- 4 days ago
In remarks on the Senate floor Wednesday, Sen. Bernie Sanders (I-VT) spoke about the Republican reconciliation bill.
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00:00from Vermont. Vermont. Thank you, Mr. President.
00:04The so-called reconciliation bill, or Mr. Trump's big, beautiful bill,
00:13that the Republican leadership is now attempting to rush through the Senate,
00:18is a rather extraordinary piece of legislation.
00:23In many respects, given the crises facing our country,
00:30this legislation does exactly the opposite of what should be done.
00:36Whether you are a Democrat, a Republican, or an Independent,
00:42you know, no one has any doubt about it,
00:45that our current health care system is broken, it is dysfunctional,
00:50it is a cruel system, and it is wildly expensive.
00:55We spend over $14,500 per person on health care,
01:03double what most countries around the world pay per person.
01:08And despite all of that spending,
01:12some 85 million Americans today are uninsured or underinsured,
01:17and we remain the only major country on earth
01:23not to guarantee health care
01:25to all people as a human right.
01:29And one out of four people who go into a pharmacy
01:35to get their prescription drugs
01:37can't afford that medicine
01:39because of the outrageously high prices.
01:44So, now, given that reality,
01:48how does this reconciliation bill
01:51address the horrific health care crisis
01:55that our country is experiencing?
01:59What one might think
02:02is that given 85 million people
02:05being uninsured or underinsured,
02:08this bill would lower that number.
02:13It would provide health care to more Americans.
02:17Given the fact
02:18that we are spending twice as much per capita
02:23on health care as any other nation,
02:25one might think
02:27that this legislation
02:29would lower the cost of health care.
02:33Given the fact
02:34that the insurance companies
02:35and the drug companies
02:37rip us off every day
02:39and make huge profits out of the system,
02:43one might think
02:44that this legislation
02:45would take on the greed
02:47of the pharmaceutical industry
02:49and the insurance companies.
02:52Well, if that is what you think,
02:55rational legislation
02:57should do understand
02:59that this bill does none of that.
03:02In fact, does exactly the opposite.
03:05This legislation, if enacted,
03:08would make the largest cut
03:11to health care
03:12in our nation's history
03:14in order to pay
03:17for the largest tax breaks
03:20for the rich
03:21that we have ever, ever seen.
03:24massive cuts
03:26to health care
03:27in order to provide tax breaks
03:30for billionaires.
03:32The Congressional Budget Office
03:34has estimated
03:35that this legislation
03:37would cut Medicaid
03:38and the Affordable Care Act
03:40by over $1 trillion.
03:43those cuts, along with ending
03:47the enhanced premium credits
03:49for the ACA,
03:51will lead to 16 million people
03:55losing their health insurance.
03:59That is not what Bernie Sanders
04:01has said.
04:04That is what the director
04:06of the Congressional Budget Office
04:09has told us.
04:11That is the non-partisan group
04:14that works for Congress.
04:18Mr. President,
04:20this bill, further,
04:21for the first time,
04:23forces millions of Medicaid recipients
04:25who make as little as $16,000 a year
04:29to pay a $35 copayment
04:32every time they visit a doctor.
04:36So, 16 million people
04:39are thrown off of health care.
04:43Low-income, working-class people
04:44now forced to pay a $35 copayment.
04:48So, what is the impact
04:49of all of that?
04:50Well, it will not surprise anybody.
04:54If people don't have access
04:56to health care,
04:58if they can't get to a doctor
04:59when they are sick,
05:01people will suffer,
05:03and tens of thousands
05:04of them will die.
05:09The Yale University School
05:11of Public Health
05:12and the University of Pennsylvania
05:13estimated in a recent study
05:16that if the reconciliation bill
05:18is enacted,
05:20over 50,000 Americans
05:23will die unnecessarily
05:26every year.
05:30That is what we are talking about.
