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Better Care
Reconciliation Act of
2017
June 22, 2017
Americans Deserve Better Care
WASHINGTON, D.C. – U.S. Senate Majority Leader Mitch McConnell (R-KY) made the following remarks today on the Senate floor outlining the Senate Republican health care discussion draft:
“Seven years ago, Democrats imposed Obamacare on our country. They said it would lower costs. It didn’t. From 2013 to 2017, premiums have on average doubled in the vast majority of states on the federal exchange. Next year, Obamacare premiums will go up across the country again — potentially by as much as 43 percent in Iowa, and 59 percent in Maryland, even a staggering 80 percent in New Mexico. Does it sound like Obamacare is working? They said it would increase choice. It didn’t. This year, 70 percent of American counties have had little or no choice of insurers under Obamacare. Next year, at least 44 counties are projected to have no choice at all — meaning, yet again, Americans could be thrown off their plans in states like Missouri, and Ohio, and Wisconsin. Does it sound like Obamacare is working?
“Now Democrats tell us it would be wrong for the Senate to actually address these problems in a serious way while the law they’ve defended for seven years teeters on the edge of total collapse. They were wrong before. They’re wrong again now. Because Obamacare isn’t working, by nearly any measure it has failed, and no amount of 11th hour reality-denying or buck-passing by Democrats is going to change the fact that more Americans are going to get hurt unless we do something. I regret that our Democratic friends made clear early on that they did not want to work with us in a serious, bipartisan way to address the Obamacare status quo, but Republicans believe we have a responsibility to act — and we are.
“For our constituents. For our states. For our country. We’ve long called for a better way forward. And we’ve been engaged in intensive talks on how to get there. Through dozens of meetings, open to each and every member of the Conference, we had the opportunity to offer and consider many ideas for confronting the Obamacare status quo. We debated many policy proposals. We considered many different viewpoints. In the end, we found that we share many ideas about what needs to be achieved and how we can achieve it. These shared policy objectives and the solutions to help achieve them are what make up the health care discussion draft that we talked through this morning.
“We agree on the need to free Americans from Obamacare’s mandates, and policies contained in the discussion draft will repeal the individual mandate, so Americans are no longer forced to buy insurance they don’t need or can’t afford. And repeal the employer mandate, so Americans no longer see their hours and take-home pay cut by employers because of it.
“We agree on the need to improve the affordability of health insurance, and policies contained in the discussion draft will eliminate costly Obamacare taxes that are passed on to consumers, so we can put downward pressure on premiums. Expand tax-free health savings accounts and deploy targeted tax credits, so we can help defray out-of-pocket costs. And shift power from Washington to the states, so they have more flexibility to provide more Americans with the kind of affordable insurance options they actually want.
“We agree on the need to stabilize the insurance markets that are collapsing under Obamacare as well, and policies contained in the discussion draft will implement stabilization policies, so we can bring financial certainty to insurance markets and hope to Americans who face the possibility of limited or zero options next year under Obamacare. And ultimately transition away from Obamacare’s collapsing system entirely, so more Americans will not be hurt. We also agree on the need to strengthen Medicaid, preserve access to care for patients with preexisting conditions, and allow children to stay on their parents’ health insurance through the age of 26.
“I’m pleased that we were able to arrive at a draft that incorporates input from so many different Members, who represent so many different constituents, who are facing so many different challenges. The draft containing the solutions I mentioned — along with many others — is posted online, and I encourage everyone to carefully review it. There will be ample time to analyze, discuss, and provide thoughts before legislation comes to the floor. I hope every Senator takes that opportunity. Next week, we expect the Congressional Budget Office to release a score. After that, we will proceed with a robust debate and an open amendment process on the Senate floor — a process that I would encourage each of our 100 Senators to participate in.
“When legislation does come to the floor, it will present Senate Democrats with another opportunity to do what’s right for the American people. They can choose to keep standing by as their failing law continues to collapse and hurt more Americans, but I hope they will join with us instead to bring relief to the families who have struggled under Obamacare for far too long. Either way, we have to act. Because Obamacare is a direct attack on the middle class, and American families deserve better than its failing status quo — they deserve better care. That’s just what we’re going to continue working to bring them.”
