Republican health care bill

Sen. Bill Nelson took to the Senate floor this evening to discuss the Senate Republicans’ health care bill that, according to the Congressional Budget Office’s report today, would cause 22 million more people to be uninsured by 2026.
“If the Senate bill were enacted, 22 million people would lose health insurance coverage,” Nelson said. “That’s not too much different from what CBO said about the House bill that was passed a couple of months ago… 22 million people. Is that the direction that we want to be going in?”
“The bottom line is this: if we want to fix the ACA, we can fix it,” Nelson continued. “but you can’t do it one party against the other. you’ve got to have the will to come together in a bipartisan agreement to fix it.”
Nelson shared the story of a Florida kindergarten teacher, Megan Geller, who passed away in 2015 at the age of 28 after a two-year battle with leukemia. Megan’s total medical expenses reached nearly $8 million throughout the course of her illness, but thanks to the Affordable Care Act, Megan’s mother had to pay only $70,000 out-of-pocket.
“The mom of this girl,” Nelson said pointing to a picture of Megan on the Senate floor, “had she been faced with this without insurance coverage, she would be bankrupt. She wouldn’t have been able to even afford the first transplant, much less the two years of extra life that her daughter had fighting for her life. And anybody who goes through something like Elaine and her daughter Megan did knows that every second counts. That’s what this health care debate is really about, giving people peace of mind, giving them that financial security, that certainty, putting people’s health ahead of other things, like company profits.”
“This bill is just as bad as the House bill,” Nelson warned. “It’s going to wither the more it is examined in the glare of the spotlight. They claim that it maintains the ACA’s protections for those with preexisting conditions. Can anybody really say that with a straight face? It leaves it up to the states.”
“Fixing our nation’s health care system shouldn’t be a partisan issue,” Nelson continued. “That’s why I’ve joined bipartisan with colleagues to introduce a bill that I described a moment ago that would lower health care premiums by 13%, and that bill would stabilize the ACA’s insurance marketplace through that creation of a permanent reinsurance fund.
“What we ought to be doing is trying to look for ways to help people like that single mom, Elaine, and that daughter of hers, Megan. We should be working together to make the ACA work better. We shouldn’t be plotting behind closed doors in the dead of night with a secret document that we now know will make it worse.”
Following is a rush transcript of Nelson’s remarks, and here’s a link to watch video of his speech: https://youtu.be/uc26QSIqKCI.

U.S. Sen. Bill Nelson
Remarks on the Senate Floor
June 26, 2017
Mr. Nelson: Mr. President, last week I spoke with a very brave mother. She had endured what no one of us ever want to have to endure while she watched her child go through cancer over and over and over again.
That mother is from my state of Florida, Elaine Geller, and I want to show you her daughter. This is her daughter. This is Megan. She was working as a kindergarten teacher when she was diagnosed with leukemia back in 2013 at the age of 26. And at the time she was admitted to the hospital, Megan’s blood count was 4. She had pneumonia and she had water on her heart. She ultimately checked in to one of the very good cancer centers down at the University of Miami, and she stayed there for seven months. And so she went through the regiment of chemo. She spent months in the hospital receiving multiple rounds of chemo, biopsies, and various other treatments. And eventually Megan’s doctor told her that she had to have a transplant, and that required $150,000 up front payment. I think you see where I’m going with this story. A payment, 150 grand, that very few families would be able to afford, especially a single mother.
So I am hearing this story last week from Megan’s mother, and she said thanks to the Affordable Care Act, she didn’t have to write a check for the transplant. In fact, she didn’t have that money. In fact, because that transplant was provided for under the Affordable Care Act coverage, she knew that that was one worry that could be taken off of her mind. She had enough to worry about as a mother, what she should be doing in such a situation. And of course she wanted to give all of her attention to her daughter.
So the cancer went into remission after the transplant. However, after leaving the hospital, 63 days later the cancer came back. And so this time they go to MD Anderson Center in Houston. And I asked the mom why she wanted to do that, and she said “when your child is dying, there’s nothing that you will not do.” I think all of us as parents can identify with that. But we’re so very fortunate that we haven’t had to go through it.
So if you can’t put a price on a life — and maybe as we get ready to vote on this health care bill, on the republican alternative which, by the way, just came out on CBO, the Congressional Budget Office, today and said if the Senate bill were enacted, 22 million people would lose health insurance coverage. You remember, that’s not too much different from what CBO said that the House bill that was passed a couple of months ago, that there’s been such a negative reaction to, CBO said it would have 23 million people in this country would lose their coverage as a result of the House bill. Okay, we just got the score minutes ago from CBO 22 million people. Is that the direction that we want to be going in?
