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Floor Speech

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Mr. BENNET. Mr. President, I appreciate the opportunity to come to address my colleagues today in the Senate.

During the course of this shutdown--what has now become the longest shutdown in American history--there are a lot of people around the country wondering about what has been at stake in this debate and in this argument. And I think, with every day that has gone by, it has become clearer and clearer what is at stake.

I have heard my Republican colleagues, including the leader of the Republican Party in the Senate, come to the floor to say, over and over again, that not a single Republican in this Chamber, not a single Republican in the United States Congress, voted for the Affordable Care Act when we passed it in 2010.

And for them, that is a badge of honor. That is a badge of honor that they recall from the last extensive debate we had around here about healthcare.

I deeply regret the fact that they are so proud of not having voted for the Affordable Care Act. It is true that there was not a single Republican in the Congress that voted for that bill.

And that bill was far from perfect--I will admit that. Even at the time, I was leading the fight for a public option to be included as part of the Affordable Care Act because I thought it would be a very important part of constraining costs for the American people in our healthcare system. I will say more about that in a minute.

Hon. Harry Reid, United States Senate Majority Leader, Washington, DC.

Dear Leader Reid: We respectfully ask that you bring for a vote before the full Senate a public health insurance option under budget reconciliation rules.

There are four fundamental reasons why we support this approach--its potential for billions of dollars in cost savings; the growing need to increase competition and lower costs for the consumer; the history of using reconciliation for significant pieces of health care legislation; and the continued public support for a public option.

A Public Option is an Important Tool for Restoring Fiscal Discipline

As Democrats, we pledged that the Senate health care reform package would address skyrocketing health care costs and relieve overburdened American families and small businesses from annual double-digit health care cost increases. And that it would do so without adding a dime to the national debt.

The non-partisan Congressional Budget Office (CBO) determined that the Senate health reform bill is actually better than deficit neutral. It would reduce the deficit by over $130 billion in the first ten years and up to $1 trillion in the first 20 years.

These cost savings are an important start. But a strong public option can be the centerpiece of an even better package of cost saving measures. CBO estimated that various public option proposals in the House save at least $25 billion. Even $1 billion in savings would qualify it for consideration under reconciliation.

Put simply, including a strong public option is one of the best, most fiscally responsible ways to reform our health insurance system. A Public Option Would Provide Americans with a Low-Cost Alternative and Improve Market Competitiveness

A strong public option would create better competition in our health insurance markets. Many Americans have no or little real choice of health insurance provider. Far too often, it's ``take it or leave it'' for families and small businesses. This lack of competition drives up costs and leaves private health insurance companies with little incentive to provide quality customer service.

A recent Health Care for America Now report on private insurance companies found that the largest five for-profit health insurance providers made $12 billion in profits last year, yet they actually dropped 2.7 million people from coverage. Private insurance--by gouging the public even during a severe economic recession--has shown it cannot function in the public's interest without a public alternative. Americans have nowhere to turn. That is not healthy market competition, and it is not good for the public.

If families or individuals like their current coverage through a private insurance company, then they can keep that coverage. And in some markets where consumers have many alternatives, a public option may be less necessary. But many local markets have broken down, with only one or two insurance providers available to consumers. Each and every health insurance market should have real choices for consumers. There is a history of using reconciliation for significant pieces of health care legislation

There is substantial Senate precedent for using reconciliation to enact important health care policies. The Children's Health Insurance Program (CHIP), Medicare Advantage, and the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), which actually contains the term `reconciliation' in its title, were all enacted under reconciliation.

The American Enterprise Institute's Norman Ornstein and Brookings' Thomas Mann and Molly Reynolds jointly wrote, ``Are Democrats making an egregious power grab by sidestepping the filibuster? Hardly.'' They continued that the precedent for using reconciliation to enact major policy changes is ``much more extensive . . . than Senate Republicans are willing to admit these days.'' There is strong public support for a public option, across party lines

The overwhelming majority of Americans want a public option. The latest New York Times poll on this issue, in December, shows that despite the attacks of recent months Americans support the public option 59% to 29%. Support includes 80% of Democrats, 59% of Independents, and even 33% of Republicans.

Much of the public identifies a public option as the key component of health care reform--and as the best thing we can do to stand up for regular people against big insurance companies. In fact, overall support for health care reform declined steadily as the public option was removed from reform legislation.

Although we strongly support the important reforms made by the Senate-passed health reform package, including a strong public option would improve both its substance and the public's perception of it. The Senate has an obligation to reform our unworkable health insurance market--both to reduce costs and to give consumers more choices. A strong public option is the best way to deliver on both of these goals, and we urge its consideration under reconciliation rules.

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Mr. BENNET. In the end, it was not included. In the end, we couldn't overcome the objections of the special interests who wanted to deny the American people that choice. But it was an important case to be made, and we made that case.

