National Defense Authorization Act for Fiscal Year 2018
Floor Speech
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Madam President, 2 months ago, millions of Americans rose up and defeated TrumpCare. In doing so, we reaffirmed that, in the wealthiest nation on Earth, healthcare is a right and not a privilege that is reserved only for those who can afford it.
The President and the Republican Party believe the opposite. To them, healthcare is just another commodity to be bought and sold, but we all know that this is not like buying a new car or a big screen TV. The Republican position shows no heart, no care, and no compassion. It is the exact opposite of what so many of you showed me when I was diagnosed with kidney cancer.
Although we successfully defeated TrumpCare in July, we face fresh assaults to deny every American's right to healthcare, but it does not have to be this way. In July, so many of us were moved by Senator John McCain's impassioned plea for the Senate to return to regular order in order to debate how to strengthen our healthcare system on a bipartisan basis. Since then, Senators Lamar Alexander and Patty Murray have worked to build consensus for a bill that would strengthen insurance markets and reduce out-of-pocket costs for consumers.
They have done this the right way--through committee hearings, bipartisan meetings, and careful deliberation. Instead of embracing and endorsing this effort, the President and the majority leader have now chosen to double down on their obsession with depriving healthcare to millions of people across the country through the Graham-Cassidy bill. Let me be clear. This bill is not a compromise. It is not a new and better idea for delivering healthcare in this country. It is just a new version of TrumpCare and, I might say, an even worse proposal than the one we defeated in July.
The details matter. This version of TrumpCare eliminates the Affordable Care Act's Medicaid expansion, and that threatens the coverage for more than 110,000 Hawaii residents who are now receiving such coverage. There are millions all across the country who now get healthcare coverage thanks to Medicaid expansion in their States.
This bill establishes a healthcare block grant, including a per capita cap on Medicaid spending that would severely limit Federal funding for healthcare--funds that States rely upon. Republicans, including the cosponsors of this bill, argue that this approach would provide more local control over healthcare. This, however, is what we in Hawaii call ``shibai''--or BS. Local control through a block grant is just an excuse that Conservatives and Republicans use as a pretext to make deep cuts to programs that Americans depend upon. You see them resorting to block-granting everywhere--from education to healthcare.
A new study from the Center on Budget and Policy Priorities reveals the cost of this latest version of TrumpCare firsthand. Under the proposal, Hawaii would lose $659 million in Federal funding for Medicaid over 10 years--part of some $80 billion in cuts across the country. This is a lot of money for Hawaii to lose--money that is being put to great use across our State.
Last month, I visited the Bay Clinic in Hilo, on the Big Island, where the Medicaid expansion under the ACA has improved health outcomes in poor rural communities across that island. Bay Clinic is the primary healthcare provider to 6 of the 10 poorest ZIP Codes in the entire State of Hawaii, where many residents went years without having health coverage. Thanks to the Affordable Care Act, the Bay Clinic has successfully enrolled thousands more people in Medicaid and decreased the number of uninsured patients who have gone through their doors. It is astounding what the numbers show.
The number of patients who have gone through their doors has been cut from 29 percent in 2010 to only 10 percent in 2015. That is how many more people on the island of Hawaii are able to get healthcare coverage. Over that same time period, the Bay Clinic has seen an almost 20-percent increase in the number of patients it has served every year.
In the years following the passage of the ACA, the Bay Clinic and community health centers all across Hawaii have hired more doctors and nurses, and they have expanded the types of services that they provide.
The Bay Clinic, for example, has expanded its Mobile Health Unit, by which doctors go to rural communities, such as in Keaau, where residents would otherwise not have access to primary care providers.
This program and others like it in Hawaii and across the country face an imminent threat from this newest version of TrumpCare.
Unfortunately, this bill's devastating cuts to Medicaid are only part of what makes it so mean and so dangerous.
It eliminates all premium subsidies that allow lower income Americans to afford coverage, and it eliminates cost-sharing subsidies that reduce out-of-pocket expenses for consumers. These are the very issues relating to the Affordable Care Act that Chairman Lamar Alexander and Ranking Member Patty Murray are addressing through regular order--how to provide healthcare for more people in our country.
The Graham-Cassidy bill creates a process by which States can receive waivers to roll back essential health benefits and eliminate important consumer protections, like guaranteed coverage for millions of Americans who are living with preexisting conditions--people like me.
I have said many times on the floor of the Senate that we are all only one diagnosis away from a major illness. Every day, 6,540 people are diagnosed with cancer in our country. There are 4,109 who are diagnosed with diabetes. There are 1,309 who are diagnosed with Alzheimer's disease every day in this country. We are all one diagnosis away from a major illness. These are people like me--many of them-- going about their business when, wham, suddenly, you get a devastating diagnosis. Not all of these people will have health insurance, and under this version of TrumpCare, even more of them will not have access to it.
When I was diagnosed with kidney cancer, I had insurance. Instead of worrying about how to pay for my treatment, I could focus on fighting my illness. No one facing cancer, heart disease, diabetes, or any other chronic or life-threatening medical condition--or, I should say, any kind of circumstance in which one needs to have access to a healthcare provider--should have to worry about whether one can afford the care that might, one day, save one's life--not in the richest country in the world, not where healthcare should be a right and not a privilege.
I yield the floor.
I suggest the absence of a quorum.
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