Well, so Megan is still going through treatment, and the cancer was only in remission for 32 days before it came back again. So, Megan received multiple blood transfusions. Now remember, this is a single mom trying to keep a daughter in her 20’s alive who has been through school and is a teacher. And this time all of the blood transfusions started to take another toll on her. She became so weak when trying to walk, she faltered, she fell, she hit her head at age 28, and she passed away.
Now let’s get to the bottom line of this discussion other than our hearts go out to all the Megans all across America. The bottom line is that that whole treatment over two years cost $8 million. There was not a cap on the total amount of money that could be paid under the existing law, the Affordable Care Act, an insurance company cannot put a cap on how much you pay — you can have your medical bills reimbursed.
Suppose before the ACA, suppose that cap was $50,000. Her single mom could not even have come up with the money for the initial transplant which looked like it worked, and worked for several months. In fact, $8 million over time — two years — how in the world could any one of us afford that?
You know, a lot of people say, well, the ACA isn’t doing it. Well, why don’t we all get together in a bipartisan way and fix it. And one of the fixes would be because certain health care problems like Megan’s cause the insurance company to pay out a lot of money. You know what we can do about it? We can create a reinsurance fund, which is a bill that I have filed, and it is to reinsure against that catastrophic health care problem like Megan’s of $8 million to reinsure the insurance company. And you know what that would do in the state of Florida if we passed this as a fix to the ACA? It would lower the premiums in the ACA in Florida 13%. That’s reinsurance. It’s not unlike what we’ve done for hurricanes. Catastrophic hurricane, it could be so much more than the insurance company has assets for. And, therefore, you create, or you go and buy from somebody like Lloyd’s of London or other reinsurance companies, you buy insurance in case of the catastrophe. The insurance company does that. And then if an insurance company did not have to pay out this $8 million because it had insured against that kind of catastrophic loss, everybody else’s premiums are going to be coming down. Otherwise, they have to make premiums actuarially sound. They’ve got to raise them in order to take care of the cases that are prohibitively expensive.
Now, all of this sounds down in the weeds, but the bottom line is this, if we want to fix the ACA, we can fix it. But you can’t do it one party against the other. You’ve got to have the will to come together in a bipartisan agreement to fix it. And, of course, the mom of this girl, had she been faced with this without insurance coverage, she would be bankrupt. She wouldn’t have been able to even afford the first transplant, much less the two years of extra life that her daughter had fighting for her life. And anybody who goes through something like Elaine and her daughter Megan did knows that every second counts.
That’s what this health care debate is really about, giving people peace of mind, giving them that financial security, that certainty, putting people’s health ahead of other things, like company profits. You can do it all and solve everybody’s problem, including the insurance company that obviously is in business to make a profit. You can do it. Elaine said her daughter would be proud to know that we are telling that story today. It matters. It matters to her, albeit deceased. It certainly matters to her mom. It matters to their senator. And it matters to a lot of other people.
The ACA, the existing law, the one that there was such a fractious fight over five to seven years ago, it’s working. And here’s a good example. And so then we see that what the aim of our friends on that side of the aisle is, they want to just repeal it. They don’t want anything that has the taint of Obamacare. And so they concoct something down in the house, and you see what kind of greeting that has gotten in the country. I think there was something in the upper teens of a poll that showed that it was viewed favorable. In other words, it’s viewed very unfavorably. And then the Senate majority leader, in order to come up with something that he can repeal Obamacare, in the dead of night, in secret, even the republican senators don’t know what it is until they hatch it in the public last Friday, and so this bill is just as bad as the House bill.
Now they will claim on trying to stand up this bill — and by the way, it’s going to wither the more it is examined in the glare of the spotlight. They claim that it maintains the ACA’s protections for those with preexisting conditions. Can anybody really say that with a straight face? It leaves it up to the states. This senator, before I came to Washington in the Senate service, I was the elected insurance commissioner, state treasurer of Florida. It was my job to regulate the insurance companies, all kinds of insurance companies, including health insurance companies. I can tell you that I have seen some insurance companies use as a preexisting condition, asthma. And, therefore, that’s the reason that they would not allow the person who needed insurance to be covered. Said you have a preexisting condition, we’re not going to insure you.
