-9999

Floor Speech

BREAK IN TRANSCRIPT

Mr. CASSIDY. Mr. President, I rise, as so many others have, to give tribute to Senator Lindsey Graham.

Lindsey was effective as a Senator, in large part, because he was so well-liked by colleagues and because he liked them in return.

He was affable, always willing to work with others, regardless of how different backgrounds, beliefs, and positions were. He just focused on getting things done and had the courage to take on issues that others would not.

We collaborated on something called Graham-Cassidy, a bill which would have replaced Obamacare with coverage for everyone--literally everyone--but at a lower cost than the Affordable Care Act. I always chuckle when I say the Affordable Care Act.

And we were a good team because we complemented each other. I was a doctor, always thinking about healthcare. He was the politician's politician.

He told me: Bill, you are good at policy, but you are a terrible politician.

And I would say that many people knew exactly what he was talking about. At one point, I was talking to him about healthcare. He said: Oh, Bill, don't talk to me about policy. It gives me headaches. But he said he would fight to get it passed. We came up short but not because he did not and I did not fight.

Once he said: I am going to go on ``FOX Morning.'' If I go on ``FOX Morning,'' I know the President is watching. And if the President is watching the ``FOX Morning'' show and I say we should be fighting to replace Obamacare, it will get the President engaged.

He just knew how to find that audience that was important. He knew how to speak to them. He had a great sense of humor, and, again, he knew how to get things done.

Ultimately, that is why somebody comes to Washington. Some people come to Washington to be a Senator. Others come to Washington to do something as a Senator. Lindsey was someone who came to Washington to do something as a Senator.

I speak for myself, but I echo what colleagues have said. Lindsey Graham shall be missed. Healthcare

Mr. President, we have got to do something about healthcare. Now, I am a physician. You might think I--of course, Bill cares about it. I can tell you who cares about it is the American people.

I was with an Uber driver last night: What do you think--you know, if you were the President, Uber driver, what would you be talking about right now?

She said: I can't afford things. I can't afford my gas. I can't afford my groceries, my housing. I can't afford my healthcare.

Now, that has been echoed.

And, in fact, what we are seeing is that the inability to afford healthcare is impacting the ability of small businesses to provide health insurance for their employees. The employer-based health insurance system is the most dominant form of providing health insurance for those less than 65, and it is crumbling. The percentage of working-age adults getting health coverage from a job has decreased from 67 percent--oh, about 25 years ago--to about 60 percent now. And the reason why is that premiums are going up so much, particularly for those 62 percent of Americans who get their insurance from a small business.

There is a recent article in STAT which, based upon Federal Government information, if you look at inflation since about 1985, premiums should have risen about 176 percent. But they have actually risen over 1,000-- almost 1,100--percent higher than they should have. To put it this way, if they should have risen 176 percent, they have actually risen about 1,100 percent. These are premiums.

Now, by the way, these premiums continue to rise after the passage of the Affordable Care Act. Indeed, the rise became higher, faster after the passage of the Affordable Care Act.

And so, if you are a small business, you are trying to make ends meet. Businesses contribute to the health insurance of their employees. Typically, they may employ--it depends upon the business, but they may give, oh, 100 percent. They may give 80 percent. They may give 60 percent. But whatever percent that the small business is contributing to their employees is going up.

The other thing to recognize is that, when it begins to rise too much, then the employer pays less and less for the employees' health insurance. This can be manifested in a couple ways. Instead of paying 80 percent of the cost of the policy, they may pay only 60 percent. Or the small business may decide to get a less expensive policy, in which case they increase the deductible.

Now, the deductible is what we pay out of pocket before the insurance kicks in. That is the problem.

And so, if you look at, since about 2000, the amount of deductible at a big business is about $1,700. At a small business, for a single worker, among workers with a deductible, it is now about $2,600.

So before the insurance begins to work for the employee, they have to come up with, on average, $2,600 to pay before the insurance kicks in.

Now, it may be something like a routine visit, which is covered. They may have preventive care covered, like a mammogram or a screening colonoscopy. But, typically, they have got to put up $2,600, on average, if they go to the emergency room after a car wreck, and only then does the insurance begin to kick in.

Now, why is that important? Because most families have less than $500 of cash in order to pay for their healthcare.

