country mobilizing against trumpcare because healthcare is personal. i am encouraged that so many people have been calling all of us and making their voices heard. the majority leader and donald trump can try to jam this bill down our throats but we are not going to let them succeed and we are going to hold them accountable. the fight continues. i yield the floor. >> the democratic leader. >> i want to salute all of us in the senate, our great senator from hawaii, her courage, her strength, her conviction to help people who need help is inspiring. that is the only word i can think of. inspiring to every one of us. we can't wait for you to rejoin the fight, doubly invigorated. i yield the floor.

>> i would like to thank my friend and colleague senator hirono for her words and willingness to share how this bill, impacting millions of americans with preexisting conditions. i along with everyone else in this chamber wish her the best and speedy recovery, the people of hawaii and the people of the united states. after weeks of secret meeting senate republicans released their healthcare legislation last weekend in many ways it is even worse than expected. it is no wonder senate republicans kept this legislative malpractice hidden behind closed doors. for working families and the elderly, for the disabled, those

suffering opioid addiction, this legislation is a death sentence. this bill takes a machete to medicaid. it abandons people with preexisting conditions, punishes grandma and grandpa who live in a nursing home including 25,000 seniors, nursing homes who are on medicaid. it causes the single greatest rollback of civil rights for people with disability in a generation, by taking away the funding for those with disabilities. it creates an age test for those over the age of 50. it shreds a critical healthcare program for the disabled,

working families, children, just to bestow billions in tax breaks for the wealthiest. this is an amazing number. the richest 400 billionaires in the united states, a tax break of more than $33 billion which is roughly equivalent to the cuts for ending medicaid expansion in four states. there are 700,000 people in just those four states that can be kicked off of their health insurance coverage to benefit just 400 billionaires in america who do not have to worry about

their healthcare or family's welfare. for those who are going to lose the coverage, people with cancer, people with alzheimer's, people who need opioid addiction treatment, people with diabetes, have their coverage slashed, 400 billionaires to get a tax break which they don't need and don't deserve. that is at the heart of the republican healthcare bill. what it is all about. of the rich, by the rich, for the rich. it is a wealth care bill for the upper 1% in our country.

your healthcare is going to suffer in order to take care of that. with their tax breaks. more than $500 billion tax break to corporations and individuals making 200,000 or more. no wonder donald trump has kept his tax return secret because he knew he was about to get a massive tax break from slashing healthcare for people with cancer, diabetes, heart disease, substance disorders. this selfish senate republican legislation will increase premiums and out-of-pocket costs, decreasing quality of

health insurance coverage for most americans. this will result in many americans especially those over the age of 50 paying thousands more in premiums or skimpier health plans. it would put insurance companies in charge of our healthcare by allowing them to waive coverage of the essential, emergency care, prescription drugs, or mental health treatment. someone with a preexisting condition like a cancer survivor or a child with asthma may have insurance but might actually be covered for the treatment which is a need. under this bill the anxiety of

suffering, the constant fear, will be exacerbated by financial insecurity. yet some of the most damaging provisions of this legislation are the brutal cuts to medicaid which already serves 70 million americans. and all seniors in nursing homes, and let me say that again, two thirds of all seniors, on medicaid and half of all seniors over the age of 85 has alzheimer's and 15 million baby boomers are going to have

alzheimer's. they are going to need some help. people have a hard time saying 60, 80, $100,000 a year i nursing home vets, whether they doing over the next 15 or 20 years? slashing that funding and medicaid for seniors in our country who will stay in a nursing home. going home to their families. they double down and opted for steeper cuts in their bill in the house version, in three years the senate bill will stop the process of kicking millions off of their medicaid coverage by ending medicaid expansion in states around the country. it will mean 22 million americans are kicked off of

coverage. in 2025, will institute more drastic medicaid cuts that every year become a deeper cut than the year before and it will literally mean death by 1 billion cuts or millions of americans who will lose their healthcare coverage. medicaid covers one third of americans with opioid use disorder. and a death sentence for thousands, it is a hallucination, the republicans are saying they will find the