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https://www.budget.senate.gov/bettercare
June 22, 2017
Senate Republican Health Care Overhaul Proposal
Seven years ago, Democrats imposed a risky health care experiment on Americans that led to skyrocketing costs and collapsing insurance markets. Senate Republicans are working to fix the mess Democrats made by acting to rescue the millions trapped by Obamacare. The discussion draft will:
- Help stabilize collapsing insurance markets that have left millions of Americans with no options.
- Free the American people from the onerous Obamacare mandates that require them to purchase insurance they don’t want or can’t afford.
- Improve the affordability of health insurance, which keeps getting more expensive under Obamacare.
- Preserve access to care for Americans with pre-existing conditions, and allow children to stay on their parents’ health insurance through age 26.
- Strengthen Medicaid for those who need it most by giving states more flexibility while ensuring that those who rely on this program won’t have the rug pulled out from under them.
Overview of the Discussion Draft of Senate Amendment to H.R. 1628
Help stabilize collapsing insurance markets that have left millions of Americans with no options.
Short-Term Stabilization Fund: To help balance premium costs and promote more choice in insurance markets throughout the country, this stabilization fund would help address coverage and access disruption – providing $15 billion per year in 2018 and 2019; $10 billion per year in 2020 and 2021.
Cost-Sharing Reductions: Continues federal assistance – through 2019 – to help lower health care costs for low-income Americans in the individual market.
Free the American people from the onerous Obamacare mandates that require them to purchase insurance they don’t want or can’t afford.
Repeals the individual and employer mandates.
Improve the affordability of health insurance, which keeps getting more expensive under Obamacare.
Long-Term State Innovation Fund: Dedicates $62 billion, over 8 years, to encourage states to assist high-cost and low-income individuals to purchase health insurance by making it more affordable.
Tax Credits: Targeted tax credits will help defray the cost of purchasing insurance; these advanceable and refundable credits - adjusted for income, age and geography - will help ensure those who truly need financial assistance can afford a health plan.
Health Savings Accounts: Expanded tax-free Health Savings Accounts to give Americans greater flexibility and control over medical costs; increased contribution limits to help pay for out-of-pocket health costs and to help pay for over-the-counter medications.
Repeals Obamacare Taxes: Repeal costly Obamacare taxes that contribute to premium increases and hurt life-saving health care innovation, like the taxes on health insurance, prescription drugs, medical devices, and “high-cost” employer sponsored plans.
Empowers states through state innovation waivers (Obamacare 1332 Waiver): Provide states additional flexibility to use waivers that exist in current law to decide the rules of insurance and ultimately better allow customers to buy the health insurance they want. Allow the Department of Health and Human Services (HHS) to fast-track applications from states experiencing an Obamacare emergency.
Preserve access to care for Americans with pre-existing conditions, and allow children to stay on their parents’ health insurance through age 26. (There are no changes to current law as it applies to Veterans, Medicare, or Social Security benefits.)
Strengthen Medicaid for those who need it most by giving states more flexibility while ensuring that those who rely on this program won’t have the rug pulled out from under them.
Targets Medicaid to Those Most in Need: In 2021, begins gradual reductions in the amount of federal Obamacare funds provided to expand Medicaid, restoring levels of federal support to preexisting law by 2024 while providing fairness for non-expansion states.
New Protection for the Most Vulnerable: Guarantees children with medically complex disabilities will continue to be covered.
Provides additional state flexibility to address the substance abuse and mental health crisis.
Flexibilities for Governors: Allows states to choose between block grant and per-capita support for their Medicaid population beginning in 2020, with a flexibility in the calculation of the base year. Allows states to impose a work requirement on non-pregnant, non-disabled, non-elderly individuals receiving Medicaid.
New Protections for Taxpayers: Curbs Medicaid funding gimmicks that drive up federal costs.