But I voted in the end for the Affordable Care Act even though the public option was left out of it because it did some really important things for the healthcare system in America. Most of those had to do with making sure that the insurance companies couldn't throw you off your insurance just because you got sick; that cancer and other conditions could no longer be a preexisting condition; that you could still get healthcare even if you had the misfortune, as I have had, of having cancer; that there would be no lifetime cap that would prevent you from being able to provide healthcare or mental health care for your children or for your family just because things had gotten expensive over a period of time.

These were really critical decisions that were made as part of that bill--in addition to the expansion of Medicaid across the country--to be able to ensure that more working people had the chance to be able to afford healthcare, which brings to mind one of the really unusual--sort of the unusual context in which we have had healthcare debates in America, which is that we are the only rich country in the world, we are the only industrialized country among all industrialized countries where healthcare is not a right of citizenship for everyone who lives in that country.

Notwithstanding the fact that we have less access to healthcare than any other industrialized country in the world, it costs twice as much in the United States. It costs twice as much for the Federal Government. It costs twice as much for our society. Most important, it costs twice as much for the people that we represent in our various States, including in the State of Colorado.

People in Colorado, as we meet here, are struggling with the cost of housing, the cost of food, the cost of President Trump's uncertain and unpredictable tariff policy. But they are also continuing to struggle with the cost of healthcare because we are spending twice what any other industrialized country is spending to get a worse result.

I know the President knows this. The President of the Senate knows this because he is a doctor. I have heard him talk about the condition of our healthcare system.

Today in the United States, our life expectancy is 6 years shorter than it is in any of those industrialized countries. What greater indictment could there be of this system? In the 1970s, we had the same life expectancy as the rest of these countries. In fact, we were in the middle. In the years since, we have fallen further and further and further behind as we have spent more and more and more money because the system we have is so shot through with benefits for special interests, among other things, and a complete lack of transparency, which is a fancy way of saying that literally nobody has any idea what anything costs in our healthcare system.

I know the Presiding Officer agrees with that. You can't tell what anything costs when you show up to fill a prescription, when you are in the emergency room. We worked together on the surprise billing issue, which is an important part of this. If you are a senior that is trying to get your prescriptions filled, you go from one pharmacy to the next to the next.

I will never forget as long as I serve in public office and probably for my lifetime the conversation I had with senior citizens in Pueblo where they basically were telling me that their entire retirement was spent fighting to get prescriptions filled that their doctors had prescribed them. Seniors in other industrialized countries don't spend their retirements doing that. Only in the richest country in the world do seniors have to do that, and that is because a lack of transparency, a lack of clarity is built into our healthcare system from top to bottom.

But we took some important steps in the Affordable Care Act. I wish it had included a public option. It didn't. I think that the rate of rise of our healthcare inflation would have been a lot less. By the way, that is what the people that have looked at that bill and scored that bill over the years have said. We have been fighting for it now for a decade and a half. They said that it would actually save the government money because it would lower healthcare costs; it would introduce some competition into our insurance market.

I will say this to the Presiding Officer. He will probably be amused by it. This is the one place where I really am a Bolshevik. I believe in universal healthcare for all Americans. I think we should provide that to people in this country as a right. There is no reason not to do it in the richest country in the world, especially if we can save half of the cost of healthcare that we are providing now.

Families all over my State, all over Colorado, are fighting to get their kid the mental health care they need, are fighting to get their parents the prescriptions they have been prescribed, are fighting to hold on to their own health insurance, because that also has become less and less affordable over the years. That is a fight that no one else in the industrialized world has to have.

I think it is important to point out that most of the people I am talking about--almost all of the people I am talking about are working for a living in this country and still can't afford healthcare, still can't afford the peace of mind that they know that if their kid breaks their leg on a hike or breaks their leg skiing or needs to have the benefit of a mental health counselor, that that is something our safety net provides. Healthcare should be a right. It is a right. And whether you get it or not shouldn't be determined by how wealthy you are or where you live.

I think, given the rhetoric I hear out here sometimes about makers and takers and all that other stuff, it is important to point out that almost all the people I am talking about are working or taking care of children or are retired.

We should have a universal healthcare system in this country, but in the meantime, we shouldn't be making matters worse, which is why this debate is so crazy.

When we passed the Affordable Care Act without a single vote from the Republican Party in the House or the Senate, they said that they were going to make President Obama a one-term President. They said that I was going to lose my Senate seat. In fact, I was asked on national television whether I would lose my Senate seat as a result of my vote on the healthcare bill, and I said: If that is the cost of being here for that period of time, it is worth it. I am happy to lose based on that vote.

They ran ad after ad after ad during that campaign attacking me for being the 60th vote for the Affordable Care Act. And because I survived and a couple other Senators barely survived, we were able to preserve that bill, and 30 million people who would have lost their health insurance in America didn't lose their health insurance.

