Nelson's remarks on GOP health care bill

Sen. Bill Nelson took to the Senate floor today to urge his colleagues to think twice before supporting the “disastrous” Republican health care bill the House passed last week.
“We’re dealing with people’s lives here. We’re dealing with their health. The last thing in the world that we ought to be doing is cutting out the sources of funding to help people who are in such dire straits,” Nelson said. “I would urge our colleagues to think twice about supporting this disastrous Republican health care bill.”
Nelson specifically cited the more than $800 billion that the bill cuts from the federal Medicaid program and how those cuts would negatively affect Florida’s ability to combat the growing opioid epidemic.
“Last week, the Florida Medical Examiners Commission released new data showing that over 2,600 Floridians had died from opioids in just the first half of 2016 alone,” Nelson said.  “In 2015 alone, 167 babies were born in opioid dependency in just one city, Jacksonville,” Nelson added, citing a recently published report.   
As the single largest payer for substance abuse services, Medicaid plays a critical role in the fight against the opioid epidemic. Nelson sent a letter last week to the Acting Director of the Office of National Drug Control Policy urging him to make treatment more available to those addicted to opioids.
A copy of Nelson’s letter is available here.
Following is a rush transcript and here is a link to watch video of Nelson’s remarks: https://youtu.be/ZMZgtUZ1ve8

U.S. Sen. Bill Nelson
Remarks on the Senate Floor
May 8, 2017 
Sen. Nelson: Mr. President, I want to talk as well about the Republican health care plan and point out why it is moving on very treacherous territory when it will affect the funding of Medicaid by lessening the amount of Medicaid money that will be spent in the states because so much of that Medicaid money is going to address the opioid crisis and the opioid crisis we found last year – you know, there was a lot of talk about it being in New Hampshire when the eyes of America were on New Hampshire in the New Hampshire primary, but the fact is it’s in every state now, and it is particularly so in my state of Florida.
There are something like 2,600 deaths that have occurred in Florida as a result of opioid overdose. So the seriousness with which we ought to be addressing this issue ought to be of extreme concern and doing something about it, and yet a bill just passes the House of Representatives that is doing exactly the opposite, that is going to cut Medicaid.
It’s a fancy term, cut Medicaid with a block grant. What that means is it’s going to be capped. And that means that a state is not going to get any more Medicaid once that cap has been hit unless the state responds. So, in essence, it’s going to cost the states more money.
I don’t think that you will find many states that are in such a fiscal condition that in fact they could do that. And so what are we doing? We’re harming poor people and disabled who get their health care from Medicare – Medicaid — but in fact we’re not only harming all of them. There is a crisis among us, and that is the opioid crisis. And this is going to particularly hurt addressing that.
So what I want to talk about today is the Republican health care plan that passed out of the House last week. This plan is going to increase costs for older Americans. Remember, it’s going to go on a ratio instead of one to three — you can charge older Americans three times as much in health insurance as younger Americans — it’s going to go up to a ratio of at least one to five and maybe more.
So it’s going to increase cost for older Americans. It’s going to cut Medicaid, and it’s going to take health care coverage away from tens of millions of people. Right now, as a result of the ACA, there are 24 million people that have health insurance coverage that did not have it before this law was passed in 2010. It’s going to reverse that.
Now, do we want to take away health care from people that can now have health care through Medicaid and/or health insurance because they can now afford the health insurance? Is that really a goal that the United States want to do, is to take away that health care through private health insurance? I don’t think that’s what we want to do.
And yet that’s what the House of Representatives’ Republican health care bill has done.
So if we just look at my state of Florida, there are almost eight million people who have a so-called preexisting condition. This includes something as common as asthma. That’s a preexisting condition.
As a former elected insurance commissioner of Florida, I can tell you that some insurance companies would use as an excuse as a preexisting condition something as simple as a rash and say, because you have a preexisting condition, we are not going to insure you. Under the existing law, the Affordable Care Act, an insurance company can’t deny you with a preexisting condition. And just in my state alone, there are almost eight million people who have a preexisting condition. Are we going to turn them out on the streets because their insurance company says we’re not going to carry you anymore? I don’t think that’s what we want to do.
The bill allows insurers to charge older Americans at least five times more than what they charge younger adults. Is that what we want to do?