U.S. Senate Minority Leader Chuck Schumer (NY)
June 23, 2017
SCHUMER: TRUMPCARE BILL WOULD BE A DISASTER FOR NEW YORK CHILDREN, SENIORS, ANTI-OPIOID ABUSE EFFORT, HOSPITALS, NURSING HOMES & MORE; SENATOR JOINS LOCAL ADVOCATES AT BELLEVUE IN MAKING CASE AGAINST PLAN PRESIDENT HIMSELF CALLS ‘MEAN’
Senate Republicans’ Version Of Trumpcare Would Kick Millions off of their Healthcare & Endangers People w/ Pre-existing Conditions While Giving Very Wealthy A Massive Tax Break
Schumer: The Trumpcare Plan Would Make NY Sick
“This bill is designed to strip away healthcare benefits and protections from New Yorkers and Americans who need it most, in order to give a giant tax break to the folks who need it the least. Simply put: this bill will result in higher costs, less care, and millions of Americans will lose their health insurance. It’s every bit as bad as the House bill; in some ways, it’s even worse,” said U.S. Senator Charles Schumer
“It is unfathomable that the Senate GOP wants to ask middle class and low-income workers to pay more money for less coverage, all to cut taxes for insurance companies and the wealthiest among us,” said Senator Gillibrand. “I could not think of a more out-of-touch or insulting proposal to working Americans already struggling with the high cost of health care today.”
Schumer said the bill would hurt the more than 6.3 million New Yorkers enrolled in Medicaid—many in nursing homes and approximately 1.3 million in New York City alone. Schumer said the bill also abandons people with pre-existing conditions, especially maternity care and mental health; defunds Planned Parenthood, eliminating care for women in New York and across the country; weakens health care coverage for those with opioid, substance abuse and mental health disorders; and forces older Americans to pay more for coverage. Schumer said the bill slashes support for healthcare programs in order to give tax breaks to the very wealthy.
Schumer added, “First, the Senate Republicans’ bill will cause health care costs for middle class and working Americans to go up. By cutting back on tax credits and making Americans to pay an even bigger percentage of their income for their premiums, they’ll send costs soaring. Second, this bill will kick millions off of Medicaid, by making even deeper cuts than the House bill. If you’re a middle class family with a loved one in a nursing home, the cost of that care could go up.Third, the Senate health care bill abandons people with pre-existing conditions, putting at dire risk maternity care and mental health coverage, by allowing states even more latitude to get out of covering essential health benefits. Fourth, the bill defunds Planned Parenthood, making it harder for millions of women to obtain the health care they need and deserve. And Senate Republicans are doing all of this to provide a gigantic tax break for the wealthiest Americans.”
Medicaid
Schumer explained the importance of Medicaid, saying “Medicaid is not just a health insurance program for Americans struggling in poverty, though that is an important and necessary part of it. Medicaid is increasingly a middle-class program. Medicaid is how so many Americans are able to access opioid abuse treatment. Medicaid foots the bill for two-thirds of all Americans living in nursing homes. Medicaid allows for people with disabilities to be able to remain in their homes and receive home and community based services. Medicaid ensures that schools can provide services to students with disabilities. Medicaid provides the cushion, particularly in rural areas, so hospitals can survive and give top-notch healthcare to all of us.
Medicaid works to help middle class families get the health care they need. In New York, 6,395,894 people are covered by Medicaid and 38% are children. Additionally: 51% of all newborns, 47% of all infants, toddlers and preschoolers, and 39% of children with disabilities or special needs in New York depend on Medicaid or CHIP for their health care. From Fall 2013 through June 2016, New York increased the number of individuals covered by Medicaid/CHIP by 717,4777. Medicaid expansion reduced the uninsured rate in NY by 32% from 2013 to 2015. New York covers approximately 114, 875 people with serious mental disorders or substance use disorders through the health insurance marketplaces and Medicaid expansion, including 44,759 solely by Medicaid expansion. This includes 11,200 with a serious mental illness and 31,362 with a substance use disorder. Medicaid also enables a shift away from expensive hospital settings. In 2014, 25% of mental health spending and 22% of substance use disorder spending was for inpatient settings, compared with 47% and 53% respectively in 1986.7 In Medicaid expansion states, the share of substance use or mental health disorder hospitalizations involving patients without insurance fell from about 20% at the end of 2013 to about 5% by mid-2015.
