Mr. President, I want to thank my colleague from Oregon for his words. And I rise today to give voice to the concerns that I'm hearing from so many people in my state and across the country about this repeal bill.

First I want to recognize my colleague from Hawaii, Senator Hirono, who spoke earlier tonight about her personal battle with kidney cancer. She is an example to all of us of the determination and grit when the going gets tough. She not only is going into the hospital for some surgery tomorrow--which isn't easy surgery--but she's decided she wanted to spend her night before she went into the hospital here, because she's so passionate about this issue. I know she's going to fight this disease and win and come out stronger than ever. I have been so moved by how she's taken on her personal fight against cancer at the same time that she has kept this fight going in the Senate. And she's doing it not just for herself or for her state, but for people all over the country.

As Senator Hirono has said, her experience shows how quickly a routine visit to the doctor can turn into a serious diagnosis. A diagnosis that becomes a prexisting condition. Everyone who faces a serious illness--no matter who they are--should be able to focus all of thier energy on getting better, not on how they're going to pay their medical bills. Unforutnately, the bill we are considering doesn't allow everyone to do that.

As the nonpartisan Congressional Budget Office noted earlier today, this bill could mean the return of annual or lifetime limits on what insurance would cover for people with expensive conditions like cancer of Alzheimer's. And some key health care benefits might be excluded from insurance coverage altogether. So it's no surprise that the Minnesota Hospital Association has said that this proposal creates a lot of chaos. 

And I was just at Northfield Hospital this weekend, a college town, but that it is in the middle of a very rural part of our state with a lot of farms surrounding it. In fact, they call it "cows, college, and contentment." And at this town and in that hospital, there wasn't a lot of contentment during my visit. The CEO of the hospital told me that he was worried that this bill would drive more of its patients to bankruptcy. I met with a number of people that were on the board and work at the hospital, and they were all very concerned about what the bill would mean. Now, this did not mean that they didn't want to see changes to the Affordable Care Act. They do. They see the issues with premiums in our state.

That's why our Republican legislature worked with our Democratic governor to pass a bill for reinsurance, to try to do something to leverage the risk fo rhte people who are in this exchange. We could do something similar here on the federal level. And we should. But that's not what this bill is about. 

The head of another hospital in my state said that, "They are shortening up the money but not giving us the ability to manage the care." A Minnesota seniors organization said that this bill "feels like we're pulling the rug out from underneath families and seniors." And that's why AARP strongly opposes the bill as well. 

So according to the CBO report that we got today, this bill would cause 22 million people to lose their coverage over the next few years. Twenty-two million people. My Republican colleague, Senator Heller, has said--on Friday he said he cannot support a piece of legislaton that takes insurance away from tens of millions of Americans. I agree. I hope that our Republican colleagues will come to the negotiating table in a bipartisan way. I hope that this Administration will not sabotage the bill that we have now and will work with states like mine that want a waiver to be able to do the kind of cost-sharing and the reinsurance that I just described. During that time, we can work together to actually make health care in America better and more affordable.

We need to think about the real and devastating impacts on people's lives that this piece of legislation would have, because that's what this debate is really about. It's not about all of us going back and forth and citing facts and figures. In the end, it's about how this will affect people.

It's about the lives of people like the mom in Minnesota who has a child with Down's Syndrome. She told me she has seen Medicaid help parents of kids with disabilities avoid bankruptcy and how it helps school districts pay for the therapy children like hers need. She said that this bill is unconscionable. Those are her words because of what it would do to adults and kids who have disabilities. Well, we have more than half a million children in Minnesota who rely on Medicaid and the Children's Health Insurance Program.

This includes kids like that of a teacher. The teacher wrote in saying that the bill was cruel and mean, especially for the families of students with special needs. This last weekend, the President did in fact admit that he had called the House bull mean after he had, in fact, celebrated its passage. But that is behind us. The President is someone who is known for speaking his mind and speaking directly. So he didn't need a poll or a focus group or an accountant to look at this House bill. He just called it waht it was. Mean.

In Minnesota, people don't mince words either. And that's why that teacher told me exactly what the impact of this Senate bill would be. And in fact, today the Congressional Budget Office--the nonpartisan Congressional Budget Office--confirmed it earlier today with its estimate that millions of people--22 million people--would lose their Medicaid coverage because of the bill. 

