Mr. President, I rise today for the third time this session -- to oppose plans by President Trump and the Republicans to gut our health care system and to throw millions of Americans off their health insurance.
On May 4th of this year -- the day the House Republicans narrowly passed their TrumpCare bill -- the president held a celebration in the White House, in the Rose Garden. He pronounced the bill, “a great plan.”
Well, TrumpCare may be a “great plan” if you are wealthy and healthy. Because if you are wealthy, you get big tax breaks. And if you are healthy, your premiums may not go up and may even go down. That is, until you're sick.
TrumpCare is not a “great plan” if you are over the age of 62 or are a hardworking family trying to make ends meet, if you live in a rural area, or if you have or have had an illness like cancer or heart disease or diabetes, or if you are a woman.
23 million Americans will be left high and dry -- out of health insurance by 2026.
They don’t think TrumpCare is a great plan. To them, it's a “mean” plan.
Actually, those are President Trump’s own words, several weeks after that Rose Garden celebration. President Trump came clean with Senate Republicans, admonishing them that their bill is “mean" and needs to be more "generous, kind (and) with heart."
For the first time since his inauguration, I agree with the president on health care.
Since day one of the 115th Congress, Republicans have had the Affordable Care Act in their sights. And so has the president. And they have tried mightily to do away with the rights and benefits under the ACA.
But, Mr. President, there is good news.
The American people have rallied, they've called, they've emailed, they've gone to town halls, they've marched, and they've made their views known and shared their stories. And, so far, they have stopped Republicans from gutting our health care system.
Just this past Saturday in my home state, simultaneous rallies in opposition to TrumpCare took place in 20 counties.
I say to them: Keep up the fight! And I will continue to fight as hard I can. We need to do all we can to stop this attack on health care.
The consequences of upending our health care system are enormous. They are enormous for the 20 million Americans who now have health care because of the ACA, through private insurance and through Medicaid expansion.
TrumpCare hurts the vulnerable – the elderly, the disabled, and those with fewer resources.
The consequences of gutting the ACA and restructuring Medicaid are enormous for our economy -- one-sixth of which is related to health care.
They are enormous for hospitals that rely upon third party reimbursements under the ACA and Medicaid expansion. These hospitals need those revenues. And even more so for rural hospitals that keep their doors open thanks to the ACA. And the Indian Health Service facilities that have reduced wait times and added services because of the ACA.
But the majority in Congress refuses to hold hearings and they are blocking all public participation. This is unconscionable and it's undemocratic.
Before Democrats voted on Obamacare, the Senate held 100 committee hearings, roundtables, and walk throughs. The final Senate bill included 147 Republican amendments.
The Majority Leader has missed an opportunity for political and moral leadership on one of the most important issues we face.
Senator McConnell should have an honest and open process — including Senate committee hearings with full public participation and a chance for patients to tell Congress how this proposal impacts them — not hidden meetings, not limited debate, and a simple majority vote.
Americans deserve an open process from their elected leaders. That is why I introduced a bill last week with my democratic colleagues called the No Hearing, No Vote Act. This bill would require a public committee hearing for any legislation that goes through the fast-tracked “budget reconciliation” process – including the TrumpCare legislation. Members of Congress were elected to improve lives, not destroy them and I believe that we need bipartisan cooperation to ensure we don’t do that.
If we want to improve on Obamacare, we could, one, make sure that all Americans have health care. And two, make health care more affordable.
So, Mr. President -- what’s really happening here? I’ll tell you. The American people don’t want the benefits they have gained through Obamacare to be repealed and replaced with an inferior plan. They do not support TrumpCare. Only 17% of Americans support the House Republicans’ current bill.
With this degree of public opposition — it is baffling that Republicans keep pushing a bill that kicks 23 million Americans off their health care.
But the moral underpinnings of TrumpCare are as bankrupt as Trump’s New Jersey casinos.
The winners of TrumpCare are the wealthy and the Republicans are plainly serving those interests.
The Republicans can keep trying to hide TrumpCare but Americans understand that it is just plain wrong, and I want to talk about a few of the ways that is just plain wrong.
While women make up half our population, no women serve on Senator McConnell’s health care working group. Yet, women are uniquely affected by TrumpCare.
For example, the range of cost-free preventative services under the ACA includes screening for breast cancer – including mammograms, bone density screening, cervical cancer screening, domestic violence screening and counseling, breast-feeding counseling and equipment, contraception, and folic acid supplements.