According to Schumer, in just 3 years, under the Senate bill, millions will be kicked off their Medicaid coverage by starting to end the Medicaid expansion, and beginning in 2025, the bill will institute even more cuts to the Medicaid program; each year those cuts will get deeper than the year before. Within 10 years of this new funding system, the cuts to Medicaid could total billions of dollars above the more than $800 billion the House bill already cuts from the program. Schumer said that if the health care bill becomes a reality, New York will be forced to make difficult decisions about which benefits they can continue to provide. States will be forced to reduce payments to providers, such as pediatric specialists, and limit access to life-saving, though costly, specialty care which would hurt thousands of middle class families in New York. Schumer went on to say that many middle class families whose children receive Medicaid-covered health use it not only at the doctor’s office, but also at school. For students with disabilities, schools must provide medical services that are necessary for them to get an education as part of their special education plans, and Medicaid pays for these services for eligible children. Under Medicaid, children with disabilities are able to receive home and community-based services, which allow them to get care in the comfort of their homes without the complications involved in traveling to see a health care provider. For those children who need to travel, Medicaid provides transportation services to and from providers, ensuring that distance is not a barrier to care for a vulnerable child. Medicaid requires states to offer services to children in state foster care systems as well as children living with developmental disabilities.
Pre-Existing Conditions/Maternity Coverage
Schumer explained that the Senate Republicans’ health care bill abandons people with preexisting conditions, putting at dire risk maternity care, mental health coverage and other services, by allowing states even more latitude to get out of covering essential health benefits. Schumer said that even though much of the early reporting said the bill will keep certain protections for Americans with pre-existing conditions, the truth is, it may well not guarantee them the coverage they need because states are allowed to waive Essential Health Benefits. Essential Health Benefits require plans to cover 10 basic types of care, including prescription drug coverage, substance abuse and mental health care services. Schumer said that this would be catastrophic for people looking for coverage and treatment for their substance use disorder. Before the ACA, nearly a fifth of those plans didn’t cover mental health.
Planned Parenthood
Schumer said that the Senate Republicans’ bill defunds Planned Parenthood, making it harder for millions of women to obtain the healthcare they need and deserve. In New York there are 58 Planned Parent Hood Centers, including five Planned Parenthood Centers in New York City.
Opioid/Substance Abuse
In 2015, more than 52,000 people in the U.S. died from opioid overdoses. In 2015, 2,754 individuals died of a drug overdose in New York State.
Currently, only about one in four people suffering from opioid abuse receives treatment, which implies that approximately 665,000 people with an opioid use disorder, including 343,000 low-income individuals, were treated in 2015. Such treatment comes at a cost: on average, Medicaid beneficiaries with opioid use disorders cost about $11,000 per year on average, compared with $3,300 per year for the average Medicaid adult. Pharmacy claims data show that the number of opioid treatment prescriptions increased an average of 11 percent over the period of 2012-2016. If that rate continues to rise, the number of people treated for opioid use disorder would rise from 343,000 in 2015 to 1.1 million in 2026. Based on projections by the Congressional Budget Office (CBO), the cost of care would also rise by an average of 5 percent annually. Average charges for opioid overdose patients treated and released from the emergency department are $3,397 per visit. Those admitted to the hospital rack up an average $29,497 in charges per hospitalization. From 2005 to 2014, according to the latest data available, opioid-related hospital visits increased nearly 65 percent, to 1.27 million emergency room visits or inpatient stays a year. Furthermore, hospital care for babies born suffering from opioid withdrawal costs an average of $66,700 per birth.
Opioid use also drives the spread of other expensive health conditions. Recent outbreaks of HIV and the rise in Hepatitis C can be traced to needle-sharing among users of injectable opioids. CDC researchers estimated that, in 2013 alone, the total economic cost of opioid overdose, abuse, and dependence was $78.5 billion, including costs of treatment, health care, criminal justice, and lost worker productivity. Nationwide, almost 3 million people had an overdose use disorder as of 2015. Of these, 1.37 million have incomes below 200 percent of the federal poverty level.
Schumer said that the Republican plan to repeal Medicaid expansion and cap Medicaid will make the opioid crisis worse. Millions will be at risk of losing coverage for substance use disorder prevention, treatment, and recovery services. Medicaid is the single largest payer of substance use disorder services in the nation and pays for a quarter of all medication-assisted treatment (MAT) in the U.S. Many states with high opioid overdose death rates, including New York, have used Medicaid to expand access to MAT. Nearly 30 percent of people covered through Medicaid expansion have a mental illness, substance use disorder, or both. The Republican plan health care plan would not accommodate for these individuals. The plan provides only $2 billion to address losses in mental health and substance abuse coverage. Projections show that it will cost $183 billion over the next ten years to fully counter the coverage losses in mental health care and to fight the opioid epidemic.