Our debate here today is about the lives of people like the retiree with Parkinson's in Minneapolis who told me she is scared and worried. She's not just worried about the cuts to Medicaid but also about depleting the Medicare Trust Fund to pay for tax cuts for the very wealthy. As she told me, the future of these vital programs that so many Americans depend on is the line. This health care bill is also about the people who are worried about taking care of their baby boomer parents as they are caring for their children.

One woman told me about her mom who died two years ago at 95 after suffering from dementia for more than 20 years. She had worked her whole life, but as she got older, she couldn't afford the nursing care she needed so much. Luckily, she was able to rely on Medicaid to pay for it. 

You know that more than half--54 percent--of residents in nursing homes rely on Mediciaid. I think when this first came out, people thought, "Well, Medicaid, what does it have to do with my life?" Then they started talking to their parents or grandparents or their neighbords and that's when they realized, whoa, over fifty percent of people that go into assisted living and nursing homes, they end up relying on Mediciad.

This woman's daughter told me that she's so worried that this bill's cuts will put those vital services for seniors at risk for so many other parents and their kids. And even for older people who don't use Medicare and Medicaid, this bill could put health coverage out of risk. That's because it has this age tax for seniors, allowing older people to be charged five times as much as younger people for insurance. As AARP has said, that's just not right. These are the concerns I've heard from seniors and their families in Minnesota, and they are shared by people across the country, especially by people in our rural areas where they tend to have a little older population.

One reason for that is because the Senate bill, actually more than the House bill when it comes to Medicaid, makes even deeper cuts over the long term that will hurt seniors and rural hospitals along with children, people with disabilities, and people suffering from opioid addiction. We actually have such a strong bipartisan group working on the opioid addiction problem. Four of us--two Democrats, two Republicans--we're the chief authors of the bill that passed last year that set the framework for the nation. We then put billions of dollars into treatment last year and we shouldn't blow it up now by passing a bill that because of the Medicaid cuts--would in my state--a third of the people that get opioid addiction treatment--a third of them get from Medicaid. So it would actually be moving ourselves backwards.

I know my colleagues, Senator Collins and Senator Murkowski, have expressed real concerns about these kinds of Medicaid cuts in their states of Maine and Alaska, which also have big rural populations. In my state, Medicaid covers one-fifth of our total rural population--about twenty percent of our rural population. These cuts could cause the rural hospitals that serve this population to close. This doesn't just threaten health care coverage, it threatens the entire local economy. That's a big deal for rural hospitals, which often have operating margins of less than one percent. And these rural hospitals are on the front lines of the opioid epidemic that is hitting communities across the country.

Deaths from prescription drugs in my state now claim more lives than homicides. They claim more lives than car crashes. Well, there is more word to do to comabt the epidemic. I want to recognize that progress. Yes, we've passed the blueprint bill that I just mentioned with the help of Senator Portman, Whitehouse, and Ayotte. But unfortunately, we're moving ourselves backwards. Medicaid expansion has helped 1.3 million people receive treatment for mental and substance abuse across the country. I know this bill's cuts to those important services for people struggling with addiction have real concerns in states like West Virginia and states like Ohio. And the problems with this bill, of course, go beyond Medicaid cuts.

As a mom from Belgrade, Minnesota told me, she asked me to oppose this bill in honor of her daughter and the thousands of other children diagnosed with cancer each year. She worried that the waivers would undercut protections for people with preexisting conditions, threatening to make health insurance unaffordable for families like hers who have children or had children with cancer. 

One man from Minneapolis told me that what this does is downright scary. Those were his words. He is scared because he is self-employed. He has a preexisting condition and gets his insurance on the indivudal market. He is worried that under his bill costs, which are already high, would skyrocket.

I am the first to say that we need to fix the individual market, but this bill is not the way to do it. Because as CBO said earlier today, it would actually cut assistance and increase deduductibles for many people on the individual market. Based on CBO's projections, the Joint Economic Committee estimates that average premiums in Minnesota would go up substantially next year, even more than they've gone up already.