I have even seen insurance companies that would use as an excuse, a rash as a preexisting condition. And that means we’re not going to insure you. Under the existing law, the ACA, they can’t do that. You’re going to have the security of knowing that you’re going to have coverage.
And you know something else you’re going to have the security of knowing? You’re not going to deal with some of those insurance companies that I regulated where they would, of your premium dollar for health insurance, they would spend 40% of that dollar not on health care, on your health care. They would take 40 cents of that premium dollar that you paid, and that was going to executive salaries. It was going to administrative expenses. It was going to plush trips. Don’t tell me that that’s not a true story. I’ve seen it over and over in the 1990’s as the elected insurance commissioner of Florida. You know what the existing law says? It says of every premium dollar that you pay, 80 cents of that premium dollar has got to go into health care. It can’t be commissions, it can’t be executive salaries, it can’t be the executive jets for the corporate executives — 80 cents of that premium dollar has to go into health care so you get that for what you pay in that premium dollar.
So at some point there’s going to be an attempt to undo that. If you start leaving things up to the states, watch out. All right. When Megan was in the ICU., she had a respiratory failure that costs thousands of dollars more, and thanks to the ACA, her insurance coverage carried — it was covered, but under the Republican bill that has been released, states could let their insurance companies pocket more of those premium dollars to pay for those things that I just shared that I had seen back in the decade of the 1990’s as the insurance commissioner. Well, we shouldn’t be padding the pockets — the premium dollar for health insurance. It ought to go to health care.
Now, the Senate bill cuts billions from Medicaid. We haven’t even talked about that. Medicaid. Who gets Medicaid? Well, millions of people in this country do. It not only the poor, it’s not only the disabled, it’s 65% to 70% of all seniors in nursing homes are on Medicaid, and it’s also some children’s programs.
Let me just give you one example. So I go to the neonatal unit at Shands Hospital in Jacksonville a hospital affiliated with the University of Florida, but in Jacksonville. And the doctors and nurses are showing me of how these miracles occur of these premature babies, that they keep them alive. Then what they wanted to show me with the opioid epidemic, which has hit my state just like it has hit other states, they wanted me to see and understand when a pregnant mom is addicted to opioids, she’s passes that on in her womb to her unborn child when born that baby is opioid dependent, and the doctor showed me the characteristics, the high shrill cry, the constant scratching, the awkward movements. You know what they do to wean them — wean those little babies off of opioids over the course of a month? They use doses of morphine.
Now, you want to devastate Medicaid? You want to take over $800 billion of Medicaid over ten years out of Medicaid. What about those single moms that the only health care they get is Medicaid? What about those babies that I just described that are also on Medicaid? You start capping the amount of money that goes to the states on a federal state program for health care, Medicaid, and you’re going to be throwing a lot of people out of any kind of health care, including senior citizen in nursing homes. And so a Medicaid block grant or a cap would end the health care guarantee for millions of children, people with disabilities, pregnant women, and seniors on long-term care. 37 million children in this country — children, 37 million — rely on Medicare for care. They are all the seniors, the poor, the disabled, the children, — they are all vulnerable to the cuts that would occur.
And if that’s not enough to vote against this bill that is coming to the floor this week — if that’s not enough, the Senate bill actually imposes an age tax for older Americans allowing insurance companies to charge older Americans up to five times more for coverage than a young person. You say, well, older people have more illnesses and ailments. Older people ought to cost more if that’s your argument. Well, that’s true, and age rating in the existing law, the ACA, is three to one, this changes it to five to one and five to one means one thing — more on the premiums for senior citizens until — I’m talking about all insurance policies — until they reach that magic age of 65 and can be on Medicaid. Now, do you want an age tax on older Americans as a result of this bill? I don’t think so. But that’s what’s in there.
So fixing our nation’s health care system shouldn’t be a partisan issue. That’s why I’ve joined bipartisan with colleagues to introduce a bill that I described a moment ago that would lower health care premiums by 13%, and that bill would stabilize the ACA’s insurance marketplace through that creation of a permanent reinsurance fund. I’ve seen the policies work, as I described with catastrophic hurricane insurance.
So there’s nothing magic about my idea. It’s just an obvious fix — to fix the existing law and ideas like that can bubble forth in a bipartisan way to make sustainable the existing law that we have and so what we ought to be doing is trying to look for ways to help people like that single mom, Elaine, and that daughter of hers, Megan. We should be working together to make the ACA work better. We shouldn’t be plotting behind closed doors in the dead of night with a secret document — a secret document that we now know will make it worse.
Mr. President, I yield the floor.