05:3450,000 Americans
05:36dying unnecessarily
05:38because they're thrown off
05:39of health care.
05:39They can't afford to see a doctor
05:41each and every year.
05:44And what's the reason for that?
05:46What's the motivation
05:48for that horrific action?
05:51It is to give massive tax breaks
05:54to the very wealthiest people
05:56in this country,
05:58people who do not need them.
06:01And, Mr. President,
06:02not only would millions of Americans
06:03lose their health insurance
06:05and tens of thousands
06:07of our constituents
06:08needlessly die,
06:10if this legislation
06:12is enacted,
06:13rural hospitals
06:14all over this country,
06:16rural hospitals
06:17that are already struggling
06:19would be forced
06:21to shut down,
06:22lay off workers,
06:24or substantially reduce
06:26the services they provide.
06:29In other words,
06:31at a time when rural America
06:33is struggling,
06:34and I come from
06:35one of the most rural states
06:36in America,
06:38that is what Vermont is,
06:39this bill would be a disaster
06:42for rural America.
06:46Further,
06:47when Trump and the Republicans
06:49in Congress
06:50make massive cuts to Medicaid,
06:52they are not just attacking individuals,
06:57they are also going after
07:00and negatively impacting
07:02community health centers,
07:03which provide primary health care
07:06to 32 million
07:08lower-income
07:09and working-class Americans
07:10in every state
07:12in this country.
07:14Community health centers
07:15rely on Medicaid
07:16for 43%
07:18of their revenue,
07:20and when you cut
07:20hundreds of billions
07:22of dollars
07:22in Medicaid,
07:24you are significantly
07:25cutting back
07:26on the access
07:27that millions
07:28of Americans
07:29will have
07:29to the primary health care
07:31they desperately need.
07:34So,
07:35at a time
07:35when the health care system
07:36in America is broken,
07:38when primary health care
07:39is even in worse shape,
07:40this will make access
07:42to primary health care
07:43even more difficult.
07:45Mr. President,
07:47some 22%
07:48of our seniors
07:49in this,
07:51the richest country on earth,
07:53are trying to survive
07:54on less than $15,000 a year.
07:58And this legislation
08:00will make it harder
08:01for seniors
08:02and people
08:03with disabilities
08:04to receive the care
08:06they desperately need
08:07in nursing homes.
08:10Nursing homes
08:11in Vermont,
08:12and I expect
08:13in every state
08:14in this country,
08:15are struggling.
08:16They're understaffed.
08:19Workers there
08:20are underpaid.
08:22The quality,
08:23in many cases,
08:24is not as good
08:25as it should be.
08:27But when Medicaid
08:29now provides 60%
08:31of the revenue
08:32nursing homes rely on,
08:34slashing Medicaid
08:35will make
08:35a disastrous situation
08:37even worse
08:38for some of the most
08:41vulnerable people
08:43in our country.
08:45So,
08:46Mr. President,
08:47let us be clear.
08:48Let us not run away from it.
08:50Let us not double-talk
08:52this issue
08:52and come up
08:53with all kinds
08:54of absurd
08:55rationalizations.
08:57This legislation,
09:00coming before the Senate
09:01this week,
09:03is the most significant
09:04attack
09:05on the health care needs
09:06of the American people
09:08in the modern history
09:10of our country.
09:12And once again,
09:14once again,
09:17we are throwing
09:18millions of people
09:20off the health care
09:21that they depend upon
09:23to stay alive
09:24in order to give
09:25tax breaks
09:26to billionaires
09:27who have more wealth
09:29today
09:29than they will need
09:31for a hundred
09:32lifetimes.
09:34And yet,
09:35Mr. President,
09:36oddly enough,
09:37despite the enormity
09:38of what this legislation
09:40is about,
09:41not a single committee
09:43in the Senate
09:43has held
09:44a single hearing
09:45on the impact
09:47this legislation
09:48will have.
09:50And in my view,
09:51really,
09:52this is absolutely
09:53irresponsible.