will to take care of these people with opioid treatments. you can't will your way to dealing with an opioid crisis. it is a disease, millions of americans don't have the treatment they need. medicaid is the way, republicans are just going to/it and the consequences are going to be catastrophic. here is what republicans are saying, to make up for the cuts to medicaid senate republican healthcare legislation creates an opioid fund of $2 billion for 2018. compare that to the $91 billion in funding for opioid use disorder treatment, provided by

the affordable care act over the next we 10 years. the opioid fund is pocket change for a crisis that took 2000 lives in massachusetts, 33,000 lives across the country and if people were dying from opioid addiction at the same rate they were dying in massachusetts, that would be $100 in people a year, two vietnam war a year dying from opioid addiction, they are going to cut the funding for treatment for these families. it will be a death sentence for these individuals if they do not have access to the funding. so the formula of this bill is simple. first, increase the cost of care so working families pay more. second, decrease the quality of care for seniors and the sick. and finally, hand over hundreds

of billions of dollars in tax breaks to the wealthiest people in our country. billions in tax breaks to people who don't need some, who don't deserve them, paid for by people who can't afford it, healthcare heartlessness. to add insult to injury, it will devastate already strapped state budgets which may be forced to raise taxes or cut other benefits like education or housing assistance to make up for the billions of dollars states will lose because of this bill. it is cruel, it is inhumane, it is immoral, it is just plain wrong. to cut the healthcare benefits for those who needed to give tax breaks to those who do not need it. that is the republican plan. republican leadership is trying to catch a political unicorn with this bill, to make moderate

republicans happy while satisfying the most conservative elements of the republican party but there is no treatment for trumpcare. it is dangerous for healthcare and there is no reviving medicaid if this bill passes. this republican proposal has never been about policy. it isn't about covering more people or decreasing costs of healthcare or making it more patient centered is the republican proposal has always been about cutting healthcare for ordinary americans to give a massive tax break to the wealthy in our country. that is the republican policy agenda, not patient centered care because this will hand the power to insurance companies in our country, not patients.

if republicans were really concerned about reducing the deficit, then every single dollar in this bill would go to reducing the deficit. the crocodile tears which they said about the deficit. no, ladies and gentlemen, they are shoving this money straight to the biggest number of billionaire beneficiaries than any tax bill in history. they are the party of the wealthy. they are the party trying to make sure that those who are in charge of funding the republican party now receive their payback in the form of tax cut at the expense of the healthcare for ordinary people in our country. that is selfish, that is unconscionable and that is why the democrats are going to fight this every step of the way this week in order to protect the health care for every american.

i yield the balance of my time. >> mister president. >> senator from vermont. >> today's congressional budget office analysis of the trump mcconnell healthcare bill gives us 22 million reasons why this legislation should not see the heart of day. it tells us in truth that this bill really has nothing to do with healthcare. rather, it is an enormous transfer of wealth from the sick, the elderly, the children, the disabled and the poor into the pockets of the wealthiest people in this country. according to cbo, the report just came out a few hours ago,

this bill would throw 22 million americans off of health insurance, cut medicaid by $770 billion, defund planned parenthood and substantially increase premiums for older americans. under this bill, a 64-year-old with an income of $60,000 could see his or her premiums increase from $4400 under current law to $16,000, an increase of nearly 800 - 850%. how are older workers in this country going to deal with an 850% increase in their premiums? meanwhile the trump/mcconnell

bill would provide a $231 billion tax break to the top 2%, hundreds of billions more in tax breaks to the big drug companies and insurance companies that are ripping off the american people every day. at a time when the middle class of this country continues to shrink and families all across america are struggling to make ends meat, put food on the table, pay their rent, save a few bucks for retirement, we cannot take from working-class families, we cannot take from the sick and elderly and children in order to get even more for the very wealthiest people in this country, people who are at this moment doing phenomenally well. mister president, this, in fact,

is a barbaric and immoral piece of legislation but let's be very clear. this is not just bernie sanders who opposes this bill. this is not just every member in the democratic caucus that oppose this bill, this is not just the overwhelming majority of the american people oppose this legislation according to a recent wall street journal, 16% of the american people thought that this bill was a good idea. this bill is opposed by virtually every major healthcare organization in this country. the people on the front lines, the people who today, yesterday and tomorrow are dealing with healthcare, dealing with the sick, working in hospitals, community health care centers

