January 04, 2017

Van Hollen Delivers First Speech on the Senate Floor

Washington, DC -U.S. Senator Chris Van Hollen delivered his first speech on the Senate floor, thanking Marylanders for their support and pledging to fight efforts to dismantle the Affordable Care Act. Video of his speech is availablehere, and a transcript is below:

"This is the first time I have risen to speak on the Senate floor and I want to start by thanking my fellow Marylanders for the honor of representing them in this great United States Senate.

"I want to thank my colleague, Senator Cardin, now the senior Senator from Maryland, for joining us. I want to thank the new Senator from California, Senator Harris, for joining us as well, and I want to say to my fellow Marylanders that I look forward to working every day for their benefit and for the benefit of our nation.

"And I want to say to my new colleagues here in the Senate, Republicans and Democrats alike, I look forward to working with all of you in the years to come for the good of our nation. I understand it's somewhat unusual for a new Member to speak so soon on the Senate floor, but what we are witnessing today in the Senate is not business as usual. And these, Mr. President, are not ordinary times. Having served as the lead Democrat on the House Budget Committee, I know that never before has the United States Senate rushed out of the gate so quickly to enact a budget procedure to deny the minority party, and by extension hundreds of millions of Americans, their rights in this United States Senate.

"Yet here we are speeding to use the budget process to fast-track a so-called reconciliation bill that will destroy the Affordable Care Act and, in doing so, wipe out access to affordable care for 30 million Americans and create total chaos throughout the American health care system. That is reckless, it is irresponsible, and it violates the traditions of this institution.

"I may be new to the Senate, but I am not new to the way this Senate has proudly been described by its members - both Democrats and Republicans, both current and former members. My colleague, Senator Harris, will attest that one piece of advice we all received from both Republican and Democratic members of this Senate was to read the chapter in Robert Caro's book about Lyndon Johnson entitled 'The Desks of the Senate.' Robert Caro talks about the burnished mahogany tops and he tells the story of the Senate through the Senators who were protagonists in great debates throughout our history, and he highlights the idea that this Senate is supposed to be a deliberative body that reflects on issues with a thoughtful exchange of ideas.

"Unfortunately, that certainly does not describe the Senate of this moment. Having just arrived from the House of Representatives, what we're witnessing today is much more like the tyranny of the majority characteristic of that body. This Senate is supposed to be different, but at least for now it seems very much like the House I just left. As a result of the fast-track process in the Senate, we will be overriding and rough-shodding over the will of a majority of the American population.

"And Americans, Mr. President, are just now waking up to learn about the bait-and-switch scheme that has been perpetrated on them. For more than six years, Republicans in this Senate and in the House of Representatives have said repeatedly that they would repeal Obamacare, but replace it. Replace it with something - they said - with something that will be much better. And now we know, as the clock ticks down, that that has been a farce. There is no Republican replacement bill to provide the kind of coverage and benefits of the Affordable Care Act, and the consequences of that failure are going to be devastating for the country.

"Let's take a moment to look at the human toll. First, there are the 22 million Americans who previously had no health insurance before the Affordable Care Act but who are now covered through the health care exchanges and through expanded Medicaid.

"These are people who've been denied access to coverage because they had preexisting conditions or their kids had preexisting conditions, whether it was asthma or diabetes or heart conditions. So they were either outright denied by insurance companies or priced out of the market.

"And that 22 million may be a big number, hard to comprehend, but behind that number are many families, like Carlos and Isabelle Martins, who live not far from where I live in Silver Spring, Maryland. They could no longer afford health insurance through their employer, and shortly before the Affordable Care Act was enacted, Carlos was told he needed a liver transplant. His wife said without the Affordable Care Act, he would never have received that lifesaving treatment.

"Or the case of Diane Bongiorni, who now lives in Hyattsville, Maryland. She had previously had open-heart surgery. So when her COBRA expired, it was only because of the Affordable Care Act that she was able to get coverage and not be denied because of that preexisting condition. Days after she was on the Affordable Care Act, a cardiologist told her that one of her heart valves was failing, that she would need another surgery immediately. And she has told us she would have died had she not had that coverage.

"In addition to Diane, and Carlos, and the other 22 million Americans who would have been denied affordable health care before the Affordable Care Act and the Medicaid expansion, there are an additional 7 million Americans on the health care exchanges today who are projected to totally lose that coverage if Republicans pull the plug on the Affordable Care Act.

"So that's 30 million Americans who will lose access to affordable care directly.

"Now, there's no doubt that in those health care exchanges we've seen increases in premiums and some of the co-pays. And we need to do something about it, which is why myself and many of my colleagues have put forward ideas to address the increases that we're seeing in the health care exchanges in terms of costs. We put those ideas on the table, and we would welcome our Republican colleagues in joining us to improve the Affordable Care Act. But you don't fix a health care system, you don't fix those problems, by blowing up the entire Affordable Care Act. That is not a solution.

