health care bill

Sen. Bill Nelson was in Orlando yesterday meeting with a group of older Americans who would be among those most hurt by the health care plan currently being considered in the House. Nelson promised the Floridians he met with that he would share their stories with the Senate when he returned to Washington. And this afternoon, he did just that:
“These are the folks that I met with yesterday,” Nelson said on the Senate floor today. “I wish every senator and every member of Congress would go out and talk to people who are real people with real problems and understand how petrified they are. … They’re scared to death that they’re not going to have health care.”
Below is a rush transcript of Nelson’s speech, and here’s a link to watch video of his remarks: https://youtu.be/wPDcAGE-r9A.

U.S. Sen. Bill Nelson
Remarks on the Senate Floor
March 21, 2017
Sen. Nelson: Mr. President, you know how we’ve seen these TV clips about various members and senators around the country having town hall meetings. There, for example, three of our colleagues this past weekend — Indiana was one of them — had tremendous town hall meetings and a lot of good exchange of information.
And so, with this looming House of Representatives health care bill, which I refer to as Trumpcare since the president has endorsed it, I wanted to see a particular group in our society that is extremely vulnerable, and that is the older Americans, but not old enough to be 65 to be eligible for Medicare.
Now, by the way, be careful because there are people lurking these halls and the administration that would like to raise Medicare eligibility from 65 to 67. But that’s not what is confronting the House of Representatives. It’s what’s going to happen to those people for their health care below the age of 65. Because once they get 65, under current law they’re eligible for Medicare.
And so I reached out to a particular group of Floridians. These are folks that I did not know that our offices in Florida had become aware of because they had written about the health care debate that’s going on, and in many cases had described their circumstances.
So, the group of eight or ten that we had in yesterday in my Orlando office all were in the range — age range — of 50 to 64. And I want to tell the Senate about this group of people because if approved in its current form, the House health care bill — Trumpcare – would dramatically increase health care costs for folks in that age group, 50 to 64. And those are folks who either get their health care through expanded Medicaid or they get their health insurance through healthcare.gov, which is the exchange, whether it be on the state exchange or a federal exchange because the state is not participating.
And according to the Congressional Budget Office, here’s one example. A 64-year-old making $26,500 could see their health care costs go from $1,700 a year that they pay now under the Affordable Care Act, all the way up to $14,600 a year under the House plan, Trumpcare.
Now that’s a dramatic jump, obviously. And do we think that that is really too much of an extreme example?
Well, I want to tell you what these people said. If you look at what the House is proposing, the dramatic rise in cost is due in large part to two provisions contained in the House bill, one that would allow insurers to charge older Americans up to five times as much as younger people. This is health insurance. And another, the second one that caps the federal tax credits meant to help seniors pay for the rising cost of health insurance.
Now, federal tax credits is a fancy way of saying the subsidy, so that if you’re a senior and you’re above 138% of poverty, which is approximately for a single individual $16,000 a year.
And, by the way, who making $16,000 a year can afford health insurance? That’s why we need the remaining 19 states — my state of Florida included — to expand Medicaid up to that 138% of poverty.
But if you’re between that level and all the way up to 400% of poverty which, by the way, what is that, for a single individual is about $46,000, $47,000 a year, in that zone of 138% of poverty up to 400%, there are these tax credits or, in other words, subsidies. So, the one with lower income gets more subsidy in order to do what? To buy private health insurance on the private marketplace through the exchange.
And as you get on up to 400%, now you say a person making $46,000, $47,000 a year, can they really afford health insurance? Not the real cost unless it’s some huge deductible plan that doesn’t give them much. That’s why these folks need some assistance. That is in place. That’s the law. That’s the Affordable Care Act that has been so maligned over the last several years.
Then aside from the health insurance, there’s the expansion of Medicaid. That has helped a lot of people.
And there’s still four million people in this country that would benefit if those 19 remaining states would expand Medicaid up to 138%. And so they’re left in the cold. They’re not getting health insurance. They’re not getting health care and they’re eligible to have it, and the federal money is there to draw down to enable them to have that Medicaid. But 19 states, including my state of Florida, have decided not to expand it.
So with all of that as background, I asked these folks to come in.
According to the AARP, there are millions of Floridians in that age group, 50 to 64, who currently receive Medicaid or tax credits to help them pay for the insurance through healthcare.gov. Millions that are eligible.
So, the group came in, and here’s what I learned. I’m going to give you some personal vignettes.
Marshall Stern, he’s a 61-year-old heart transplant survivor. He lives in Kissimmee, Florida. Marshall has had a serious heart condition since he was a young man. Three years ago his condition worsened and it resulted in several hospitalizations, after which he would — he was told he would need a heart transplant. Though he is on full disability, he was told that he had to enroll in Medicaid or he would not be eligible for the transplant.
Just the medication for the after-the-transplant operation patient, it cost around $100,000 a year, which obviously Marshall would not be able to afford without Medicaid coverage. He would also like to take this medication — and is going to have to if he’s going to live — for the rest of his life.
He worried that turning Medicaid in the House bill, the House Trumpcare bill, turning it into a block grant program, which is a fancy way of saying we’re going to cut it off and you’re not going to get any more and if you do, you’re going to have to finance it from your own state resources. Governors, as the presiding officer would appreciate, you are going to have to share more of the health cost burden, Mr. Governor and Mr. State legislatures.
And so he’s worried that if that House bill passes and Medicaid is threatened as we know it, he’s not going to be able to have the medications that he needs to stay alive. And this is what Marshall told me, and it was very dramatic. He says, quote, “It’s as good as saying that I’d die.”
The rest of us who are not facing that, you have a fellow tell you that. This is serious business.
All right, let me tell you about another one.