and almost without exception, every major healthcare organization in this country opposes this bill and maybe my republican friends might ask themselves to get beyond the politics of this, get beyond republicans and democrats, ask people who know about healthcare in america and ask yourself how does it happens that virtually every major healthcare organization in this country opposes this legislation. this is the aarp that opposes this legislation, largest senior group in america who knows what high premiums for health care will do to their membership. this is the american hospital association. they know a little bit about hospitals and what will happen to rural hospitals if this legislation is passed. this is the american medical association, the american

medical association is a conservative organization. it is not a progressive radical group, these are our doctors. they oppose this legislation because they know what happens if there are massive cuts to medicaid for 22 million people thrown off of health insurance. it is the american academy of family physicians, the american academy of pediatrics who know what this will mean for the children of our country, the american psychiatric association, the federation of american hospitals, the american lung association, the cystic fibrosis foundation, the american nurse's association. every one of these organizations opposes the republican legislation. not bernie sanders but every

major healthcare organization says do not go forward with this disastrous bill. this is what the aarp said recently the senate but was crafted in secrecy behind closed doors without a single hearing or open debate and it shows. the senate bill will hit millions of americans with higher costs and result in less coverage for them. aarp is adamantly opposed, it would allow insurance companies to charge older americans 5 times more for coverage than everyone else while reducing tax credits that make insurance more affordable. i ask all of my republican friends to think for a moment about the implications of this bill and what it means to your constituents when they lose the currently have.

put yourself in their place. today you have health insurance but tomorrow, next year, what does that mean? think about it. what does it mean if you are in individual today, sadly their too many of them, suffering with cancer, fighting for your life, maybe under radiation treatment, under chemotherapy, you are scared to death, you have cancer, you are struggling, now you read in the papers that this republican bill may take away your health insurance from you. how do you think you feel? i suspect scared to death. the same with people with heart disease, asthma, diabetes or any other life-threatening illness. what happens to those people, millions of those people when they cannot afford to go to the doctor, when they are sick, cannot afford to buy the

medicine they desperately need. and mister president, i know this is a sensitive issue, the horrible and unspeakable truth is if this legislation were to pass, i will do everything to see that it doesn't, if it were to pass, many thousands of our fellow americans every single year will die and many more will suffer and become much sicker than they should. that is not bernie sanders talking. that is exactly what a number of studies have shown. study after study including one from the american journal of public health to the new england journal of medicine to the harvard school of public health, this is not bernie sanders engaging in a rhetorical debate. this is what scientists and

doctors are telling us. this afternoon a few hours ago, the annals of internal medicine, a prestigious medical journal published an article from researchers at the city university of new york school of urban public health and harvard medical school, quote, the relationship of health insurance and mortality is lack of insurance, deadly, that was the title of the article appearing today. according to a summary of this article, quote, insurance decreases the odds of dying among adults by at least 3% and is much is 29% and, quote, being uninsured substantially raises the risk of dying. the co-author of this article commented according to the cbo you senate republicans plan would strip coverage from 22 million americans.

the best estimate based on scientific study is 29,000 americans would die each year as a result. i know that no republican wants to see anybody die, none of us do but that is the reality we are given because you cannot ignore it. if somebody has cancer, if somebody has heart disease and you take away their health insurance i don't need studies from harvard university to tell you what is the case. this is the united states of america and we can do better than that and i ask unanimous consent the article that appeared today in the annals of internal medicine be submitted to the record. >> without objection. >> this issue is not just about healthcare. this is a profound moral debate

defining who we are as a people today and who we want to be as a people in the future. mister president, a great nation is not simply one judged by how many millionaires and billionaires we have and by how many tax breaks we can give to billionaires. it is judged by how we treat the weakest and the most vulnerable among us. those who don't contribute hundreds of thousands of dollars, a great nation is judged by how we treat the children, people who have disability, that is what a great nation is. this legislation is not worthy of a great nation. this must be defeated, i yield

