WASHINGTON – During a U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee hearing with Vice Admiral Jerome M. Adams, Surgeon General of the U.S. Public Health Service, U.S. Senator Chris Murphy (D-Conn.), a member of the committee, criticized his Republican colleagues for planning to repeal the Affordable Care Act’s individual mandate – a critical component of the health care law – as part of their tax reform efforts. Murphy warned that even though Senate Republicans are turning tax reform into a health care repeal plan, the Senate health committee may not even hold a single hearing on the bill. Murphy also emphasized to Surgeon General Adams that that gun violence is a public health issue. 

Click here to view a video of Murphy’s remarks.

“This tax bill has turned into a health care bill in the last 48 hours,” said Murphy. “I was so proud of this committee when we held, I think, three or four hearings to study how we could stabilize the individual market. But the impact of [that] will be dwarfed by the impact of repealing the individual mandate…without a single hearing in this committee. CBO says that premiums are going to go up 10 percent compounding year over year…because of the repeal of the individual mandate. So to most middle class families, yesterday, this bill stopped being a tax bill and started being a health care bill. And this committee, again, is not reviewing it.” 

The full text of Murphy’s remarks is below:

MURPHY: Mr. Chairman, you’re hearing our frustration about the way in which this tax bill has turned into a health care bill in the last 48 hours. I was so proud of this committee when we held, I think, three or four hearings to study how we could stabilize the individual market, so proud of how you and Senator Murray worked together to develop that plan.

But the impact of Alexander-Murray should it pass or had it passed, will be dwarfed by the impact of repealing the individual mandate and it is potentially going to come up for a vote in the United States Senate without a single hearing in this committee, maybe a markup in the Finance Committee, but no serious attempt to understand what the impact is.

CBO admitted that it’s very hard to understand what happens when the mandate disappears. It could be catastrophic in the sense that if you keep the requirement that plans continue to price without respect to medical acuity, but you don’t require that people buy insurance, the rational individual would not buy insurance until they become so sick that they need care, knowing that they’ll never pay any more for it. A rational healthy person simply would not buy insurance with the protection in place and no mandate. At the very least, CBO says that premiums are going to go up 10 percent compounding year over year, simply because of the piece of legislation that the Senate is potentially going to pass.

 And the reason that I say that this bill is becoming a health care bill instead of a tax bill, is because from what we understand, the individual income tax relief – which will help about two out of every three middle class families – is temporary. It disappears in seven years. And by seven years from now, premiums will have doubled according to CBO, because of the repeal of the individual mandate.

So seven years from now, an average family will get almost no individual income tax relief because their tax cuts will have expired, and their premiums will be potentially $10,000 higher than they are today, according to CBO. Seven years from now, the doubling of annual premiums for the average family will mean an increase in cost of $10,000. So to most middle class families, yesterday, this bill stopped being a tax bill and started being a health care bill. And this committee, again, is not reviewing it.

Dr. Adams, thank you for being here. I have one question for you. Dangerous neighborhoods are not healthy neighborhoods. What we know about the biology of trauma and toxic stress is that if you’re walking to school every day fearing for your life, if you live in a neighborhood in which gun shots are your bedtime music as is the case in a lot of neighborhoods in this country, your brain is bathed in adrenaline and cortisol. Which from what I understand, fundamentally alters the way in which your brain works. 

As we’re talking about trying to build healthy communities, how important is it to make sure that we’re building safe communities? That if kids fear violence, if kids fear gun homicides, then all the work we do to build resources and health care equity doesn’t really matter because their brans have been altered.

I know you’ve thought a lot about this and done a lot of work around this issue. Talk about the connecting between safe communities and healthy communities. 

ADAMS: Thank you so much for bringing up that point because community safety is a critical part of wellness. I’ll give you a quick example. I was in Atlanta this last week and the East Lake community of Atlanta had some of the highest high school dropout rates, some of the worst crime, some of the lowest employment rates in the nation. They brought together multiple different sectors, different partners around the idea of economic wellness and productivity, and now they are above the state average for high school completion, their crime rates have gone down, and they have become a more prosperous and a safer community which leads back to the point that I originally made – that health and the economy are intimately connected, and embedded in that is safety. If you’re a more prosperous community, you’re going to be a safer community and a healthier community, and vice versa.

MURPHY: When we talk about gun violence, we tend to think of the impact as being on the victims and on the victims’ immediate close set of friends and family. But the fact of the matter is, the impact in these neighborhoods is felt by everyone who has this fight or flight mechanism that sets off in their brain. It’s a public health issue and I appreciate your comments on that.

Thank you, Mr. Chairman.

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