Susanna Perkins, a 62-year-old living in Altamonte Springs. Susanna’s husband lost his job in 2009 and she lost her employer-provided health plan during the recession. The couple blew through their IRA, and they ended up selling nearly everything they had. They eventually moved out of the country to save money.
But in 2014, they decided to move back. Why? Because the Affordable Care Act passed, and the ACA made it possible for them to afford health insurance again.
And this is what Susanna said, quote, “If they shred the ACA like they are threatening to do, we’re going to have to high-tail it out of here, because dealing with the health care cost and the insurance complications just makes you sick. We’re getting by, but we’re getting by on the ACA and if it goes away, if they make these changes the way they’re talking about, we’ll be uninsured again.”
All right, I was going to show you a picture here of these are the folks that I met with yesterday. I won’t point out the individual ones. And I’m going to talk about some of the other ones, but you can see most everybody, there’s one person over here that’s outside of the photograph. But we sat down for an hour’s conversation, and I heard their stories.
I wish every senator and every member of Congress would go out and talk to people who are real people with real problems and understand how petrified they are.
These folks, they look like our neighbors and our friends. They look like the people that we go to church with. They look like the people who have children or grandchildren that we play with. And they’re petrified. They’re scared to death that they’re not going to have health care.
So let me tell you about another one of those ladies, Terry Falbo is a 59-year-old living in the Orlando area. She moved to Florida back in 2012 because she had to take care of her elderly mother and her disabled sister. And for 25 years, she had already had good health insurance through her employer where she lived up north. And she rarely used the health insurance.
After losing her job in 2006, as we went into the beginnings of the recession, she purchased an individual insurance policy that cost her $500-$650 a month. Prior to the ACA, she had to make withdrawals from her retirement account, she had to max out her credit cards to pay for the premiums, and as a result, she depleted all of her reserves and all of her retirement funds.
So since the Affordable Care Act was implemented, she has had an affordable policy because she qualifies for the monthly subsidy of $600, bringing her premium payments to $70 a month, and that was without a deductible — with zero deductible. She could have gotten a policy at a $5,000 a deductible for $3 a month. She needed that assurance at her age that she would be able to have the health care she needed, and for $70 a month because of the subsidy.
But that is not what is protecting her in the House Trumpcare bill. Under that proposed health care plan, her maximum subsidy would be less than $300 a month, which means she would end up paying $4,000 more per year, an amount that she simply can’t afford, and that’s what she told me — I can’t afford it. She said she would have to go without health insurance instead. And she was desperately, before the ACA, trying to have health insurance. She depleted all of her retirement funds.
There’s another lady sitting around that table that I showed you the picture, Nancy Walker. She’s a 51-year-old self-employed actor living in Kissimmee. She is active, she’s healthy. She chose to pursue a career in the arts. The unstable nature of her profession has often left her unable to afford health insurance so she’s gone without it most of her adult life as an artist, as a performer.
Since the ACA took effect, however, she’s been finally able to afford health insurance thanks to the subsidies. She told me it’s been a relief for her to go to the doctor not only for checkups, but actually, when she has a problem, to fix it. But if Congress passes that House Trumpcare bill, her premiums are going to go up and she has no doubt that she will once again be unable to afford health insurance and health care. She told me that she fears simple health issues will fester, becoming serious, chronic, and expensive to treat. Remember I said they were petrified, that they are scared to death? There’s an example, and she finally has health insurance after all of these years of going without it because she didn’t have an employer that paid it for her.
Take another one, Marilyn Word, a 63-year-old retiree living in Orlando. Marilyn lives mainly off of Social Security payments but is not old enough to qualify for Medicare. She’s under that magic 65 age year that you’re eligible. After retiring, Marilyn enrolled in an insurance plan through the ACA exchange and is eligible for annual tax credits to help her pay for her insurance. Marilyn told me that she was extremely worried about the increased premiums that she would likely have to pay under the House Trumpcare plan.
I’ll give you another lady that’s sitting around that table. Sharon Brown. She’s a 58-year-old widow. She lives in the Orlando area. After her husband’s death, Sharon has been dealing with several medical issues and pulling money out of her retirement account to pay for her current plan. She has a nest egg from her husband’s life insurance money, but due to her health condition, she will likely need long-term medical care. This is what she told me, quote, “My premium’s pretty high because I have multiple medical conditions that make it so I can’t work. I’ve done a lot of reading and the cost of my health care under the Trumpcare plan will amount to double what I make right now in income.” She looked at me with this pained expression on her face and said – “It’s very scary and the anxiety that goes along with this happening right now is making it worse.”
Sharon told me that she’s a lifelong registered republican. She volunteered this and said that the bill being considered now is forcing her to reconsider her party. She says, quote, “I’m changing my political affiliation to independent. I want to vote my conscience,” she says.
So, Mr. president, when you put a face to these stories of these people that I have just talked about that we just talked yesterday, the House Trumpcare plan ends Medicaid as we know it because it cuts it off, the amount going to the states, and I understand that in trying to fix up some things, just last night in the House they filed an amendment in an attempt to address some of the problems.
One of the things that they were trying to fix is it would allow states to choose between capping or block granting the Medicaid program, but under either proposal what that means is that the federal government is going to be contributing less to the states and that means more money will have to be picked up the tab by the states. Just go and ask the governors how much more they can pick up.
So, Mr. President, I urge our House and Senate colleagues to join all of these people that I have talked about and vote, as Sharon said, with your conscience on what you’re going to do to folks like this, gutting Medicaid and forcing struggling older Americans to pay more for health insurance is simply not the right thing to do. And for a change, Mr. President, we ought to be trying to do the right thing.
Mr. President, I yield the floor.