates will go up for everyone except for young, healthy people. Costs will continue to spiral out of control, and no additional measures will be taken to make quality better. Every single problem that Republicans address in the existing health care system gets worse,” Murphy said. “Today, Alison worries that if this bill is passed, she – as a young woman with a preexisting condition – will be destined to a life of discrimination because she may not be able to find a plan that covers her condition. Republicans should scrap this garbage piece of legislation.”
The full text of Murphy’s remarks is below:
Mr. President, I’ve had the good fortune of being in both the House and the Senate during the period of passage of the Affordable Care Act implementation and now the debate over repeal, and I have heard consistently from my Republican colleagues two things.
One, that they didn't think the Affordable Care Act was the right approach to fix the problems in America's health care system – 60-some-odd times the House and the Senate voted to repeal all or parts of the Affordable Care Act.
The second thing I heard consistently over that period of time dating from 2009 is that Republicans were prepared to offer a replacement to the Affordable Care Act that would be better, that would be an improvement over the Affordable Care Act, indeed, over the status of the American health care system when the Affordable Care Act was passed. The ground has shifted mightily since then.
The Congressional Budget Office tells us that under the Republican plan, either passed in the House or in the Senate, a humanitarian catastrophe will result in this country. Tens of millions of people would lose their health care. That's not what Republicans promised. That's not what Republicans said their replacement would do.
They said their replacement would be better than the Affordable Care Act. CBO says rates will go up immediately by 20 percent on almost everybody. After that, if you're young and healthy, rates will go down, but for everybody else, the amount of money you have to pay in premiums, cospays, and deductibles will go up. There's nothing in the Republican bill about costs – nothing that addresses the underlying issues with an American health care issue that procedure by procedure costs twice as much as most other countries – and there's nothing about quality. There's not a single provision in the bill which encourages higher quality.
So as we get ready for the Republican repeal bill, 3.0 or 4.0, that will be released secretly to Republicans tomorrow, I think it's worth reminding everybody what Republicans said would happen. So I will just use the words of our president. I understand that many of my Republican colleagues here don't ascribe to all of the beliefs and statements of our president, but he is the leader of the Republican party. All of my colleagues did support him and they stood with him in the House of Representatives arm in arm when they passed the Republican House repeal and replacement bill.
So President Trump said this – he said, “I was the first and only potential GOP candidate to state there will be no cuts to social security, Medicare, and Medicaid. Huckabee copied me.” So no cuts to Medicaid, that was the promise, and yet the bill that the President has endorsed – is trying to help Leader Mcconnell push through the United States Senate – involves debilitating cuts to Medicaid, resulting in millions of people being pushed off of that benefit. The cut to the state of Connecticut would be $3 billion. We are a tiny state. Our Medicaid program is somewhere in the order of $8 million. The promise was that we wouldn't cut Medicaid. This bill cuts Medicaid.
President Trump said, “if our health care plan is approved, you will see real health care and premiums will start tumbling down. Obamacare is in a death spiral.” There is always one long sentence and one short sentence. Here are the two claims here. Premiums already start tumbling down. That was a promise and a consistent promise – costs will go down if the Affordable Care Act is repealed and replaced with a Republican plan. CBO debunks this. They said that premiums will go up at rates of 20%. If you are older or if you have any history of preexisting conditions, your premiums will continue to go up.
The danger, of course, is thinking that the only thing you pay in the health care system is premiums. I can pretty easily construct a health care reform proposal in which your premium would go dramatically down. How would I do that? I would just shift all of the payments on to the deductibles, on to copays, and I would give you nothing with regard to the actuarial benefit of the plan. So it’s easy to get premiums to go down if you don’t care about what you’re actually covering and the size of your deductibles and the size of your copays.
And then, “Obamacare is in a death spiral.” CBO debunks that as well. CBO said if you leave Obamacare in place, two or three million people will lose health care insurance. If you pass the Republican health care bill, that's where the death spiral occurs. Twenty-three million people lose insurance if you pass the Republican bill, two to three million people lose insurance if you don't pass it.
