Following is a statement from U.S. Sen. Bill Nelson (D-FL) on the revised Republican health care bill released today:
“This latest Republican health care bill is just as bad as the previous versions. It makes huge cuts to Medicaid, allows insurance companies to hike rates for older Americans and will take coverage away from millions of people. We need to be working together to improve our nation’s health care system, not make it worse. If approved, this bill will hurt a lot of Floridians and for that reason alone, I will oppose it.”
GOP health care bill
Sen. Bill Nelson's remarks on GOP health care bill
Sen. Bill Nelson took to the Senate floor this evening to discuss Republicans’ efforts to negotiate a health care bill behind closed doors.
“I would just merely pose the question,” Nelson said, “why is it being done in secret if it is to be something that is to help the American people more than what the existing law is? Why wouldn’t that be something that you would want to expose to the light of day?”
Nelson urged his colleagues to focus on working together to fix the existing health care law instead of working in secret to repeal it outright.
“Last week, I filed a bill with a number of other senators that would lower health care premiums for people in Florida by up to 13%,” Nelson continued. “It’s not the ultimate solution to solving the health care system, but it’s one small step in the right direction to making health insurance available and affordable for the people who need it most.”
“If you’re going to fix the health care system, you’re going to have to do it together in a bipartisan way, building consensus,” Nelson told his colleagues. “Let’s work together to make health care more affordable for people and stop all of this stuff behind the closed doors. The American people deserve better.”
Below is a rush transcript of Nelson’s remarks. Click here for a video of his speech.
U.S. Sen. Bill Nelson
Remarks on the Senate Floor
June 20, 2017
Sen. Nelson: Mr. President, I wanted to speak about what is going on here in this capitol at this moment. It’s been the subject of a lot of discussion last night and again as we have been in session today. And that is trying to hatch a plan to overturn the Affordable Care Act and to find something that would replace it. And in fact it’s being done in secret.
And I would just merely pose the question: why is it being done in secret if it is to be something that is to help the American people more than what the existing law is? Why wouldn’t that be something that you would want to expose to the light of day? And if it is to improve the existing law, why in the world would that not want to be done in a bipartisan basis?
And yet, we find ourselves confronting a situation where the majority leader has said he’s trying to cobble together 50 votes to overturn the existing law. And it must be something that is not very palatable in what it is to overturn, the existing law. Otherwise it would be done in the open and in the sunshine.
Now, the existing law is not perfect. So we ought to improve it. But the existing law, as we have heard in some of these dramatic town hall meetings, is the reason that some people are alive today. It’s the reason why some folks no longer have to worry about being denied coverage for a preexisting condition.
And, by the way, that requirement of not allowing an insurance company to deny you coverage because you have a preexisting condition is not applicable just to those that are on the state and federal exchanges. That’s applicable to all insurance policies. And so if you have that kind of condition which I can tell you might be a reason of asthma. And we’re not going to insure you for the rest of your life because you had asthma. Or if you want to go to the extreme — and it has been done — an insurance company saying I’m not going to insure you because you have had a rash. Or, you know, the flip side of that is insurance companies put a lifetime limit on you. So if they pay out up to a certain amount, let’s say, $50,000, the insurance policy stops.
No more payouts, not according to the existing law. The existing law, they can’t say you’re going to lose your coverage because you hit that cap of a lifetime limit that their payout is.
So, Mr. President, every day I hear from Floridians who tell me how the House-passed bill would affect them and what we speculate, since we don’t know that the Senate bill that is attempting to be brought out at the last minute next week, what we suspect is going to be in it. And every day I hear from people.
So take, for example, the lady from Sebring, Florida, Christine Gregory. She’s allowed me to use her name. “My daughter has juvenile diabetes. She was diagnosed at age 15. When the Affordable Care Act was signed into law” — and I’m continuing her quote – “I absolutely rejoiced about the end of the horrible things that had come along with having a preexisting condition. She no longer had to worry about cancellation of her insurance, waiting periods, denial of coverage, annual or lifetime limits, higher premiums, and the dreaded high-risk pools.” Then she continues to write, “Fast forward to 2017. All the fear and the worry are back. Our president and Congress plan to repeal and replace the affordable care act. Now she has the very real prospect of having to enter a very expensive high-risk pool. That could mean bankruptcy for us and denial of the needed medicines and care.
Or take, for example, here’s an unnamed constituent from Florida’s panhandle. Wrote me — and I got this today – “I have chronic and persistent illnesses that would be debilitating without affordable and comprehensive care. I have chronic back pain from degenerative disk disease in every part of my spine. I’ve had innumerable procedures to help manage the pain, including epidural and targeted nerve block injections at multiple levels.” And this unnamed individual, a constituent of mine, continues, “I am now planning to get radio frequency ablations of the nerves using pre-ACA rules,” before the existing law. “I would have hit my lifetime limit at least a year ago and been able to continue getting pain-managing treatment. I often feel like I’m a burden to my wife, who is one of the most understanding and supportive people I know. And he concludes, “if the ACHA,” which is the House-passed bill, “passes, and our insurance and total health costs go up significantly, the burden I feel I am right now, that burden will become a reality. Please, I deserve more than to suffer from uncontrollable pain. And my wife deserves more than to have to care for me in that condition.”