In previous speeches, I have talked about how people are putting their healthcare expenditures on their credit card. And that credit card debt factors into 60 percent of household bankruptcies. So they have a $3,000 deductible, and they don't have the money in their bank account. Their child gets sick, and they bring them to the emergency room. They don't have the $3,000. So they put it on the credit card, and that credit card debt mounts.

Indeed, if you look at the percent of income that Americans are now paying upon credit card interest, which means that they are carrying a balance, it has risen from about 1 percent to 3.2 percent. So 3.2 percent of their income is going to pay for interest on credit cards.

This shows that they are rolling these big credit card balances forward. So with credit card balances not paid, but being the minimal amount being paid, they are up to $10,000.

Much of this relates back to: How do you pay for healthcare? I don't have the money in my account. So I am going to use my credit card in order to pay for these large deductibles.

Well, I have got a way to address that, Mr. President. We call it the MVP Act. Under our plan, we would give an advance, an income tax credit, to the family--on average, for a family of four, about $2,000-- that would go into an account that they use to pay for their benefits.

By the way, this is paid for. This is paid for.

But they would prefund a health savings account.

Now, we don't give it to the insurance company because, if you give the money to the insurance company to subsidize the premiums, the insurance company takes 20 percent of it for overhead and for profit. You give it to the individual or family, and they are going to use 100 percent of it for the healthcare that they need.

Now, we have coupled that. So it is money in your pocket. We couple that by adding value, price transparency, so that the family knows the price they pay before they go in for the service. That could be powerful.

I was up here in DC once. Actually, I remember we were having a crawfish boil. Every year, Louisiana people have a crawfish boil. And there was a woman who saw me on the street. She stopped me.

She said: Hey, Dr. Cassidy.

And I said: Yes.

She said: I am from Texas, but I saw that you gave a speech about price transparency, and that if I paid cash, it would be cheaper than if I went through my insurance. So the doctor ordered an MRI on my son's shoulder, and they told me it was going to cost $2,000. Well, my deductible was whatever it was--say a thousand dollars. So I said: How much, if I pay you cash? They said: Well, if you pay us cash, it is only $600.

In this case, paying cash was cheaper than paying her deductible.

So if you know, if you have price transparency, if you say, ``Wait a second; I am going to have at least a thousand dollars out of pocket because of my deductible, but if I paid cash right now and don't go through my insurance, it only cost me $600,'' you are going to bring value to the patient.

In this transaction, under the MVP plan, there would have been money placed into her health savings account. She could have used--in this case, she did it on her own--price transparency to find out the price. So there is money and value for the patient.

We take the power away from the middleman, the power away from the insurance company to approve or disapprove of the care that the patient knows that she needs; and, instead, we would give the money directly to her, with the tools of price transparency to bring value to the patient.

Now, we are making steps on this. Right now in the HELP Committee-- the Health, Education, Labor, and Pensions Committee--of which I am the chair, we are working on price transparency legislation. We hope to get that passed in the next 2 weeks out of Committee, and we hope this passes on the floor of the Senate. This is how we bring value to the patient, by bringing the power of price transparency, as she chooses what healthcare and where to get her healthcare.

Now, we can get this done. Whenever there is a big idea like this, how do we actually help the American people with affordability? How do we actually put money in their pocket and couple it with tools that would give them the power of price transparency, in order to bring money in their pocket and value for the patient?

People say: Oh, that is too big. We can't get that done--no way.

But, folks, we have actually achieved a lot on healthcare in the last few years. The No Surprises Act blocks about a million surprise medical bills per month for the American people. A PBM reform bill, which was signed into law by President Trump a few months ago but that was negotiated by Congress--and it was tough, but we actually got it so that the value to the patient in terms of lower drug prices, if you will, cutting out or restricting activities of the insurance company in the middle--we got that through. The administration is working on TrumpRx, which allows patients to buy drugs without hidden costs.

So if we are going to make healthcare affordable to the American people, we have to build on that record, and we have to work together.

So my challenge to the Senate, to the House, and to the President: Let us come together. Let us get things done. Let us work for the American people.

Ask any Uber driver, ask our constituents: What is the biggest issue right now?

And they will say: Affording life.

Affording life means to be able to afford healthcare.

And, Mr. President, with the MVP health agenda, we help our constituents afford healthcare.

BREAK IN TRANSCRIPT

Source