the floor. >> senator from washington. >> i come to the floor to join my colleagues, you can see numerous colleagues on the side of the aisle who are speaking, as my colleague from vermont just did, my colleague from massachusetts, great passion, i am sure my colleague from minnesota, we have all been home for the weekend talking to our constituents. we have been back here with cbo news and we are here because we are very concerned about the next step the senate might take in this healthcare debate. when i was at home, i heard unbelievable positive stories about healthcare. i was at a hospital in our state, virginia mason, one of the leaders in reducing healthcare costs for new efficiencies, they improved return time of getting lab results for patients 85%, they

have increased productivity 90%, they reduced liability insurance charges by 76%. they have innovated, they have innovated, they have talked about the direction health insurance should go and not once did they mention cutting or attaining medicaid as the solution. i also talked to a community health clinic who, under the affordable care act, was able to expand in the community, literally cut in half the uninsured. ..al access to a population of 46,000 people in that county that don't have access to dental care. so they're making great progress. i talked to a veteran who had served our country, who literally got out and is now going to school, but without the help of medicaid will not be able to cover her health care expenses. i met a woman just on the street

i met a woman just on the street told me her husband had lost his job. she never thought it would be unmedicated but when he lost his job and were unmedicated and they depended on that to provide health care for them and their children. and i met a gentleman who also said he, too, lost his job and then, then after that came down with a serious threat, life-threatening illness. and it was only medicaid that saved him. so what do we know today that is different than last friday? now we had some cbo numbers. we know the numbers. we know the numbers that 22 million americans after the result of this if it passed will be undeterred, 15 million unmedicated, 772 billion in medicaid cuts. we know that we thought it was heartless and now we see the numbers that say cutting that

many people off of medicaid is,, in my opinion, as my colleagues have also said, not something that we should be pursuing as al nation.ust and it leads us to ask about not just the impact of this on individuals as i just mentioned, because i believe there's a much better way to go with innovati innovation. but what it also does for the individual market. a lot of this debate started because people thought the individual market had not seen some of the benefits it why not talk about the individual markets? why it 7% of health care delivery the individual market was having a problem why not talk about ideas to improve the individual market? t instead we have a bill from the house and the senate that beats up on the medicaid population as if they are the culprit.d if you want to improve medicaid and delivery services and help decrease costs, let's do that. there are so many innovative

ideas. by just cutting people off of medicaid to solve the individual market problems just doesn't m even make sense to me. we now have as of last friday, the central budget policy and priorities assessment talking about how this would raise annual premiums in the individual market. and they gave some various examples.ir for example, in west virginia, and nevada, a six-year-old with an an income of $36,000 wouldere pay five, 4000 morse and what they were paying now pick or in alaska a 60 of making $45,000 would pay $5777 more than whatre they are paying now forn dr so the notion that this is driving down costs is just a fallacy. we've heard from republican governors and democratic governors together talking about

this. they sent us a letter saying the first thing we should do is focus on improving our nation's private health insurance system. where did the governors ask thai you come and beat up onase medicaid? he didn't say that that they didn't say please beat up on medicaid, have a big party in covering people on medicaid as r partner for us for 65 years and then leave the stuck with half the bill. they didn't say that. they basically say quote medicaid provisions included in this bill are problematic.ec instead we recommend congress focus on addressing factors we can all agree need fixing, end quote. that's a pretty clear message id from republican governors who are saying this is not the way to fix health care. also last week a nonpartisan study by the george washington university found that the

house-passed bill basically would have a huge economic impact on our country. states economies would shrink by 93 billion compared to where we are today. business output would be cut 148 billion. the study notes that it would combine with normal economic cycles and quote could contribute to a period of economic and medical hardship in the united states, end quote. that report also talks about job loss throughout the country saying that we could lose more than 1 billion in gross products in individual states just because of the number of people who would not be covered, the number of health care providers that would no longer be there, the infrastructure and bee and e impact on the health care system overall of uncompensated care. these are costs we can't afford. and as my colleague senator sanders mentioned, there are all