What is the principle of insurance? The principle of insurance is that you spread the risk. You get as many people in the pool as you can — young, old, sick, healthy — and you spread that risk.
So if you get fire insurance on your home, you’re paying a premium every month, and the insurance company has calculated in an actuarial calculation what it is going to cost you to insure that you don’t get that, but you are part of hundreds of thousands of people in that pool that are also insuring against fire damaging their house. It’s the same principle with health insurance.
So you get young and old, sick and well, and some people with preexisting conditions, and you spread that risk over a lot of people.
This — one of the fallacies we hear is they talk about, well, we can replace this by creating a high-risk pool. In other words, we’re going to set up some money for people who have really sick conditions, and we’re going to take care of them. That’s the most inefficient way to do it because insurance is about spreading risk, not concentrating risk, which is what a high-risk pool exactly is. So the ones down at the House of Representatives who have concocted this thing called the Republican health care plan, they have come up with exactly the opposite idea of funding, instead of spreading the risk, concentrating the risk, and then saying they’re going out an getting $8 billion and that’s going to pay for it. It’s not going to even touch it. But, again, it’s the most inefficient way to approach the subject of spreading risk because they don’t spread the risk, they concentrate the risk.
And what this bill does is over ten years it cuts over $800 billion out of Medicaid. You start doing that and we’re going to lose what we know Medicaid is: a program primarily for the poor, to give them health care, and the disabled.
By the way, isn’t it interesting that they cut over $800 billion to save it out of Medicaid and, oh, by the way, what do they do in the same bill? They give upwards of $600 million in tax breaks to those who are at the highest income levels.
So let me get this right. It’s kind of reverse Robin Hood. I’m going to take from the poor by cutting $800 billion and I’m going to going to give to the rich by tax breaks for the highest income folks. Is that what we want to do? I don’t think so.
Medicaid is a program that guarantees health care for millions of Americans, including children, people with disabilities, pregnant women, and seniors on long-term care. Now, think about that. Seniors on long-term care. What am I talking about? How about seniors in nursing homes? How about seniors that don’t have enough resources, assets in order to pay for their care in the twilight years and, therefore, they’re being paid for by Medicaid, and that’s the only source of income to take care of them? Is that what we want to cut in order to give a tax break for the highest income group? It ought to be the reverse. That is upside down thinking.
So last week the Florida Medical Examiners Commission released new data showing that over 2,600 Floridians had died from opioids in just the first half of 2016 alone. Over the entire year before, 2015, fentanyl killed — and that’s an opioid — killed 705 Floridians. And just in the first half of the next year, 2016, almost the exact same number, 704, in one half of the year died.
You see, we’ve got a problem in the state of Florida, and there are a lot of other states that have the same.
Last month I went to a research institute down in Palm Beach County. They’re using NIH grant money to research new, non-addictive opioid drugs. If they can come up with this that is certainly all to the better to help people with pain and it not be an addictive drug. But we’re not there yet, and we’re using NIH money that is going to that research.
And also last month I sent a letter to the Republican leadership pushing for more funding for the opioid fight and for the National Institutes of Health, NIH and, Mr. President, I would like to enter that letter in the record.
The Presiding Officer: Without objection.
Sen. Nelson: And so, what we need to do is take a comprehensive approach to helping our states and local governments respond to this opioid epidemic.
I was very happy to be a part of an early part of putting together and sponsoring a bill called the Comprehensive Addiction and Recovery Act of 2016 and the funding included in the 21st Century Cures Act to start putting more resources into our states right away for this opioid epidemic. And those laws have resulted in Florida receiving more than $27 million to help our state respond to the opioid crisis.
Yet a lot more action is needed, as you can see by just the first half of last year alone, 704 people died from opioid overdoses. Last week in Florida a local paper reported about how the opioid epidemic is affecting our nation’s children. In 2015 alone, 167 babies were born in opioid dependency in just one city, Jacksonville, contributing to Duval County being tapped as having the second-highest number of babies born addicted to opioids in the state. Isn’t that sad that children come into this world and they’re already addicted?
And so, Mr. President, we’re dealing with people’s lives here. We’re dealing with their health. The last thing in the world that we are ought to be doing is cutting out the sources of funding to help people who are in such dire straits. And I would urge our colleagues to think twice about supporting this disastrous Republican health care bill.
Mr. President, I yield the floor.