Executive Session

Floor Speech

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Mr. President, before the Senator leaves the floor, I just want to draw attention to the central point the Senator from Illinois has been making tonight. He has been focused on what our duties to the American people are all about, which is to make their lives better and particularly to improve the quality of their healthcare, which is a lifeline for millions of families.

Now, instead of looking at bipartisan approaches to make the lives of our people better--Chairman Hatch and I introduced the children's health bill today. Nine million youngsters with that program get better health. Instead of focusing on that, as my colleague from Illinois has said, we are going to be looking at a bill that will hurt our people, will give them worse healthcare, will go backward with respect to the march in our country to make sure we recognize that all our people--all our people--deserve quality and affordable healthcare.

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 which is going to go backward with respect to the healthcare needs of our people.
The fact is, Graham-Cassidy-Heller has been exposed to sunlight for just a few days, but it is already clear this legislation is a bad deal for the American people.

Now, Senator Cassidy has introduced healthcare bills before. Earlier this year, he introduced a bill with our colleague from Maine, Senator Collins, as an alternative to what the Senate Republican leadership put on offer. Now, I had my concerns with that proposal, but the first thing I want the Senate to understand is this Cassidy bill, which we will soon be considering, is much worse. The reason I say that is, this bill lowers the bar for legislation which has been hastily written and ill-considered. I want to be clear. This Cassidy bill will flunk the Jimmy Kimmel test of not hurting kids in America with preexisting conditions.

To make matters worse, just this evening, I have been informed that the Senate Finance Committee will shortly announce a hearing for next Monday on the Graham-Cassidy-Heller proposal. Contrary to the norms of the Senate Finance Committee, I was not consulted in this matter as the ranking Democrat. I am all for debating major legislation, but talking about a piece of legislation which will not have the Congressional Budget Office--our independent arbiter of these matters--give us their thoughts on coverage or premium matters less than 48 hours before a vote is scheduled to happen is a sham process, which makes a mockery of the very eloquent words of our colleague from Arizona Senator McCain, who appealed for the regular way in which the Senate handles legislation.
This means Senators will not know how many millions of Americans are going to wake up not knowing if they have healthcare, how many seniors would get kicked out of a nursing home or see their core healthcare 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 do is give a super block grant blank check to the States. They can do whatever they want--whatever they want--in terms of Americans' healthcare, and it guts the funding for those block grants over a very short period of time. This will mean a whale of a lot of pain for vulnerable people and an open door to some of the worst abuses of insurance companies, the 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 are talking about bringing them back. This bill amounts to the largest healthcare devolution, moving power without any accountability at all to the States.

Now, if I might get into some of the specifics. This bill does especially serious damage to Medicaid. In fact, it really hollows out the Medicaid Program.

This year's debate over healthcare made one thing quite clear: Medicaid matters. It pays for the healthcare of our most vulnerable. It serves as a safety net for those who might not think they are 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 is what millions of Americans are facing now. It helps Americans with disabilities and kids with special needs live a healthier, more productive life in their communities rather than in institutions.

That is just a little bit of the good Medicaid does for folks from Portland, OR, to Portland, ME. Under the Graham-Cassidy-Heller proposal, that is gone--simply gone. The plan ends expanded Medicaid coverage which 11 million Americans count on right now. It caps Medicaid and guts hundreds of billions of dollars in support from the Federal Government. In effect, it is like telling States, good luck, and telling them you can make the hard decisions about which Americans are going to get adequate healthcare and who are going to be those unfortunate souls who go without.

My view is, this is going to lead to destitution for older Americans who count on Medicaid for nursing home care. It also represents a massive transfer of dollars from States which expanded Medicaid to States which chose not to.
History tells us that the most vulnerable Americans without a voice or a powerful lobby are the ones who 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 Program-- 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, now covering 9 million youngsters. Part of that success is due to its reliance on a strong Medicaid Program. If Medicaid and the rest of the healthcare system is block-granted and slashed by hundreds of billions of dollars, the pillars that support a successful Children's Health Insurance Program will crumble. They will lose their structural support. A vote in favor of Graham-Cassidy is a vote to demolish successful healthcare programs like the Children's Health Insurance Program and its promise of affordable healthcare for millions of kids and their families.

There is one more step that the Graham-Cassidy-Heller bill takes that is different from previous versions. 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 healthcare priorities, in effect, pitting vulnerable Americans against each other and not having enough at the table to meet the 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 housing.

Graham-Cassidy-Heller is a recipe for disaster. This proposal, again, opens loopholes for insurance companies that, as I described, we thought we had closed, thought we had finally closed the book on the days when healthcare wasn't just for the healthy and wealthy. That is what happened when we had discrimination against those with preexisting conditions. If you had a preexisting condition and you were wealthy-- just pay the bill. If you didn't have any preexisting conditions, there was nothing to worry about.

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 a key consumer protection, the protection that bars discrimination against those who have preexisting conditions, is just tossed aside--just as what looks to be the setting aside of 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. Many of our friends and neighbors have spent the year raising their voices and showing up to stop bad healthcare legislation. Thanks to their grassroots efforts, the partisan approach that I have described as being used here again has been stopped multiple times.

I wanted to come on the floor tonight to say to people in every community across our great country that, once again, we need people power. Once again, we need them to stand up and say that we don't want to turn back the clock on the healthcare needs of the most vulnerable, like seniors and the disabled and our kids. Once again, we hope they will speak out all across the country.

I am going to be having townhall meetings this upcoming weekend after the Jewish holiday. You can be sure that I am going to hear a lot from the people of Oregon about this. I am very hopeful that, once again, people power around America is going to come forward 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 healthcare; they want to move forward. Instead of turning back the clock, what they are looking for is leadership, for example, that will hold down their prescription drug costs.

I have introduced legislation to require these companies to publicly justify raising their prices. We have had Senators introduce a host of bills. That is what we ought to be doing--talking about how we are going to improve American healthcare.

My colleague from Illinois mentioned the Children's Health Insurance Program, which Chairman Hatch and I worked with our Finance colleagues to get introduced, and there is the Community Health Center Program. I could go on and on about opportunities for bipartisanship to take the country in the right direction rather than in the wrong direction.
Instead, it doesn't look as though that is going to be on offer any time soon. What is 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 healthcare system to be sustainable and lasting, they have to be bipartisan. That is why I mentioned an effort that I was involved in. Several of my colleagues who cosponsored the bill I am talking about have been supportive of that for quite some time.

We know Republicans and Democrats know how to write bipartisan legislation. But what the Graham-Cassidy-Heller bill seeks to do is just the opposite--to use the most deeply partisan process the Senate knows, called reconciliation. It basically says: Our way or the highway--not interested in trying to find common ground.

I will point out that didn't end too well earlier when we talked about healthcare. 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 healthcare on a bipartisan basis, in a way that helps people all across the country.

I have mentioned--this is 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, people will step up and they will say, as I have said on this floor: The political change doesn't start in Washington, DC, and then trickle down; it is bottom up. It is bottom up, as people come forward and say ``That is not the way to go'' and say ``Here is the way that really would make sense and make our lives better.'' I yield the floor.

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