Mr. Chairman, I am disappointed we are here today to consider legislation that reflects not only bad policy, but bad process. And a number of important groups agree: AARP, AMA and AHA all oppose this bill. This bill suffers from an identity crisis. Is this a health care bill or a tax cut bill?
Does it lower costs? No.
Does it bend the cost curve? No.
Does it cover more Americans? No.
Does it cut the deficit? No.
Even the President wants more information-earlier this year he called it an “unbelievably complex subject. Nobody knew healthcare could be so complicated." This Republican bill--- which they cleverly broke up into separate parts to try to distract the American public -fails to protect 152 million Americans with pre-existing conditions and would allow insurers to charge older people five times as much as younger people, essentially implementing an “age tax". It forces millions to pay more for less care.
Transparency is clearly lacking in this process. As recently as last week, I called upon House Republicans to provide an open and transparent process when they consider any health care legislation aimed at repealing or replacing the Affordable Care Act. The goal: to ensure all Americans had the opportunity to fully understand and consider how any Republican health care plan could impact them. Instead, the Republicans hid a draft bill somewhere in the basement of the Capitol with armed police officers. That is as far as you can get from transparency. The American public deserve better from their representatives. Also to consider a bill of this magnitude without a CBO score is not only puzzling and concerning, but also irresponsible. When the Democrats created the Affordable Care Act, it was a thoroughly transparent and open process. Let’s look at the numbers:
In the House
* 79 bipartisan health insurance reform hearings and markups over 2 years
* 100 hours in hearings
* 181 witnesses from both sides of the aisle
* 239 Republican and Democrat amendments-121 were accepted
* 30 days of online review of the original House bill before the first markup
* 72 hours-number of hours the House bill was online for review before final vote
* 3,000 health care town halls and public events
In the Senate
* 53 health insurance reform hearings in the Senate Finance Committee
* 8 days of markups with 135 amendments considered in Senate Finance Committee
* 47 bipartisan hearings and other open dialogues with 300 amendments during a 13 day markup in the Senate HELP Committee
* 25 consecutive days in session to discuss health reform in the Senate
* 160 hours total in the Senate considering health reform legislation
* 147 Republican amendments in the final Senate bill
This bill sabotages the Marketplaces where close to 10 million Americans today get coverage and starts a death spiral from which we will never recover. Healthy people won’t bother with coverage or only buy bare bones policies. Sick people who need coverage would buy policies - if they are even available - that will undoubtedly become more and more expensive and unaffordable, especially in light of the inadequate tax credits.
The most egregious part of the Republican plan slashes Medicaid funding to pay for tax cuts that benefit the rich. Medicaid helps pay the costs for more than 60% of all nursing home residents nationwide, and helps families afford quality nursing home care for their elderly parents and family members with disabilities. The Republican Medicaid proposal makes it harder and much costlier for families to find long-term care for elderly parents or children with severe disabilities.
In addition, it would end the Medicaid expansion-a move that would have devastating consequences in my state of Massachusetts where it has been a critical tool for thousands of individuals and families with loved ones in long-term care facilities or who have dementia. It also provides rehabilitation options for individuals and families in the grips of opioid addiction. The reality is that Medicaid is now a middle-class benefit.
The measure also would cut the span of Medicare by two years at a time when millions of baby boomers are joining and will rely heavily on this critical program. It’s a $170 billion tax giveaway to the wealthy, while starving the Medicare trust fund.
Hospitals would face crippling debt as they face increased uncompensated care and lower reimbursement rates. In turn, this would lead to job loss in many hospitals and have a negative ripple effect in communities where hospitals are the largest employer. For example, in Western Massachusetts, Baystate Healthy provides 12,000 jobs and has a $4 billion statewide economic impact.
Let’s call this bill what it is: a plan that creates chaos in the insurance market that directly impacts patients and providers, hurts hospitals, the communities they serve and their regional economies.
Before concluding, I would like to note that today’s markup is really the Republican’s first step on tax reform. This legislation is a tax bill; almost every provision amends the Internal Revenue Code. So, we need to view this bill through the lens of tax reform as well. And through that lens, the bill fails the test set out by Secretary Mnuchin for tax reform that, “there will be no absolute tax cut for the upper class." The Republican bill absolutely provides a tax cut for the wealthy and health care industry of almost $600 billion dollars. In fact, it has been estimated that 400 households with the highest-income would receive tax cuts averaging about $7 million apiece each year. At the same time, the bill hurts the middle-class through less generous tax credits, cuts to Medicaid and higher premiums with less quality care.
Bottom line: this is ultimately about affordability. If Republicans take away critical coverage benefits in the ACA coupled with hurting the middle-class, it would drastically increase costs and lower coverage and quality care. As the Republicans have heard loud and clear during town halls, people are afraid of losing their health insurance. It would be irresponsible for Republicans to take away health care programs on which their constituents across a broad age and economic spectrum depend.