09:54I'm not quite sure
09:54why we continue
09:56to even have committees
09:58if the Health
10:00and Labor Committee,
10:01of which I am
10:02ranking member,
10:04does not hold
10:05a hearing
10:05on the most important
10:06piece of health legislation
10:07in the modern history
10:08of this country.
10:10And that is why
10:12this morning
10:12I released,
10:14as the leader
10:15of the minority
10:16on the committee,
10:17a report
10:19discussing the impact
10:22that this legislation
10:23would have
10:24on our nation's
10:25health care system.
10:28And I did that
10:29by doing something
10:31pretty radical.
10:33I guess
10:33we actually reached out
10:35to health care providers
10:37all over the country.
10:38You know,
10:39if you're going
10:39to decimate
10:40American health care,
10:41you may want
10:42to talk
10:42to the doctors
10:44and the nurses
10:44and the health care
10:46organizations
10:47around America.
10:48I think it's kind
10:49of a common sense
10:51thing to do.
10:53And let me
10:54take this opportunity
10:56to thank
10:58the over 750
11:00health care providers
11:02from 47 states
11:05who responded
11:06to my request.
11:08I want to thank
11:09them sincerely
11:10for their thoughtful
11:10responses.
11:12We basically said,
11:13well, what is this
11:13legislation going to do
11:15in your state?
11:15And we got
11:16hundreds and hundreds
11:18and hundreds
11:18of responses.
11:21And,
11:21Mr. President,
11:22I would ask
11:23unanimous consent
11:24that this entire
11:26report be included
11:27in the Congressional
11:28record.
11:29Without objection.
11:33Mr. President,
11:33let me just
11:34summarize
11:35and quote
11:38some,
11:39a small number,
11:41of the responses
11:42that we got.
11:44if this legislation
11:48were to be signed
11:50in law,
11:51it would drive up
11:54the number
11:55of uninsured
11:56Americans
11:59in every single
12:01state in this country.
12:04For example,
12:05if this legislation
12:06was signed into law,
12:08the uninsured rate
12:09in my state of Vermont
12:11would go from
12:133.3%
12:14to 6%.
12:16In Louisiana,
12:19the uninsured rate
12:20would go from
12:216.7%
12:22to 12.4%.
12:25In the state
12:27of Washington,
12:29the uninsured rate
12:30would go up
12:30from 6.2%
12:31to 11%.
12:33In Florida,
12:36in Florida,
12:38the uninsured rate
12:38would go up
12:39from 10.4%
12:41to 18.8%,
12:44almost 19%
12:46of people
12:46in Florida
12:47will be uninsured
12:50if this bill
12:51goes through.
12:52And this is true
12:53for every state
12:54in the country,
12:56in many cases
12:57an almost doubling
12:58of the number
12:59of uninsured.
13:01and now let me
13:04just quote
13:04for you
13:08what health care
13:10providers
13:10and state
13:12organizations
13:12around the country
13:15are saying
13:16as to the horrific
13:17impact that this
13:18legislation would have.
13:20Now, I know
13:20many of my
13:22Republican colleagues
13:23are getting up
13:23and they're saying,
13:24oh, it's not true,
13:24it's this, that.
13:25The other thing,
13:27listen to the doctors,
13:31listen to the organizations,
13:33the health care providers
13:34in your own state.
13:37Let me just begin
13:39with Texas,
13:40a Dr. Audrey Knapp
13:41where the uninsured rate
13:44will reach 20%.
13:45I don't know
13:46if anybody from Texas
13:48watching this,
13:49you're going to be,
13:51if this bill goes through,
13:52you might want to
13:53say hello to your senators here,
13:56your uninsured rate
13:57is going to go up to 20%.
13:58And this is what
13:59Dr. Audrey Nath wrote.
14:01Quote,
14:02these cuts
14:03will cause
14:05rural hospitals
14:06in Texas
14:07to close entirely.