of these health care institutions that have now come out saying they don't support the senate drafted bill. the academy of family physicians, they know more, they are seeing so more patience. they know what this challenge is the american psychological association doesn't support thia bill. other health care associates, the catholic health association doesn't support this bill. mr. president, i have a list so long i think i would just enter into the record of all the health care related organizations and others that don't support this legislation. >> without objection. >> mr. president, i hope my colleagues understand that there are those here that are very willing to talk about how we improve our system, but we're not going to make poor americans the scapegoat of our health care

challenges. m in a gentleman named joe baker, president of the medicare rights center i think said it best. he said quote, you are someone -- you or someone you love is going to need medicaid. you may not need the nursing home care, but you may rely on community-based services like home care, that will allow you to stay in your home and stay out of a nursing facility.di medicaid is a lifeline that covers many of the benefits that medicare does not provide. why did i read that? why did i pick that, i guy who is the head of the medicare organization? because he knows what his individual organization participants meet in the health care delivery system. everybody knows, everybody knows, america is living longer

and as they age, need more health care. and to our colleagues a lot to reduce those costs, we are ready. we are ready to talk about how we can reduce those costs. i have talked about how i've authored community-based health care that has helped our states save $2 billion. and if we did that in every state we would be saving billions of dollars. t but i notion that we're going to proceed and next 24 hours or so on a motion after we have a cbo report that says this is a devastating impact on millions of people with medicaid is not the right way to go. taking this out on the poor people of america who need medicaid will make it worse for us as well. it will raise rates, return the cost to where they are and not

help us solve this problem for the future. so i hope our colleagues will po understand that so many people raising so many concerns about this, yes, they are about economics but they are also about personal stories of people, just like our colleagues from hawaii who said you never know, you never know when an individual situation is going to affect you, and you want to make sure that there's health care tc help you get to that crisis. i think the president. i yielded the floor.

>> mr. president? >> the senator from minnesota thank you, mr. president. i rise to talk about the effort to repeal and replace the affordable care act. before i begin i want to thank senator hirono for sharing her story and for leading us all here in this discussion tonight. i also want to thank the presiding officer who has been e listening. and i appreciate that. i really do. in recent days we have finally gotten to see the plan that 13 republicans, senators come have been working on and behind closed doors. you know, i really thought the

senate bill would be better. i thought it would be better than the house, the version that was passed, even senator burr said of the house bill, that it was quote that on arrival unquote in the senate. but, unfortunately, the senate plan is just, just as bad. the nonpartisan congressionalt budget office announced just today that under the senate plan 22 million more americans would be uninsured. that has consequences. perhaps worst of all, the bill and partly because this is, this causes of the reduction in the number of americans who would be

covered. the bill instant medicaid expansion. and cuts the funding for the medicaid program by nearly $800 billion. a program that is been a vital part of our social fabric since 1965. this bill, and i don't like to say this but it is mean. ththe president said that of the house bill. i don't like to characterize something that way. but it is mean and would have far-reaching effects for millions of americans across the country. this past weekend i hosted a health care forum in burnsville. minnesota. it's a suburb south ofthe twin

minneapolis, of the twin cities. it was on the importance of medicaid and how the republican plans cuts, these devastatingta cuts would affect minnesotans. over 230 people showed up to share their stories about howha medicaid change their lives, and it was very moving. take, for example, and i think it's really important to tell this in terms of not in numbers, and the numbers are pretty stark, but in terms of people. this one story, brandon and his mom spoke, brandon and sherry. they are both from burnsville. now, brandon here was born 15

weeks premature. he weighed just one pound 13 1/2 ounces. he. he was so small that his parents wedding ring could slide on his arm. he was also born with cerebral palsy and hydrocephalus, which is a condition that causes fluid to collect in his brain, in brandon brain, which result in brain damage. brandon is now 17, and he got up at the event with a walker. he and he told about, he was taken immediately to mayo clinic in rochester. he was born in the twin cities.

mayo said his case was too complicated to handle, so they sent him back to the twin cities to gillette which is a children's hospital, a great children's hospital, a great children's hospital.f within 24 hours of his birth, the hospital told brandon said parents that his costs were already over a million dollars. a terrifying addendum to what must have been a harrowing, harrowing experience. over the years brandon hasgeries needed 38 surgeries, surgeriesns to reduce the fluid in his brain. he has a shunt. surgeries to straighten out his legs, i surgeries, and more.

