Mr. President, I’d like to talk today about the ongoing efforts by Senate Republicans to take away health insurance for millions of Americans by repealing the Affordable Care Act.  I was here on the floor just a couple of weeks ago reading letters from my constituents about how they have benefitted from the ACA and what Trumpcare would mean for them, based on what we had seen of their bill so far. 

Since then, my colleagues on the other side of the aisle have continued forging ahead in their effort to repeal the ACA, in spite of overwhelming opposition. Indeed, nearly every major health care organization, representing patients, doctors, nurses, and hospitals, among others, is opposed to this misguided effort. And that’s on top of the millions of Americans who know firsthand how devastating Trumpcare would be for them and their families.

Senate Republicans are working on tweaks to convince their colleagues to vote for this disastrous bill.  Unfortunately, their so-called “fixes” are not improvements.  That is because, in my view, Trumpcare is fatally flawed and cannot be fixed. My constituents know better and have continued to write and call me – even stopping me in the store and on the streets – to express their opposition and fear, quite frankly, of all versions of the Senate Trumpcare bill. 

For example, my Republican colleagues are looking to add a provision that would bring us back to the days when insurance companies could deny coverage or charge exorbitant amounts to those with pre-existing conditions.  The Affordable Care Act ended this practice once and for all and I can’t imagine why my colleagues would want to bring back those discriminatory policies.  However, the amendment that several senators have proposed would do just that.  They would allow insurance companies to sell plans on the marketplace with no protections for those with pre-existing conditions, which would create a death spiral in the marketplace so that the very people who need health insurance the most will be priced out entirely.

Just last week, I heard from Anne in North Smithfield, Rhode Island about this very issue. Anne said:

“I am the parent of a childhood cancer survivor. The last 11 months of my life have been fighting alongside my warrior, my hero, my 9-year-old osteosarcoma survivor, Julia. She loves unicorns, horses, the beach and going for walks. Due to no fault of her own, she hasn't been able to walk for the past 11 months. I am writing to ask for your support to ensure all children fighting cancer have access to affordable, quality health care. If enacted into law, the current proposal for the healthcare bill will have devastating impacts on the hundreds of thousands affected by childhood cancer. Without quality health insurance and access to treatment my child would not have survived.”

Anne went on to explain that the Republican efforts to undermine pre-existing conditions protections would be devastating for childhood cancer survivors.  Even parents who get their insurance through their employer would be at risk. Anne pointed out that nearly half of families of children with cancer will experience gaps in coverage because one or both parents often need to stop working or reduce their hours to care for the child.  Further, Trumpcare erodes other critical consumer protections like allowing annual and lifetime limits on care.  Anne continues:

“Additionally, childhood cancer patients must be assured of access to essential health benefits without the threat of lifetime or annual caps that would effectively price patients out of life-saving treatments. Two-thirds of childhood cancer survivors will develop serious health conditions from the toxicity of treatment. My child's future is already uncertain enough. We should not have to worry about annual or lifetime caps on coverage.”

I agree with Anne. What use is health care coverage that expires just when you need it the most?  Why would anyone think it makes sense to sell a health insurance policy for thousands of dollars that doesn’t actually cover anything when you need it to?  This is a step in the wrong direction and I continue to urge my Republican colleagues to reverse course.

I’d also like to talk about what this bill will do for those suffering from opioid addiction, a public health crisis that has taken a tremendous toll on our country, and in particular on my home state of Rhode Island.  I, along with many of my Democratic colleagues, have been talking about how the Senate Trumpcare bill would pull the rug out from many of those who are suffering from substance use disorders, like opioid addiction, by decimating Medicaid, which is how many people suffering from the opioid crisis access treatment.  News reports suggest that Republicans are considering adding a fund for opioid addiction treatment as another so-called fix to the Trumpcare bill.  While we absolutely need more federal funding to expand access to drug treatment – in fact, I have been urging Republican leaders to do just that for years – what they are proposing cannot make up for their bill’s nearly $800 billion in cuts to Medicaid with a $45 billion opioid fund.  The math simply doesn’t work. Second, short-term drug treatment programs do not provide a full spectrum of health care coverage, like Medicaid or other health insurance coverage. The Medicaid expansion under the ACA has provided the security of reliable health care coverage and long-term stability to help people with chronic conditions such as substance use disorders seek treatment and turn their lives around.  Trumpcare takes that away.  People with opioid addiction suffer from other mental health conditions at twice the rate of the general population and higher rates of physical health conditions as well.  We will be setting people up for failure if we provide drug treatment services, but cut access to the other mental and physical health care services they need.  An opioid fund alone will not solve this public health crisis and in fact, would be a drop in the bucket compared to how the rest of this bill would worsen the crisis.

The cuts to Medicaid under the Senate Trumpcare bill are beyond repair.  The Senate Trumpcare bill fundamentally changes the structure of the Medicaid program, making massive cuts, representing a 35 percent cut over the next two decades. Simply put, this will end Medicaid programs as we know it, which will hurt not only those suffering from the opioid crisis, but also seniors, children, and people with disabilities.  We may see Republicans try to spread out this harm over more years to hide the damage, but do not be fooled.  Whether they make massive cuts to Medicaid in 2021 or 2022 or even 2026 for that matter, the cuts will be devastating.

In short, no fix can undo the damage this bill will cause.  This bill is a massive tax break for the wealthiest Americans at the expense of everyone else.  No amendment or tweak to the bill will change that.  Sharon from Wakefield, Rhode Island wrote to me just a couple of days ago and summed this up very well.  She said:

“I do not support the so-called American Health Care Act because it is not a health care plan, it is a tax cut for the rich.  I am 67 years old and have a mild version of Muscular dystrophy and have Medicaid. Since the GOP want to end Medicaid, I am asking you to vote NO on the bill.”

Republicans must abandon this effort and come to the table to work with Democrats on a new path forward.  Let’s have productive conversations about how we can improve access to care and bring down costs.  Let’s harness this interest in improving access to drug treatment and work together on those efforts.  But coupled with the Trumpcare bill, those efforts will not mitigate the damage that this bill will inflict on my constituents and those across the country.  

I hope those on the other side of the aisle who have expressed misgivings will oppose Trumpcare in all of its forms so we can work together a on bipartisan solutions and attempt to do something positive for our constituents.