14:09As a neurologist,
14:10I am terrified
14:11that the closest hospital
14:13for many rural folks
14:14may then be hours away.
14:18During an ischemic stroke,
14:20there is only three hours
14:22of precious time.
14:23you get a stroke,
14:23you got to get care
14:24very quickly.
14:26And she writes
14:27that the increased
14:28travel time
14:28may cause
14:29unnecessary cases
14:31of paralysis
14:32and death.
14:33End of quote.
14:34That is obviously
14:35what happens
14:35not only for stroke,
14:37but for many other illnesses
14:38if you don't have
14:40a hospital nearby.
14:43Dr. Faram Malik
14:45from Florida
14:46where the uninsured rate
14:47will surge
14:48to almost 19%
14:49wrote,
14:49plainly said,
14:53children will die
14:54as a result
14:56of these cuts.
14:58Hospitals
14:59will cut back
14:59on ICU doctors.
15:02Doctors will leave
15:02because of salary cuts.
15:04Critical ancillary services
15:06will be reduced
15:08and more medical students
15:10will avoid going
15:11into pediatric residencies.
15:13End quote.
15:15Dr. Mia Henderson,
15:17Maya Henderson,
15:18who works at a community
15:19health center
15:20in Missouri,
15:22wrote that the cuts
15:23to Medicaid
15:23contained in this legislation
15:25would mean,
15:26quote,
15:26that we may not be able
15:29to keep the doors open
15:30of a community health center.
15:32We would potentially
15:33have to stop caring
15:35for many of our patients.
15:37End quote.
15:38The Louisiana Rural
15:39Health Association
15:40wrote,
15:41and I quote,
15:42Louisiana's rural hospitals
15:44and health care providers
15:46are already operating
15:48on razor-thin margins,
15:50struggling to keep
15:52their doors open
15:52while serving some
15:53of our most medically
15:54vulnerable communities.
15:56In Louisiana,
15:5738% of hospitals
15:59operate on negative margins
16:00and 27% are currently
16:03vulnerable to closure.
16:05Medicaid cuts
16:06would worsen these losses,
16:07putting more hospitals
16:08at risk of shutting down
16:10entirely.
16:13Dr. Sanjay Chauvi,
16:15a doctor from Louisiana,
16:17told the health committee,
16:18quote,
16:19the proposed cuts
16:21to Medicaid
16:21will cause untold hardship
16:24and deaths
16:25deaths among my patients.
16:28Don't do this,
16:32he puts in capitals,
16:34capital letters.
16:35You don't want the deaths
16:37of tens of thousands
16:38of Americans
16:39on your hands.
16:41that is Dr. Chauvi from Louisiana.
16:45Dr. Gregory Amlor
16:47from Akron's
16:49Children's Hospital
16:50in Ohio
16:51told us that,
16:53quote,
16:54if the proposed bill
16:55is passed
16:56and my
16:58patient's Medicaid
17:00insurance is cut,
17:02it doesn't mean
17:03their asthma
17:04will go away.
17:05it will mean
17:06that in most cases
17:07they will not receive
17:09preventative care
17:10and some children
17:11will die
17:12of their asthma,
17:14end quote.
17:15And here's what another
17:17doctor from Ohio
17:18said,
17:19and I quote,
17:20implementing work
17:22requirements
17:23into Ohio Medicaid
17:25will threaten
17:26my patients' gains.
17:29Most of my patients
17:30want to work.
17:32They are desperate to.
17:34There just aren't
17:35jobs available
17:36for folks
17:37with very low skills
17:38and health conditions
17:40that could cause them
17:41to miss work
17:42unexpectedly.
17:44The jobs that are available
17:45do not pay enough
17:46for an adult to survive
17:48and they certainly
17:49don't offer
17:49health insurance.