All these services are critical to maintaining women’s health. And the health of their babies as well. New Mexico leads the nation in the percentage of births that are covered by Medicaid — at 72% of all births in the state. So these services that are now available to everyone are essential.
TrumpCare would repeal the cost-free preventative care requirements for the Medicaid expansion population. Not only would this repeal risk the health of women and their babies, it would result in increased medical care costs overall. Preventative medical services save money in the long run.
The Affordable Care Act requires insurance plans to provide a range of Essential Health Benefits. For women, these required services include maternity and newborn child care.
But TrumpCare would allow states to apply for a waiver to define their own Essential Health Benefits, beginning in 2020. So states could choose to exclude maternity and newborn care, and women would end up paying more for this care. The result — women not getting the care they need.
TrumpCare would cut Medicaid funding to Planned Parenthood for one year.
Planned Parenthood provides preventative, medical, and reproductive health services to women, and men, and Planned Parenthood clinics provide a safety-net to low-income women. According to the CBO, cutting off Medicaid payments to Planned Parenthood for one year would mean a total loss of access to services in some low-income communities because Planned Parenthood is the only public provider in some regions.
Take Elena, from Albuquerque. Elena found out when she was 30 years old, and in law school, that she had the brca gene mutation that puts her at much higher risk for breast and ovarian cancer. Treatments for the brca mutation include a mastectomy and ovary removal – treatments she couldn’t afford. Thankfully, Elena qualified for Medicaid under the expansion. She got breast cancer screenings and decided to have a mastectomy because of a cancer scare. Elena had three surgeries, costing thousands of dollars covered by Medicaid. And now the chances of her getting breast cancer are very low.
But Elena now worries that if she decides to have her ovaries removed – and TrumpCare becomes law — she will not be able to have this potentially life-saving surgery. If she has had a lapse in Medicaid coverage, her Medicaid expansion coverage will be gone. And because TrumpCare would end the ban against insurance companies denying coverage for people with pre-existing conditions, she may never be able to get insurance or surgery.
Mr. President, public schools and school children will be hurt by TrumpCare.
Schools are now are eligible to receive Medicaid funds for necessary medical services for children with disabilities. Schools are reimbursed for vision, hearing, and mental health screenings. These services help children get services early – so they can be ready to learn.
Right now, New Mexico schools are reimbursed $18 million dollars a year from Medicaid, but, under TrumpCare, states would not have to consider schools Medicaid eligible providers and the costs would be on the public schools.
The problem is that New Mexico public schools cannot take on these kinds of costs. And that might mean hundreds of school children each year will go without vision, hearing and mental health treatment because no one else will be able to provide them.
Dr. Anne Lynn McIlroy is Superintendent of the Loving Municipals Schools – a rural school district in Southeast New Mexico. Dr. McIlroy says that "Medicaid funding is vital to our continuum of care and service to the majority of our students. Often our school nurse is the only medical professional our students ever see."
Mr. President, New Mexico has one of the highest percent Native American population in the country – more than 10% of our residents. Even though many Native Americans receive health care through Indian Health Services, IHS has not always been able to provide needed care due to the lack of funding. Medicaid expansion has changed that, and changed it dramatically.
According to Dr. Valory Wangler, who works with the Zuni Pueblo, she says “Since the Affordable Care Act, patients in Zuni have access to specialist services that were once difficult to fund and often delayed or denied.”
An IHS physician working on the Zuni reservation had a patient with severe knee arthritis that was making it difficult for her to stay physically active and work at a local school. She needed knee replacement surgery. Before Medicaid expansion, IHS had trouble funding knee replacements, and the surgery was denied for years because IHS could only afford to pay for “life and loss of limb” services. But this patient is now on the Medicaid expansion. She was able to get a total knee replacement, is working fulltime, staying fit, and is no longer in pain.
One of the ACA’s most popular provisions is the protection from discrimination if you have a pre-existing condition. This is one of the most mystifying parts of TrumpCare. Republicans would end that protection by allowing states to waive out and set up high risk pools.
All of us know someone with a serious illness or condition.
Like Kitt here. Kitt is 4 1/2 years old and has Type I diabetes that will require life-long care. Her mother, Daena, is worried about TrumpCare. Daena says, “It breaks my heart that elected officials are leaning towards dropping the Federal mandate to guarantee affordable health insurance for those with pre-existing conditions. Sit down with a child that has an unbearable disease and be their warrior in DC to make everything possible for that special soul and their family to have an easier tomorrow.”
I hope we will all be those warriors to protect that health care program that has been put in place for them.