Today, Schumer was joined by Stan Brezenoff, Interim CEO of H+H; Bill Hicks, Bellevue CEO; Bellevue employees who are also members of DC37, New York State Nurses Association (NYSNA) and the Doctors Council 1199; Mark Hanny of Metro New York Health Care for All Campaign; Lois Uttley of Raising Women’s Voices; Ben Anderson of the Children’s Defense Fund; Susan Dooha, Center for Independence of the Disabled; Elizabeth Benjamin, Vice President of Community Service Society; Rebecca Novick of the Legal Aid Society; Maria Alvarez, Director of Statewide Senior Action Council; Michael Davoli of American Cancer Society Cancer Action Network; Carla Rabinowitz, Mental Health Action Network; Claudia Culkin, New York Immigration Coalition; Allison Sesso, Human Services Council; Anthony Feliciano, Association to Protect Public Health System; Glennda Testone, Executive Director of LGBT Center and New York families who would be impacted by Trumpcare.
“Senate Republicans finally released their secret healthcare bill and it’s now clear why they kept it hidden in the bowels of the Capitol for so long,” said Congresswoman Yvette D. Clarke. “This bill is as bad as and in some ways worse than the House version of Trumpcare. Trumpcare is nothing more than a massive tax break for millionaires and billionaires at the expense of ordinary Americans like the 1.6 million New Yorkers that have gained access to health insurance thanks to the Affordable Care Act. Nearly 2.3 million New Yorkers enrolled under the ACA’s Medicaid expansion are at risk of losing their insurance thanks to this wicked, mean-spirited, and treacherous bill. The American people expect Republicans and Democrats to work together in a bipartisan fashion to lower premiums and expand coverage for all. They deserve nothing less.”
Chairman of the Democratic Caucus Joe Crowley (NY-D) said “The Senate Republicans’ health care repeal bill is cut from the same cloth as Trumpcare, the disastrous House-passed health care repeal effort. It slashes coverage and raises costs for millions of people in New York and across the country, while cutting funding for New York’s health care providers and state programs. These proposals are simply unacceptable to all of us fighting for hardworking men and women and their families. Despite the name, this bill will not be better for our state and America. In fact, this cruel legislation confirms that Republicans have abandoned any guise of seeking quality and affordable health care for New York’s families.”
“For years, Republicans have promised that they have 'a better way' for America's health care system. If they want to lie to themselves about what Trumpcare is, that’s fine. But they need to stop lying to the American people,” said Congressman Eliot Engel, a leading member on the House Energy and Commerce Committee. “The latest version of Trumpcare makes harsh cuts to Medicaid, abolishes the Medicaid expansion, and lets states gut protections Americans rely on for quality coverage. In the end, millions will lose coverage, hospitals will struggle to care for those in need, and hardworking families will pay more and get less. I stand united with my Democratic colleagues in opposition to this cruel bill.”
“Senate Republicans, in lockstep with their Republican colleagues in the House, have offered Americans 142 pages of legislative text that does nothing to lower health insurance premiums, address the rising cost of drug prices, or increase the number of Americans with access to affordable and robust health insurance,” said Rep. Adriano Espaillat. “This exercise began, in earnest, as a massive tax cut for the rich masquerading as heartless health policy. It has now become an unadulterated attack on the safety and livelihood of Latino and black minorities, women, children, disabled individuals, and senior citizens. New Yorkers will not stand for this affront and I stand with them, firmly and in opposition to this harmful legislation.”
Congressman Jeffries said, “The Republican health care bill is an unmitigated disaster. It will take away healthcare from millions of hardworking Americans, give a $1 trillion tax cut to the super wealthy and result in skyrocketing insurance costs. Together, we will fight to defeat this legislative train wreck.”