he is also needed physical therapy, extensive physicalpeech therapy, occupational therapy, speech therapy. and across his lifetime he has needed other interventions to help them do basic tasks like eat, and now walk. he couldn't turn over. he couldn't do the things that babies do, that we parents and grandparents relish in every day. but guess what. he's thriving. in fact, he just passed his first college course at dakota county technical college. he probably told the of the rest of us that he got an a. at at gillette, at the gillette children's hospital, the very

place that provided him with a unique and high-quality care that he has needed over the years. but all this has been possible because brandon and his family were able to get health insurance through medicaid. sherry, randy's mom said quote, if we didn't have medicaid, tranten probably wouldn't be here, meaning at our forum -- brandon. he wouldn't be doing as well as he is doing, end quote. brandon simila semler noted thae kids with special needs are referred to as special needs. i like to think i'm pretty t special here i also like to think our needs are also special, depending on the kind of care we need, and that's what medicaid provides, end quote.

i really believe that all of us here tonight must do all that we can to protect kids, these kids, and protect their families and anyone who relies on medicaid. and i sincerely believe that that means we have to defeat this bill. defea now, my colleague, senator hirono, stated last week that, quote, we are all one diagnoses away from a serious illness, end quote. and that's the case. you know what else we also just one accident away from a life-changing injury. another minnesotan, deborah, shared her story with my office she described to me a car crash and subsequent traumatic brain injury that she survived in 2012 it she explained to me quote, it

was just another day. i was on my way to work. i lost control of my suv after sliding on a patch of ice, and slammed into a concrete median, end quote.t her whole life changed at the moment. she had to learn, relearn basic tasks, reading and walking, talking and eating. se because of the home and community-based services that she is able to receive through medicaid. and she said quote, without the services funded by medicaid michael for returning to paid employment would be impossible. i honestly worry that proposed changes to the medicaid program could significantly diminish my overall health outcomes. and even leave me facing long-term homelessness, unquote.

as my colleagues and people at home watching this debate well know, this week could prove to be an extremely consequential week in the history of this country. the decisions that we make, the 100 of us, over the next few days could literally mean life or death for many americans. lives are on the line. tomorrow i will give a speech that's more about the data, and we've heard about some of that, but there is a study in "the new england journal of medicine" that came out this week that says that medicaid, having insurance, improves peoples

lives, and that for every 800 -- 300-800 -- this is a precise -- lose h lose health care, would lose medicare, there will be a death, a premature death. this is a study i would really like all my colleagues, it's going to be sunrise in the new yorker an article by a tool to want -- that the effect of this, having insurance does it mean, this isn't about dramaticis emergencies. this is about especially things like diabetes and heart illness and cancer, the day-to-day, h having access because you have

insurance to care improves the health of people. and it extends mortality. this is real stuff. this is really serious what we are doing. i strongly urge my republican colleagues to talk with their constituents about the bill that was drafted, and again, it was behind closed doors, and many of my colleagues have not, my republican colleagues didn't even see it until last week. i urge them to talk to the constituents about the consequences this bill would have for seniors, for children and parents who have medicaid wo coverage.

talk to the people who would seo their health care costs rise. talk to families who may lose, lose their health insurance. people are afraid. i am cochair of the rural health caucus. i go all around my state. rur i talk to roundtables, at rural hospitals, nursing homes. these are parts of my state that voted for donald trump. donald trump said during the campaign he would not cut are medicaid. these are people who are scared. whose elderly parents stay home because medicaid pays for their home health care, and they areo

afraid because that will go away, and both she and her husband, this is a woman in minnesota, they both work and they don't know what they will do. please listen to your constituents. you need to do the right thing. vote no on this bill for their sake, for the sake of your constituents. thank you, mr. president. i yield the floor. s >> proud to stand with my colleagues, and hope that i will be proud at the end of this week, of all of my colleagues, when we vote to defeat this measure, or at least delay it. because we owe the american people the right to be