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Schumer Floor Remarks on Trumpcare and the Need for a Comprehensive CBO Score

Washington, D.C. – U.S. Senator Chuck Schumer today delivered remarks on the Senate floor regarding the major steps backward Senate Republicans are taking by attempting to ram through Trumpcare once again. Below are his remarks:

There is a possibility that by the end of next week, the Senate will have a vote, again, on a Republican healthcare bill that was assembled in the dark of night, by one party, without a full account of what that bill would do. It would be shameful, shameful return to the same process that the Majority used to try to ram a bill through in July, unsuccessfully.

To consider a bill like this without a full CBO score is worse than negligent, it’s grossly irresponsible. We were told yesterday that the CBO may be able to provide a baseline estimate of the cost of the bill, but not the coverage numbers or a detailed analysis of how the bill would affect Americans’ health care choices.

Now Mr. President, we are talking about 1/6 of the economy; we are talking about the health care of the nation, we’re talking about the lives, day in and day out, of millions of Americans who need health care, and we’re not going to know what the legislation really does? Senators will be voting blind? You know they say justice is blind, but the Senators on the other side of the aisle should be walking around here with a blindfold over their eyes, because they don’t know what they’re voting on.  Maybe they don’t care. I don’t know how any Senator could go home to their constituents and explain why they voted for a major bill with major consequences to so many of their people without having specific answers about how it would impact their state.

What we do know is that this new Trumpcare bill, the Graham-Cassidy legislation, is worse in many ways than the previous versions of Trumpcare.

The new Trumpcare would devastate our healthcare system in five specific ways:

First, it would cause millions to lose coverage. Second, it would radically restructure and deeply cut Medicaid, ending the program as we know it. The dream of the hard right—get rid of Medicaid—could happen, even though that’s a program that affects the poor and so many in the middle class.  Nursing homes, opioid treatment, people who have kids who have serious illnesses. 

Third, it brings us back to the days when insurance companies could discriminate against people with pre-existing conditions.  The ban on discriminating against people with pre-existing conditions would be gone. We had a lot of promises from the other side.  ‘They’d never vote for a bill that didn’t protect people with pre-existing conditions.’  That seems to be going by the wayside, in a headlong rush to pass a bill so you could claim a political victory.  And what about that mom, or dad, who finds out his son, or her son/daughter, has cancer? The insurance company says ‘Yeah, we’ll cover you. It’ll cost you $50,000.’ They don’t have it, and they have to watch their child suffer.  This was an advance that almost all Americans supported. It’s an advance that most people on the other side of the aisle claimed to believe in. Gone.

Fourth, the bill gets rid of the consumer protections that guarantee Americans access to affordable maternity care, substance abuse treatment, prescription drugs.  All of those could be out of any plan. Pay a lot for a plan and not get much for it under this bill.

And fifth, it would throw the individual market into chaos immediately, increasing out-of-pocket costs for individual market consumers and resulting in 15 million people losing coverage next year.

On the first point –Trumpcare would cause millions to lose health insurance in two ways: first by undoing the Affordable Care Act’s major coverage expansion under Medicaid and premium and cost-sharing assistance, instead putting that into an inadequate and temporary block grant, and second, by radically restructuring and cutting the traditional Medicaid program through a per-capita cap.

We don’t have a CBO score yet, and may not get one in time, but previous CBO scores of similar schemes have shown that more that 30 million Americans could lose coverage under this bill. 30 million Americans, 10%, approximately, of our population.

On the second point – the new Trumpcare would end Medicaid as we know it by converting Medicaid’s current federal-state financial partnership to a per-capita cap, which cuts current Medicaid funding on an annual basis.

This is a direct blow to nursing home patients, folks in opioid treatments. And CBO has said that 15 million fewer people would receive Medicaid in similar proposals.

On the third point – the new Trumpcare actually brings back the ability for insurers to discriminate against folks with pre-existing conditions, as I mentioned.

Fourth – the new Trumpcare would no longer guarantee consumers affordable access to maternity care, substance abuse, and prescription.

And fifth – like the previous repeal and replace bills, it would immediately eliminate the individual mandate, which would raise the number of uninsured by 15 million relative to current law in 2018 and increase individual market premiums by 20 percent.

So, if you vote for this bill, right away, 15 million lose coverage, premiums go up by 20%.  People who vote for this bill are not going to be happy with its results. 

Mr. President, each one of these five things represents a major step backwards for our healthcare system. Bringing back discrimination against folks with pre-existing conditions? Ending Medicaid as we know it? These are overwhelmingly popular with Democrats, Independents, Republicans. The hard right doesn’t like it. The big financiers of the other party.

We’re going to go backward, backward.  We’re going to go backward and not even know exactly the effects.  I think the other side, why are they rushing this through? They’re ashamed of it.  They need to have that political scalp, ‘See? We abolished Obamacare!’ But what they’re putting in its place, even for those who don’t like Obamacare, is worse. They don’t want to know that. And the joy that they will have, misplaced joy in my opinion, of abolishing Obamacare will evaporate quite soon when their constituents feel the effects of this bill, and they hear about it from people, average folks, who are so hurt.

The Washington Post summed up Graham-Cassidy yesterday. They said the bill “[Graham-Cassidy] would slash health-care spending more deeply and would probably cover fewer people than the July bill — which failed because of concerns over those details.”

Republicans could not garner 50 votes for their various healthcare plans earlier this year because of how much damage those plans did to Medicaid; how they rolled back protections for pre-existing conditions. And some opposed because the process was such a sham. Well Mr. President, all three of those conditions are here again with this bill. Cuts to Medicaid. No guarantee of protections for pre-existing conditions. Sham of a process.

Now there is a better approach. Right now, Chairman Alexander and Ranking Member Murray are working in a bipartisan way – holding hearings, working through the committee, coming back and forth between the parties with discussions—each side’s going to have to give, that’s how it works around here, or should work—and trying to get a proposal that will improve things. That’s the kind of legislating many members of the Senate have said they want to get back to. That’s the kind of process worthy of the world’s greatest deliberative body.

But after a rancorous, divisive health care debate that took up the better part of this year, Democrats and Republicans were working, have been working, in good faith to come to a bipartisan agreement on healthcare in the HELP Committee. The Republican Majority will toss all of that progress away if they pursue Graham-Cassidy next week the way they’re pursuing it: returning to reconciliation, not working through the committees, no full CBO report, making a mockery of regular order.

Mr. President, I hope -- for their sake and for the country’s -- that my Republican friends turn back from this new Trumpcare, and join us again on the road of bipartisanship. We’ve seen bipartisan sprouts bloom in the last month.  Graham-Cassidy would snuff them out.  Nobody wants that, nobody.