Again, President Trump saying, “health care is on its way. We will have lower premiums and deductibles.” Here he makes a claim on deductibles. Once again, the Congressional Budget Office says premiums go up and deductibles, especially for individuals who are older or individuals with preexisting conditions, go up.
“At the same time taking care of preexisting conditions.” This bill does not take care of people with preexisting conditions. Why? Because it allows for any state to allow insurance companies to get out from the minimum benefits requirement. So if you have cancer, well, technically, the Senate Republican bill says you can't be charged more, but you may not be able to find a plan that covers cancer treatments. So that's not protecting people with preexisting conditions. And CBO says this specifically. They say, especially for people with preexisting mental illness and preexisting conditions, you can't just protect people with preexisting conditions by saying insurance plans have to cover them. You actually have to have insurance plans offer the medical benefit that they need.
And once again, “our healthcare plan will lower premiums and deductibles and be great health care. Insurance companies are fleeing Obamacare. It is dead.” I’ve already covered the part about premiums and deductibles. But let's remember that insurance companies weren't fleeing Obamacare until President Trump was sworn into office.
In the period of open enrollment covered a period prior to his inauguration and a period after his inauguration. Before President Trump's inauguration, open enrollment was on pace to enroll a record number of patients. Enrollment fell off a cliff after President Trump was sworn into office and signed an executive order telling all of his agencies to unwind the Affordable Care Act. People listened to President Trump who said he was going to kill the Affordable Care Act and they stopped signing up for those plans. It got worse when he refused to pay insurance companies. Right now, the president will not commit to paying cost-sharing subsidies to insurance companies more than 30 days ahead of time. He stopped enforcing the individual mandate and it's no surprise that insurance companies are saying they don't want to participate in these exchanges because the president is trying to kill them.
He’s made it clear from day one. And i've had the benefit of being on the floor a number of times with Senator Barrasso, who often came down to the floor following my remarks during implementation of the Affordable Care Act. I heard him talk about the fact that there will be freedom for Americans to have or not have insurance if this piece of legislation is passed. That's a wonderful idea – that people will be free to not be able to afford insurance.
The reality is, yes, some individuals buy insurance today because they are compelled to by the individual mandate, but there's a reason for that. If you don't compel people to buy insurance who are healthy, then you can't protect people who are sick. I sat where the presiding officer is during Senator Cruz’s 24-hour filibuster. And in the middle of that filibuster, he said exactly that. Senator Cruz, in the middle of his filibuster, says, we understand that you have to have the individual mandate in order to prevent companies from pricing those who were sick higher prices. The Republicans know that. This nonsense about no one being required to buy insurance is belied by the text we are considering.
There is a mandate and penalty in this bill. It is a far meaner and crueler penalty than included in the Affordable Care Act. What do I mean by that? The Affordable Care Act doesn't mandate that you buy insurance in the sense you don't buy it, you will be locked up in jail. It says if you don't buy insurance, you will pay a penalty on your income tax statement. Okay. If you don't buy insurance, there will be a penalty. That's exactly what the Senate Republican bill says. It says if you don't buy insurance, you will incur a penalty. In their bill the penalty is you will be locked out of buying insurance for six months. If you are sick or even, frankly, if you're healthy and you need to go see a doctor for something, you will have to pay for that out of your pocket for those six months. If you are sick and you have a serious condition and you are legally refused health care because of this legislation, the consequences could be dire.
But whatever the scope of the consequences, it is still a penalty, just like there was a penalty in the bill that the Democrats supported and passed in 2009 and 2010. So it's just not true to say that now Americans have the freedom not to have health care. You don't because you're going to be penalized if you let your health insurance lapse. If you don't make payments for a couple months, you are locked out of the insurance market. That's just a different kind of penalty than the one that is in our bill. And the truth of the matter is that, well, while I admit there are some people that buy insurance today because they fear that penalty, it is necessary, as Republicans realize, in order to make sure that the markets don't spiral out of control. Because if you say that you can't charge people with preexisting conditions more and you don't require healthy people to buy insurance, then why would any healthy person buy insurance? They'll just wait until they're sick because they know that once they are sick and need very expensive care, they can't be charged any more for it.