Then the efforts in the House began to repeal the Affordable Care Act. They voted, I think--I lost count--I think it was 70 times to repeal the Affordable Care Act in the House of Representatives--at least 70 times. They never were able to do it. And the longer it was there, the more people came to see the benefits of the insurance protection, came to see the benefits of the expansion in Medicaid, came to see the benefits of at least having a little bit of comfort that they couldn't just throw you off your insurance because they felt like it.

Now we have found ourselves in a debate related to the tax credits that so many Americans rely on to make insurance just a little bit more affordable. I wouldn't say affordable. I would say a little bit more affordable. I would say barely affordable but somewhat more affordable.

At a moment when grocery prices are what they are, at a moment when rent is what it is, at a moment when we are dealing with the incredible uncertainty these tariffs are causing, it would seem the least we could do is not make matters worse. The least we could do is extend the tax credit so it is a little bit easier for people to buy insurance for themselves and for their families. But just like with the passage of the Affordable Care Act, when not a single Republican supported it; just like when they voted 70 times in the House of Representatives--70 times--to repeal the Affordable Care Act, during this period, this episode, this shutdown, the longest in American history, the Republicans have voted 15 times to take away those benefits from the American people that they are relying on just to make insurance a little bit affordable.

We have taken the position that we shouldn't make matters worse, and that is why I voted again against the budget that has been proposed by President Trump and the Republicans, because they refuse to extend the tax credits. They refuse to make things just a little bit better for the American people.

I can't say I am surprised by the position. Who could be surprised after a vote on the Affordable Care Act where nobody joined it; all those years of voting to repeal it; wanting to make President Obama, they said, a one-term President; and now the vote day after day after day to not provide the American people the benefit of those tax credits.

Before this debate closes, I just want to say again that the current system is in dire need of help.

The American people are hanging on by their fingertips when it comes to the cost and availability of healthcare. There is no rich country in the world that doesn't have a universal system of healthcare. There is no rich country in the world that doesn't routinely supply access to doctors and primary care, access to mental health care for families and for kids, prescription drugs that don't cost an arm and a leg. It is not a pain point for those people in the different phases of their lives, much less a pain point every single day, which it is for the people that I represent in Colorado.

Apparently, President Trump is going to get his way, and those tax credits are not going to be extended by the majority here. And the cost of health insurance in Colorado is going to increase by 200 percent for some people, 300 percent for some people, 400 percent for people that are living in rural areas in my State. That is thousands and thousands of dollars to a typical family that just doesn't have that kind of money.

I just want to remind everybody in this Chamber that when this debate is done, we still have a very important project that we need to be engaged in with the American people, and that is to be able to provide a healthcare system like other wealthy and industrialized countries have provided--where people can count on their healthcare; where they know it is not going to cost them an arm and a leg; where they know, in the course of their lifetime, there are other things they can worry about, like the cost of their rent and the cost of food. But the one thing we are going to do is take care of this problem, just as countries all over the world have taken care of it for their citizens.

I wish I could say that the politics around healthcare have gotten better over the years that I have been here. They really haven't. But I think that the debate that we have had in this moment is going to serve to clarify who is fighting to try to make the system better for the American people and who is not.

I guarantee you this, as long as we have President Trump in the White House and a majority of Republicans in this Chamber, we will never have political leadership that is fighting for universal healthcare, that is fighting for a public option that can be available to every single family in America.

By the way, that is my proposal. It relies on everybody in America to make the best choice for their family. It is not something that would be imposed from here. It would be the chance for every family to say: You know what? I will stay with the private insurance I have or, actually, I would rather be on a system that is run by Medicare, where I know I am going to have access to mental health care and healthcare for my family in a predictable way.

I can see my colleague from Massachusetts. I will close by saying that my heart especially aches for young people across this country, the people the age of my own daughters.

I had a young woman ask me the other day, a recent graduate of Western State in Gunnison, CO--she said: I am coming off my parents' insurance after I am 26.

You will remember that we put that in the healthcare bill. Before that, there was no opportunity for people to stay on their parents' insurance. We did it. We said you get to stay on until you are 26.

She said: Senator, what am I supposed to do, take two or three jobs to pay for my health insurance when I have to come off my parents' insurance?

I said: That is exactly the right question. That is a question that 26-, 27-, and 28-year-olds are not having to ask in any other industrialized country in the world. Only in the United States of America are we running a system where young people in their twenties have to decide between health insurance and their rent, or health insurance and food, or health insurance and the ability to put some money away to save for a house.

We should change that.

I believe strongly that if we ever get to the point where we are expanding Medicare in this country, we should do it for the younger kids that are in their twenties first because they have done absolutely nothing to design the system that they are inheriting.

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