So the existing law is not perfect, but it’s given millions of people, including those with preexisting conditions, like juvenile diabetes, access to health care they otherwise would not receive. This health care bill that passed the House that is being the model for apparently something of taking it out of that if they’re ever going to get an agreement between the two houses. That Republican health care bill will take us back to the days when it was nearly impossible for people with a preexisting condition to get health insurance coverage.
People with asthma, they could be forced to pay more than $4,000 more because of that preexisting condition. People with rheumatoid arthritis could be forced to pay up to $26,000, and people who are pregnant could pay more and more and more.
Let me tell you about another constituent from Volusia County who shared how repeal of this would affect her. “My husband,” she writes, “a 50-year-old leukemia survivor would lose his ability to obtain comprehensive health insurance due to the lack of protections for people with preexisting conditions. My daughter who has asthma and rheumatoid arthritis would lose her ability to obtain comprehensive health insurance due to the lack of protections for people with preexisting conditions. Our family, all hardworking, tax-paying Americans will once again be subjected to annual and lifetime limits which could easily bankrupt us. My daughter who is a young woman just starting her career would lose her ability to purchase affordable health insurance and receive tax subsidies that she currently receives under the ACA” and she goes on to say that she’s afraid that it would regulate them if you change all of that to second class citizens.
Why am I saying about what was passed at the other end of this hallway down in the House of Representatives about preexisting conditions? And they say no, no, preexisting conditions are not eliminated down there. That doesn’t tell you the whole story. The whole story is that in the House-passed bill, it’s left up to the states and the states see that as a way of so-called lowering their premiums. But if you start doing that for some and don’t keep that spread over the millions and millions of people that are now under the protection of the preexisting conditions, it’s going to become a select few more, and it’s going to spike the cost of that insurance.
And so I will just conclude by telling you another part of what happened down there in the House. In effect, they changed Medicare as we know it by cutting out over $800 billion out of Medicaid over a ten-year period. So Donna Krajewski from Sebastian, Florida, wrote to me recently to tell what Medicaid is to her family. Quote, “I am writing this letter on behalf of my son who has Down Syndrome. The blocks, “which is the technical term that they’re using in the House of Representatives, in other words capping Medicaid to each of the states, “will cause states to strip critical supports that my son needs to live and to try to learn and work in the community with Down Syndrome. These Medicaid funds have enabled him to participate in an adult supervised day program and transportation to and from the site. This program involves classes, such as daily living skills, social skills, and daily life skills. He’s also able to go out once or twice a week to socialize. He has become more confident and happy.” That’s from a lady in Sebastian, Florida.
Mr. President, we need to find ways to improve the health care system. We need to fix the existing law. We don’t need to unwind all the good things that we have done. We need to fix it in a bipartisan way. So when folks come to me and say senator, what are we going to do to fix it, then what I say is it’s my responsibility to do something.
So last week I filed a bill with a number of other senators that would lower health care premiums for people in Florida by up to 13%. What it would do is help stabilize the existing law’s insurance marketplace by creating a permanent reinsurance fund that would lower the risk insurance companies face, a risk pool, a reinsurance fund.
It’s kind of like what we did back when I was the elected insurance commissioner of Florida in facing in the aftermath of the monster hurricane, Hurricane Andrew, insurance companies just simply couldn’t take the risk of that a category 5 might come along, hit directly on the coast, and just wipe out everything and wipe out all the capital reserve that the insurance companies have. So what they did was go to a reinsurance fund which we actually created in Florida for hurricanes, the catastrophic reinsurance fund, so that they could reinsure themselves, the insurance company, against catastrophic hurricane loss. That’s exactly what this proposal is that would lower premiums by 13%, create a reinsurance fund, a permanent one, that would lower the risk to the insurance companies that are insuring people’s health. And at least one Florida insurer estimates this bill if passed will reduce premiums for Floridians who get their coverage from healthcare.gov by 13% between 2018 and 2020.
So you ask what’s a suggestion? I figured it was my responsibility to come up with a suggestion on how to fix it. This is one of several fixes, and it’s a tangible fix, and it is in fact filed as legislation. So what we are facing in the suggestion that I’ve made, it’s not the ultimate solution to solving the health care system, but it’s one small step in the right direction to making health insurance available and affordable for the people who need it most.
So how are we going to fix it? You’re not going to do it by running around in the dead of night secretly putting together a plan that’s only going to be a partisan plan. If you’re going to fix the health care system, you’re going to have to do it together in a bipartisan way building consensus. And that’s what I urge the Senate to do instead of what we are seeing happen behind closed doors.
So let’s get together. Let’s work together to make health care more affordable for people and stop all of this stuff behind the closed doors. The American people deserve better.
Mr. President, I yield the floor.
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.