The nature of insurance is that people who have the good fortune to be healthy or to be free of accident or natural disaster subsidize individuals who are not so fortunate – who are sick, who do have an accident occur to their home, who are subject to a natural disaster. That's how insurance works. Republicans realize that because they put a penalty in their bill. But for as many people who buy insurance because they are forced to, most people buy insurance because they want it, because they recognize that it's better to have insurance in the case that they or their loved one gets sick. And that is who we are talking about here.
Of the 23 million who lose insurance according to the CBO under the Republican bill, millions and millions of those want insurance but they won't be able to get it because they are priced out by the Republican bill. So I can see there will be some people who will make that choice, but there will be millions more who had insurance today who will not be able to get it moving forward.
As Republicans finish up this latest round of secret negotiations, I just want to make sure that we're on the same page about what this bill does. It mandates that you buy insurance, just in a different way. It has a penalty just like the Affordable Care Act has a penalty. And I want to make sure that we remember what Republicans stated as their goals for this replacement. The goals were that the system would be better, but by every single metric, this proposal will result in worse health care for people. Fewer people will have insurance. Rates will go up for everyone except for young, healthy people. Costs will continue to spiral out of control, and no additional measures will be taken to make quality better. Every single problem that Republicans address in the existing health care system gets worse.
Senator Barrasso complains mercilessly about these exchanges. CBO says the exchanges will shed even more people. The costs will go even higher. Senator Cornyn regularly tweets out that the Affordable Care Act still left 28 million people uninsured, but this bill that you're debating will double the number of people that don't have insurance. For all of my Republican colleagues who rightly come down to the floor and talk about the fact that cost is too high for individuals in our system, there's not a single provision in this bill that deals with the actual cost of the service, of the procedure, of the visit, of the surgery. I'm deeply worried that this next version of the Republican repeal and replace bill will result in premiums going up by 15% and only 17 million Americans losing health care, and it will be declared a victory.
But that's not what Republicans promised. They promised to repeal the Affordable Care Act and replace it with something that's better, not something that is less worse than the original version of the replacement plan that they introduced. And I think the reason that to many people it appears that this bill is falling apart is because when my colleagues went home this weekend, they heard an earful from their constituents, from real folks who will be affected by this piece of legislation.
Alison is 28 years old. She is from Milford, Connecticut. She was in my office this week. She came down to DC this week. She and her boyfriend, I think -- I don't want to ascribe an engagement to them that is not true, I think her boyfriend – they came down here this week. They were supposed to be on vacation this week, and they decided to spend some of their vacation coming down to Washington so that Alison could tell her story to members of Congress.
When she was 9 years old, she was diagnosed with a rare liver disease. At the time, she and her family were told that they would need to find a liver transplant in roughly ten years or she wouldn't survive. At the start of her sophomore year at Sacred Heart University in Connecticut, she was starting to have symptoms of a condition that results from a buildup of ammonia in her brain. She was having a hard time concentrating, she had abdominal pain, nosebleeds, nausea, vomiting, and joint pain. Her doctor said it was time for a transplant, that she was at the critical moment where she needed a transplant.
Unfortunately, none of her family or eight other candidates, friends I think of the family, were a match for her. In desperation, her parents wrote an e-mail and sent it out on a listserv to people that lived in Trumbull and the Sacred Heart University community. From that email, an anonymous young man stepped forward, was tested and determined to be a match. The surgery was a success. And when she walked on stage to receive her diploma from Sacred Heart University, she was joined by that anonymous donor and her fellow graduates gave her a standing ovation.