“The Senate Republicans' so-called healthcare bill is deceptively named and disastrously constructed, especially for New York. This bill, drafted in secret, is just as cruel as the one every Democrat opposed in the House,” said Congresswoman Carolyn B. Maloney (NY-12). “Instead of expanding access to healthcare as promised by the President, it will rip away health insurance from millions of New Yorkers. Instead of making premiums more affordable as promised, it will cause New Yorkers' premiums to increase. It does all this while cutting coverage for essential health benefits like maternity care and mental health, and cutting off federal funding for Planned Parenthood, leaving many New Yorkers with no access to affordable care. This new Senate Republican bill is a Category 5 man-made disaster for New Yorkers and I hope my colleagues in the Senate will stop it dead in its tracks.”
Rep Meeks said, “I stand with Senator Schumer and Democrats in denouncing the Senate Republicans’ heartless and harmful Trumpcare bill. The individuals who stand to gain the most from it are the millionaires and billionaires who would receive an immediate tax cut. The people who stand to lose the most are millions of hard-working low and middle-income Americans who rely on the Affordable Care Act for Medicaid, tax credits, and coverage. I hope Republicans will listen to their constituents and improve, not worsen, their care.”
Congresswoman Grace Meng said, "The Senate’s healthcare bill is no less of a disaster for the American people than the House version. Millions of hardworking Americans will lose health insurance. Families will need to pay higher premiums for skimpier plans. The most vulnerable among us, including children, the elderly, and people who are sick, will face the steepest barriers to coverage and care. All the while, this bill hands out tax breaks to corporations and the wealthiest Americans. What part of this bill is supposed to improve our healthcare system?"
“Senate Republicans have managed something I did not think was possible: they drafted a health care repeal even crueler than what the House Republicans passed last month,” said Congressman Jerrold Nadler. “This bill would make devastating cuts to Medicaid, pulling the rug out from millions of working families, children, seniors, and people with disabilities. Millions will have to pay more for bad insurance; premiums and deductibles will go up, and protections for consumers will disappear. Millions will lose their insurance and see their costs skyrocket for one despicable goal – to give the wealthiest Americans billions of dollars in tax cuts. Republicans should be ashamed of this bill and of the damage it will cause to millions of Americans.”
“Senate Republicans spent weeks working in secrecy just to come up with a bill that’s just as cruel as what passed in the House and in some ways even worse,”said Representative Kathleen Rice. “The only people whose lives would be better under this legislation are wealthy Americans who get a big tax cut, while millions of Americans lose their insurance and the rest of us are forced to pay more for less coverage. And even though President Trump claims to care about ending the opioid epidemic, this bill would be devastating for people struggling with addiction on Long Island and across the country. Republicans are doing their best to rush this bill to a vote, but my New York colleagues and I will keep standing together and fighting back with everything that we have.
"This bill is a disaster for New Yorkers and Bronxites. It represents a betrayal of seniors, working families, and those with pre-existing conditions. It fails the basic tests of humanity and morality and the Senate should reject it," said Congressman José E. Serrano.
Congresswoman Nydia Velázquez said, “No wonder Senate Republicans were keeping their Trumpcare bill secret from almost everyone -- they know what a disaster it would be for the American people. In order to finance billions of dollars in tax cuts for the extraordinarily wealthy and corporations, the bill would impose higher health costs, sever coverage for tens of millions of hard-working Americans, gut key pre-existing condition protections such as maternity care and prescription drug benefits, and steal from Medicare. When it comes to Medicaid, the Senate Trumpcare bill is even ‘meaner’ than the House bill, to paraphrase the President. Vulnerable children, pregnant women, families living paycheck to paycheck, and middle class seniors with long-term care needs would be hit particularly hard. In short, the Senate Trumpcare measure would be disastrous for New Yorkers. All of us must resist this heartless bill with every ounce of energy we have.”
June 22 Facebook post
I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.
We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course.
Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams.
And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past.
We did these things together. So many of you made that change possible.
At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.
That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.
But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.
The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else.
Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.
Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.
I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?
To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.
That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family.
After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.
June 26, 2017 - Congressional Budget Office
"CBO and JCT estimate that enacting the Better Care Reconciliation Act of 2017 would reduce federal deficits by $321 billion over the coming decade and increase the number of people who are uninsured by 22 million in 2026 relative to current law."
Copyright © 2017 Eric M. Appleman/Democracy in
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