"Mr. President, I also want to focus for a moment on the tens of millions of Americans who are not included in that 30 million who benefit directly from the Affordable Care Act, but who are benefiting right now from Obamacare. They may not realize it now, but mark my word, they are going to face very unpleasant and unexpected consequences if the Affordable Care Act is ripped apart.

"First, let's take a look at the overwhelming number of Americans who get their health care not on the health care exchanges but through their private employer - most members of this body, most Americans. The premiums in those plans have actually risen much more slowly since the Affordable Care Act was enacted than before. The overwhelming number of Americans who are on those plans have benefited dramatically from the reduction of cost.

"Why did that happen? Because all those people who have been previously denied access to health care, who are in the Obamacare exchanges, they used to show up at the hospital as their primary care provider. Or, since they weren't getting any care at all because they couldn't afford the bill, they were showing up at those hospitals when there was an emergency, when cost was most expensive. And we don't deny people care in emergency. And then they get the bill, and they can't pay the bill. That's why so many people were going bankrupt in America before the Affordable Care Act.

"But somebody pays. Who pays?

"Well, everybody else in the system pays. Everybody else who has private insurance through their employer pays. Or taxpayers in states pay for the uncompensated care that their hospitals would otherwise have to carry. So in the end, people's premiums were going up really fast. But by providing the health care system through Obamacare with those exchanges, however imperfect, it has helped those other tens of millions of Americans.

"Let's look at Medicare beneficiaries. Millions of seniors -- watch out. Their costs are going to rise in three and maybe four ways right away. First of all, their Part B premiums that every senior on Medicare pays are going to go up. Why is that? Because as part of the Affordable Care Act, we got rid of some of the overpayments, the excessive subsidies that were being paid to certain providers, including some of the managed care providers that were being paid, on average, 115 percent more than fee-for-service. So we said that makes no sense. That's a waste of Medicare beneficiaries' money. So we reformed that by saving the Medicare system money. We also saved the Medicare beneficiaries' money in their premiums because those premiums are set partly to deal with the cost of Medicare. So if you reduce the cost of Medicare in a smart way, you reduce those premiums. That's why seniors have seen such slow increases in their Part B premiums since the enactment of the Affordable Care Act. Those will go right back up.

"Second, seniors on Medicare no longer have to pay for preventive health screenings -- cancer screenings, diabetes screenings, other kinds of preventive health care. Because we want to encourage them to identify the problems early and solve them for their own health care purposes, but also because it saves money in the system. You get rid of the Affordable Care Act, those seniors are going to be paying premiums, co-pays for those preventive health services.

"Prescription drug costs. Seniors -- and there are millions and millions of them -- who face high prescription drug costs are benefiting today from the fact that we are steadily in the process of closing the prescription drug donut hole. We had an absolute crisis in this country where so many seniors were faced with the difficult choices of getting the medications they needed to live day to day and keep a roof over their head. That's why we're closing the prescription drug donut hole. You get rid of the Affordable Care Act, all those seniors who, on average, have saved thousands of dollars through the Affordable Care Act, they're going to see their costs go up.

"And finally, Mr. President, if you enact the plan that's been put forward by the Speaker of the House, Paul Ryan, and by the person that President-elect Trump has nominated to be his Secretary of Health and Human Services, Tom Price - I encourage every American to look at their plan because they want to voucherize Medicare and they want to save the Medicare system money by raising the prices and the risks on every Medicare beneficiary. That is the result of that plan.

"So, the Affordable Care Act benefits 30 million people directly, and we need to make sure we don't put them in harm. But it also benefits all these other people in the system. The people on the employer-provided health plans who have seen historically low premium increases and seniors on Medicare. Rural hospitals will be particularly hard-hit by repealing the Affordable Care Act.

"So the proposed Republican action is going to hit those 30 million Americans, including my neighbors in Silver Spring. It's also going to hit those tens of millions of other Americans who right now may not realize the extent to which they're benefiting from the Affordable Care Act. And yet our Republican colleagues have not put forward a single plan to help either the 30 million or all the other Americans who are benefiting from the Affordable Care Act. Instead, we see a rush to generate chaos throughout the health care system and that is counter to what the President-elect has said he wants. Here's what Donald Trump said on 60 Minutes, 'everybody's got to be covered. I'm going to take care of everybody.

"Well, it's really important, Mr. President, that the majority in the Senate and the House talk to the President-elect, because they're not on the same road when it comes to that commitment. When the President-elect was asked about finding a way to keep the Obamacare rules that prevent discrimination based on preexisting conditions, he said, 'I like those very much.' When he was asked about the provision that allows children to stay on their parents' insurance plans until they're 26 years old, he said, 'we're going to very much try to keep that.'