Now, her family was lucky because she had insurance through her father. She was, because of the Affordable Care Act, allowed to do that at the time being under 26 years old. Her insurance paid for virtually everything that was necessary. But she says, “had my dad not had the health benefits he did, I know my family would not be in the place they are today because my parents would have lost everything that they worked so hard for. There was no way we could have afforded to pay for all of those burdens.” And today she worries that if this bill is passed, she – as a young woman with a preexisting condition – will be destined to a life of discrimination because she may not be able to find a plan that covers her condition because of the withdrawal of protection with respect to the minimum benefits requirement.
And even in Connecticut she's vulnerable to that withdrawal of protection, not because Connecticut is likely to allow insurance plans to offer coverage that doesn't include the minimum benefits, but because if you work for a big company, even if you're housed in Connecticut, if that company anchors their plan in a state that does strip away the insurance protections, then you lose the protections even as a resident of Connecticut.
Alison is now a nurse in the neonatal intensive care unit at Yale University Children's Hospital. She is contributing in a big way to our state and to the health care system and yet she is living in fear of this legislation being passed. And so she took some of her vacation to come down here and share her story with us.
I'm with Senator Collins. I think the Republicans should scrap this garbage piece of legislation, and I hope that they understand that our offer is sincere – it is not political – that Democrats do want to sit down with Republicans and try to provide some reasonable fix to what still ails our health care system.
And I’ll end with this thought. It doesn't have to be like this. Health care does not have to be a political football that is just tossed from one side to the other every ten years. That's what's been happening here for my entire political lifetime. I was elected to Congress in 2006 in part because of the tempest of popular frustration with the way in which Republicans passed the 2003 Medicare Modernization Act, which included the new prescription drug benefit that Democrats saw and sold as a giveaway to the drug and insurance industry. Democrats used health care as a political cudgel to bludgeon Republicans after the 2003 Medicare Modernization Act. Its implementation went very rocky just as the implementation of the Affordable Care Act and Democrats used it against Republicans. In 2009, it was Republicans' turn to bludgeon Democrats. Democrats lost a lot of seats in 2010 in part because Republicans used the passage of the Affordable Care Act to politically harm Democrats. Once again, it's Democrats' turn to politically bludgeon Republicans.
Whether this bill passes or not, the fact that Republicans have walked out on a plank with a partisan piece of legislation that takes insurance from 23 million people across the country and, as every poll shows, is widely unpopular, will be a political liability for Republicans. But what if we decided to stop tossing health care back and forth? What if we decided to jointly own one-fifth of our economy? What if we decided to sit down and give a little bit from our side to yours, from your side to ours? What if I said that I understood you cared about flexibility in these marketplaces? What I understood your desire for more flexibility for governors and state legislatures under Medicare? What if you said you understood our interest in providing long-term stability in these marketplaces? That you understood our desire to try to get at some of the costs of the actual services and devices and drugs that are sold?
What if we sat down and fixed the things that aren't working, kept the things that are working, and held hands together and said that we're going to jointly own the American health care system? It would leave plenty of things to fight over. There would still be no shortage of disagreements that we could run elections on, whether it be immigration or taxes or minimum wage. There would still be lots of things that we could disagree on. But for as long as I’ve been in politics, this issue has just been thrown back and forth to hurt Democrats, to hurt Republicans. And in the process we've injected so much uncertainty into the health care system and into the economy-at-large that we make it impossible for private sector reform to take hold.
Hospitals and health care providers have been doing really innovative things since the Affordable Care Act went into effect, because they got a signal from the federal government that we wanted them to start building big coordinated systems of care, that we were going to reward outcomes rather than volume. So they started making all these big changes. Then about a year ago they stopped because Republicans said they were going to blow up that model and pass something new. We frustrate innovation because we telegraph that health care policy is just going to ping-pong back and forth between left and right. We hurt ourselves politically. We frustrate private sector innovation at no benefit to us or the economy.
My offer, and I think the offer from most of my colleagues, is sincere. If my Republican friends do choose to throw away this piece of legislation because it doesn't comport with the goals that Republicans have long said were at the heart of their effort to repeal this bill, there is an important bipartisan conversation about keeping what's working in our health care system and admitting together that there are big things that aren't working and fixing them together.
I yield the floor. I note the absence of a quorum.
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