National Defense Authorization Act for Fiscal Year 2018--motion to Proceed

Floor Speech

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Madam President, yesterday we learned that, once again, my Republican colleagues do not have the votes to pass their latest effort to repeal the Affordable Care Act, even though the budget reconciliation process we are currently under requires only 50 votes.

There are not 50 votes.

Many of my colleagues have spoken on this floor about the challenges, the problems, or the issues with the latest iteration of the Graham- Cassidy bill. We have also heard as a body from many organizations all over the country that represent Americans in healthcare: the American Medical Association, which speaks for America's doctors; the American Hospital Association, which speaks for our hospitals; America's Health Insurance Plans; the American Cancer Society; many other patient advocacy groups; and the AARP, which advocates for seniors. All have weighed in about the challenges with this legislation.

But rather than continuing to bear down on that point, I would like to quote a colleague and hero of mine. Senator John McCain said on this floor:

We should not be content to pass healthcare legislation on a party-line basis. . . . The issue is too important, and too many lives are at risk, for us to leave the American people guessing from one election to the next whether and how they will acquire health insurance. A bill of this impact requires a bipartisan approach.

Senator McCain also said:

I hope that in the months ahead, we can join with colleagues on both sides of the aisle to arrive at a compromise solution that is acceptable to most of us, and serves the interests of Americans as best we can.

Senator McCain is right. Fixing and improving our healthcare system cannot be done on a partisan basis. When it has been attempted to turn big bills into law on a narrow party-line basis, the results are often not sustainable. That is why we have work to do together, because this issue of providing for America's healthcare is too complex, too big, and too important for us to do with only one wing or one party.

I was encouraged, as were many colleagues, Republican and Democratic, when Senators Alexander and Murray, the Republican and Democratic leaders of the Senate Health and Education Committee, held bipartisan hearings. They brought in Governors, insurance commissioners, healthcare experts, physicians, and hospital leaders from across the country to talk about what we need to do short term and long term to stabilize healthcare markets and to lay the foundation for improvements to our healthcare system.

So let's listen to Senator McCain. Let's give that bipartisan effort another chance. Let's work together and do this the right way.

I ride the train back and forth almost every day from Wilmington to Washington, and the Delawareans I hear from on that train or at home in the grocery store or around my State are simply tired of Congress fighting endless partisan battles with their healthcare. And it is not just frustrating to hear about on television; we know for a fact that uncertainty in the healthcare markets is causing premiums to go up for Americans all over the country. The CEO of Highmark, which is the sole provider of individual market health insurance to the ACA market in Delaware now, conveyed to me that half of the rate increase for this coming year was due to uncertainty about whether the Trump administration would continue to enforce the individual mandate, to make the CSR payments, and other things that are part of the ACA.

So today, recognizing that the only way this gets fixed in such a closely divided and partisan Senate is if we work together, I would like to commit again to my constituents and colleagues that I am willing to work to find bipartisan solutions to our healthcare problems.

Let's sit down together, and let's bring in organizations like the AMA, the AARP, the American Cancer Society, the American Hospital Association, and let's listen. Let's listen to them, to healthcare leaders, and to patient advocates, and frankly I think we should listen to thousands of faith leaders from across the country as well. We have received letters--all of us as a body--from leaders of the Christian, Jewish, Muslim, Sikh, and Buddhist communities across our country. They jointly wrote a letter to Congress urging us to reject the Graham- Cassidy bill and to immediately address urgent matters that are right in front of us.

The next one is CHIP reauthorization. CHIP--the Children's Health Insurance Program--serves nearly 9 million American children, 17,000 in Delaware alone, and it is going to expire. There are a lot of Federal health programs that expire at the end of this week: the Children's Health Insurance Program, the Community Health Center Fund, which provides access to cost-effective primary and preventive care for 26 million patients throughout the country; the teaching health centers funding; the special diabetes program. There is a whole list of healthcare-related programs that expire at the end of this week. So I think we need a sense of urgency. We need a sense of urgency to finding ways to work together in the short term to stabilize the market, to extend these programs, such as CHIP, that have long enjoyed bipartisan support and to begin the steps needed to show flexibility and compromise by both parties.

First, as I said, we have to stabilize the individual ACA marketplace. Fortunately, we know how to do that. As I mentioned, there have already been hearings in which testimony was received from Governors, insurance commissioners, healthcare experts, and they said the No. 1 priority was funding the ACA cost-sharing reduction subsidies, or CSR payments. That is something the Trump administration can do today. The administration can simply announce that they will continue to meet the law and make those payments. At least in my State, that will reduce the rate of increase of individual insurance premiums by a significant percentage.

We can also work together to establish a reinsurance program, to support enrollment outreach activities, and to enforce the individual mandate. All of this would translate to lower premiums. As I said, the President is already authorized under the ACA to take a few of these steps and stabilize the marketplace.

From there, we are going to have to find bipartisan ways that we can make this a more workable system. I have introduced legislation in the past to make the ACA small business tax credits more appropriately sized for the small businesses I have heard from in Delaware, many of which can't afford the increased costs of the Affordable Care Act.

There are ways we can work together to reduce the reporting requirements so they are less burdensome to employers. I introduced a bill on that in the last Congress and would welcome a chance to work with a Republican colleague to introduce and pass that legislation now.

We could also look at ways to make the tax credits--or the way that subsidies are provided through the ACA--both more affordable and more sustainable, so that families who qualify aren't caught in a situation where they qualify for tax credits, but they are nowhere near enough to afford comprehensive health insurance.

We also have to take a hard, bipartisan look at what is driving up healthcare costs across this country. We aren't just challenged with resolving issues around health insurance; we also have to find a bipartisan path toward addressing healthcare costs.

The bottom line to all of this is that we must work together to return to regular order and to give these programs the stability and certainty they need to serve patients across the country and our constituents at home.

In my view, the Affordable Care Act has helped millions of Americans live healthier, safer, more secure lives. Repealing it and replacing it with one of the proposals we have seen in recent months would have been very harmful to millions of Americans. But that doesn't mean the ACA is perfect. There is hard work to do. Compromise is needed on both sides.

And I think the call that Senator McCain has issued to this Chamber is one we should hear.

So let's work together. Let's listen to our constituents. Let's listen to faith leaders. Let's listen to doctors and healthcare experts. Let's do the hard work and together improve, not tear down, our healthcare system.

Thank you.

With that, I yield the floor.

I suggest the absence of a quorum.

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