"But here's the dirty little secret. Many people, Republicans and Democrats in this chamber, know there are only a very few ways you can design a health care system that meets those conditions. One way, which many Democrats have historically supported, is the idea of Medicare for all. The other way is the Obamacare model. It was not always known as the Obamacare model. The foundation for Obamacare actually had its roots in the conservative Heritage Foundation think tank reports. It was an idea long promoted by Republicans, including many Republican Senators, some of them still here today. It's an idea rooted in the concept of personal responsibility, the idea that every American needs to do their part and help pay for their health insurance. Otherwise, if they don't pay, they're going to force other people to pay when they go seek that care in the emergency room or wherever it may be.

"And in order for that idea to work, the idea that was put forward by the Heritage Foundation, the idea in Obamacare, everyone needs to have coverage, because it wouldn't make a lot of sense for us to be paying out all the time if we were able to wait until we got sick and then decide to pay. That's the idea having everyone in the pool of health insurance. The idea is that you don't want to use it, but you buy that protection. And if other people don't buy the protection, then the rest of folks feel like they're being taken advantage of -- which is why everyone has to be part of the pool. That's why it's an idea that came out of the Heritage Foundation.

"In fact, Mr. President, I got the Heritage report right here: Critical Issues: A National Health Care System. This is back in 1989. I want to read you the three elements in the Republican plan. Element number one: every resident of the United States must by law be enrolled in an adequate health care plan to cover major health care costs. Number two: for working Americans obtaining health care protection must be a family responsibility. Number three: the government's proper role is to monitor the health market, subsidize needy individuals to allow them to obtain sufficient services, and encourage competition.

"Sounds like a description of Obamacare. And it is, which is why, of course, it was dubbed Romneycare when they adopted this model for then State of Massachusetts. He adopted it based on the Republican Heritage model.

"And so here's the problem: Republicans can't come up with an alternative. That's why it hasn't happened for six years. Because if you're going to come up with an alternative, you've got to go to either one of two models. One is Medicare for all. The other is the idea that every American has to be in the system and the idea based on personal responsibility, which, at its start, was a Republican idea when President Obama adopted it. For many months some Republican Senators were willing to go along, but then the politics overtook them. And since then, we've had the Republicans opposing their own proposed model for providing health care.

"So rather than repeal and replace -- since there is no replace - it is repeal and run. Here's the problem for our colleagues politically -- but more importantly, here's the problem for all Americans and all our constituents. No one is going to be able to hide from the devastating consequences of undoing the Affordable Care Act, which is going to hurt not just the 30 million Americans who are directly benefiting through the exchanges and the Medicaid expansion, but also all those seniors on Medicare and the others getting health care through their private employers.

"Now, as I said at the outset, it's really truly sad to see the Senate at this point and in this state, especially because of the terrible consequences it's going to have on the American people.

"You know, the very first time I was ever on the floor of the Senate was in 1985. I wasn't thinking of running for office myself at that time -- it was the farthest thing from my mind. It was in the middle of the Cold War. I was working on national security and foreign policy issues for a moderate Republican Senator by the name of Mack Mathias from the State of Maryland. I talked about the desks of the Senate at the outset of my remarks. Senator Mathias sat right there, one seat behind the seat that Senator Booker is sitting in right now. Great to see you. That's where he sat.

"The reason I happened to be sitting next to him that day was he was working with Senator Kennedy. Senator Kennedy was at a desk back there, I believe. It was the second from the aisle. It had been his brother, Jack Kennedy's desk in the Senate before him. And even though there were many desks between the desk of Senator Kennedy and the desk of Senator Mathias -- and the center aisle between them -- they were able to work together for the good of the country, just as many Senators from both parties have done since.

"That's the way the Senate is supposed to work. That's the way the Senate was described in the Robert Caro book that Republicans and Democrats alike told us to read as new members before we came here.

"So, Mr. President, I am really glad to be here. I'm excited to get to work on behalf of Marylanders and work for the good of our state and the country. I wish it could have been at a moment when the Senate was not hell-bent on breaking the very traditions that have made it great, the tradition of being a deliberative body and not using -- right out of the gate, the very first thing -- the process to short-circuit the will of the minority party. That is not what any of us were taught the Senate was about.

"And it's particularly troubling that the Senate is engaged in breaking that tradition in order to undermine affordable health care for tens of millions of Americans and generate chaos in our health care system.

"Mr. President, I will fight every day to prevent that from happening. I will also fight every day to try to live up to the true tradition of the Senate, which is people trying to work together for the good of the country. It is disappointing to be here at a time when the Senate is embarked on violating that tradition in order to strip Americans of their health care. I hope we will not let that happen. I will fight every day to prevent that from happening, and then work with my colleagues to try to make sure we address the real priorities and concerns of the American people. And I thank my colleagues for joining me here on the floor."