People across the country are making their voices heard about these types of problems. According to the Kaiser Family Foundation poll that came out just last week, thirty percent of Americans had a favorable view of the House bill. I know this bill has some differences from the House version, but as Speaker Ryan said last week, the two are very similar. I hope that hearing from Americans on both sides of the aisle prompts my colleagues to start working together to make our system better in a bipartisan way. Here's some ideas.

I would love to include, if we worked in a bipartisan basis together, not only the work that needs to be done on the individual market, on the exchanges, to the rates, for small businesses. But I'd also like to work on prescription drugs. I have a bill that would harness the negotiating power of 41 million seniors on Medicare to bring drug prices down. We have a number of senators on the bill. And right now, Medicare is actually banned from negotiating with 41 million seniors. That is just wrong. Our seniors should be able to use their market powers to negotiate. 

I would also love to see more competition in this market. There are several ways we can do it. One is bringing in less expensive drugs from other countries. When we have drug shortages now in this country, we worked on this--Senator Collins and I did--and the bill passed this Senate and got signed into law. Now, the Secretary of Human Services can actually bring in drugs that are safe from other countries when we have a drug shortage. We refined some of the language with the rules already allowed the Secretary to do that. Now, they could do the same thing right now, but we could make it even more clear if Congress got behind it.

Senator McCain and I have a bill to bring in less expensive drugs from Canada, which is very similar to the American market. And we have a provision in the bill that they would be safe. Many people in my state are doing this now. We once had bus rides of seniors going up there to get less expensive drugs. We could do it with other countries as well, as long as they are certified as safe. 

One of the ways you can do it--we have a bipartisan bill--is that if you have less competition in the market, less competitors, that would trigger the bill to bring in more drugs. You could do it based on the price. If it goes high and you find the Secretary or someone else that we could put in its place, find that it's not because of input costs, you could allow this competition to come in from other countries. It would be a trigger. And I would bet you right now that if you did that, that would create incentives on American drug companies to not jack up the prices like they have been doing.

Four of the top ten selling drugs right now in America have gone up over 100 percent--things like insulin up three times. Things like naloxone that we rely on for overdoses. It seems like when these drug companies get a monopoly in their lap, they go for it. The second way you get more competition is by encouraging more generics. Senator Grassley and I have something called pay-for-delay. Big pharmaceutical companies are actually paying off generic companies to keep their products off the market. The nonpartisan Congressional Budget Office has found that this would save something like $3 billion over a number of years if we passed our bill. That's for the government. That's for taxpayers. But you could save an equal amount of money for consumers who are paying for this in premiums. How could you ever explain that pharmaceuticals are actually paying generics to keep their products off the market? That's a vote I would like the Senate to take, and I would like to challenge anyone to explain why they would vote agianst that. We also have another bill called the CREATES Act with Senator Grassley, Leahy, Lee, and myself that makes it easier to get generics to market by sampling and other things.

These are just a few of the examples of bills that I think would be very good if we would consider them. But so far we have nothing. We have banned seniors from negotiating. There is nothing in the House or Senate repeal bill that does nothing about these pharma issues. And that again is one reason alone to be concerned about these bills. 

So I was at that baseball game a few weeks ago and saw firsthand that incredible bipartisan spirit--at the women's softball game as well--but the men's baseball game where the played together. And at the end of the game, when one team won--the Democratic team--they took their trophy and they gave it to the Republican team, and they asked them to put it in Representative Scalise's office. That's what we need to see more of. Not just two teams, but one team. And certainly on an issue as complex as health care, we just can't be playing in our separate ballparks. This is a time to come together. And we have changes that we must make to the Affordable Care Act. I said that the day it passed--that it was a beginning and not an end. And I also though it was unfortunate that it was more of a Democratic bill than it was a bipartisan bill.

So we have an opportunity now to fix that to make fixes to the bill, to work together. But this bill is not the answer. This bill that we were not allowed to take part in, where the doors were closed, not only to the Democratic Senators but to Americans themselves. So I hope, Mr. President, that as we go forward, that our colleagues on the other side will work with us on a truly bipartisan bill that would make some of the changes we need to bring down health care costs instead of moving forward with this bill. Thank you.