17:51My patients
17:52who rely on Medicaid
17:53have frequently been born
17:55into generational poverty,
17:57have only had
17:58access to poor quality
17:59schools
18:00and live in neighborhoods
18:01where their health suffers.
18:03End of quote.
18:05And by the way,
18:08this Dr. Amlau
18:10talks about work requirements.
18:12Let us understand,
18:13Mr. President,
18:15that every single year
18:17millions and millions
18:19and millions
18:20of Americans
18:21lose their jobs.
18:24Not through any fault
18:26of their own
18:26that company shuts down,
18:28company goes bankrupt,
18:29whatever it may be,
18:30they lose their jobs.
18:32They don't have a job.
18:33Well, how are they
18:34going to get health care?
18:36Well, we've taken
18:36health care away from them
18:38because they're not working.
18:41The Vermont Association
18:42of Hospitals,
18:43my own state,
18:46the Association of Hospitals
18:47and Health Systems
18:48wrote that this bill,
18:49quote,
18:49reduces coverage and access,
18:51particularly in rural areas
18:53such as Vermont,
18:54where hospitals
18:55and other health care providers
18:56are already financially fragile
18:59and that it will force
19:01hospitals in Vermont
19:02to cut back
19:03on clinical staff services
19:05and care delivery.
19:06I can tell you,
19:07hospitals in Vermont
19:08are struggling.
19:09This will make
19:10a very, very difficult situation
19:13even worse.
19:14Now, Mr. President,
19:15I've got a radical idea,
19:17probably one that,
19:18hmm, I would say
19:1970 or 80%
19:21of the American people
19:22agree with.
19:24And that is maybe,
19:25just maybe,
19:26instead of throwing
19:2816 million people
19:30off of health care,
19:33instead of creating
19:35a situation
19:36where 50,000 Americans
19:38die unnecessarily,
19:40why don't we do
19:42what every other
19:44major country
19:45on earth does
19:46and guarantee
19:49health care
19:49to all people
19:51as a human right.
19:52What do you have?
19:53That, Mr. President.
19:54Instead of throwing
19:5516 million people off
19:57so we have almost
19:58100 million uninsured,
20:00hey, why don't we do
20:01what Canada does,
20:03what the UK does,
20:04what Spain does,
20:06what Finland does,
20:07what Holland does,
20:09what every other
20:09major country on earth does,
20:11guarantee health care
20:12to all people
20:13as a human right.
20:15But,
20:15the problem there
20:16is it is easier
20:18to throw working people
20:20off of their health insurance
20:22around here
20:24than to take on
20:25the big money interests
20:27who run the insurance industry
20:29and the pharmaceutical industry.
20:31That's what this is about.
20:34Mr. President,
20:35in many respects,
20:38this bill represents
20:40exactly why many Americans
20:42are giving up on democracy
20:44and have such contempt
20:46for Congress
20:48and for the Democratic Party
20:50and for the Republican Party.
20:53At a time
20:54when the richest people
20:55have never ever had it so good,
20:57they now see Republican leadership
21:00working overtime
21:01to make the billionaire class
21:03even wealthier.
21:05at a time
21:06when a majority of Americans
21:08are struggling
21:08to put food on the table
21:09and pay
21:10for health care,
21:12they see Republican leadership
21:14making life
21:15even more difficult
21:16for average Americans.
21:19So,
21:19Mr. President,
21:20I would say
21:21that I speak
21:21for the overwhelming
21:22majority
21:23of the American people
21:25who think
21:25that it is basically
21:26insane
21:27that we are talking
21:29about throwing
21:3016 million people
21:32off the health care
21:32they have,
21:34creating a situation
21:36where 50,000 Americans
21:37will die unnecessarily
21:39each year
21:39in order to give
21:41hundreds and hundreds
21:43and hundreds
21:43of billions of dollars
21:45to billionaires
21:46and the wealthiest people
21:47in this country.
21:49This is a disastrous,
21:51obscene piece of legislation.
21:54It must be defeated.