Wyden Statement on Senate Floor on Seema Verma Nomination and Trumpcare
As Prepared for Delivery
Today the Senate turns to consider the nomination of Seema Verma to be the administrator of the Centers of Medicare and Medicaid Services. Now I’ll admit, people in coffee shops across America probably aren’t atwitter with the latest buzz out of CMS. But the fact is, this is an agency that controls more than a trillion dollars in health care funding each year. And furthermore, if she’s confirmed and if the Trumpcare bill somehow gets rammed through Congress over loud and growing opposition, that’ll be the biggest issue she faces right from the get-go. Members ought to recognize that this nomination is a big deal because of all the administrative power the head of CMS has.
If Trumpcare passes, under section 132 of the bill, she’d be able to give states a green light to shunt sick patients into high-risk pools that have failed historically at offering good coverage that anybody can afford. Under section 134 of that bill, she’d be in charge of deciding exactly how skimpy Trumpcare plans will be and how much more Americans will be forced to pay out of pocket for the care they need. Under section 135 of the bill, she’d pave the way for health insurers to make coverage more expensive for people approaching retirement age.
Given all that, I want to start this debate with Trumpcare. The odds were against Republicans writing a single piece of legislation that would make health care more expensive, kick millions off their coverage, weaken Medicare and Medicaid, and give enormous tax breaks to the wealthy all at the same time, but they found a way to do it. And now they’re rushing to get it passed before the American public catches on.
For seven years, my colleagues on the other side have pointed to the Affordable Care Act as the source of just about every ill in our health care system. The Republican slogan was to repeal and replace, and they rode that wave through four elections to great success. The only problem was, the replacement plan was nowhere in sight.
But now the curtain has been lifted, the lights are shining on Trumpcare, and there aren’t a lot of people enjoying the show.
Trumpcare really comes down to going back to the days when healthcare in America worked only for the healthy and the wealthy.
There are almost too many problems with this proposal to talk about in one shot, but with a lot of debate ahead, I want to walk through some key points this afternoon and how they relate to the role Ms. Verma is nominated to fill.
First let’s set aside the health care aspect for a moment and address what would happen strictly in terms of dollars and cents.
This proposal, in my view, is Robin Hood in reverse. What you have is hundreds of billions of dollars coming out of the pockets of working people and going straight to the most fortunate in our country.
Nothing illustrates this issue more clearly than the fact that the Republican proposal gets rid of the ACA’s Medicare payroll tax on the wealthiest earners.
Every time an American earns even one dollar, a little bit of Medicare tax is taken out to fund the program. The Affordable Care Act asked the wealthiest Americans to pay a little bit more to strengthen Medicare’s finances and make sure the program is available for future generations.
The Trumpcare bill does a 180, so the only people who are getting a tax reduction are the fortunate few who need another tax break least. And it cuts three years off the life of the Medicare Trust Fund.
Let’s be clear, this bill breaks a clear Trump promise not to harm Medicare. When the president was asked about cutting Medicare, he said, quote, “You can’t get rid of Medicare. Medicare’s a program that works … people love Medicare and it’s unfair to them, I’m going to fix it and make it better but I’m not going to cut it.”
The promise not to cut Medicare lasted about six and a half weeks into the Trump administration before it was broken.
So while the most fortunate get a tax break, the runway gets shorter for Medicare. And that ought to be infuriating and concerning for people who’ve paid into the program for decades – people who are 50, 55, or 60 years old today – and are counting on it to be around when they retire.
Those individuals are going to take a gut-punch under this bill, too, in the form of higher costs.
In parts of my home state – particularly out in rural areas like Grant County, Union County and Lake County – a 60 year old who brings home 30,000 dollars a year could see their costs go up by 8,000 dollars or more.
A big part of this is because a major part of Trumpcare is built on an age tax.
Republicans want to give insurance companies a green light to charge older Americans five times as much as they charge younger Americans.
Bottom line, older Americans are going to pay a lot more under Trumpcare – if they’re able to afford insurance at all. The fact is that a lot of those older people are struggling to get by, particularly people out in those rural areas I mentioned a minute ago.
Instead of this Trumpcare bill that raises their costs by thousands of dollars, seniors need to see their costs go down. Because in America, it’s expensive to get older.
And that brings me to the Medicaid nursing home benefit. A lot of older Americans scrimp and save and do everything right. But between the rent payments, gas, food, and medical bills, eventually a lot of seniors burn through their savings. So when it’s time to pay for nursing home care, they have to turn to Medicaid. The Medicaid program picks up the tab for two out of three seniors in nursing homes.
Today, the Medicaid nursing home benefit comes with a guarantee that seniors will be taken care of. Grandma won’t get kicked out on the street.
Trumpcare would end that guarantee. You could have state programs forced into slashing nursing home budgets. You could see nursing homes shut down and seniors’ lives uprooted. You could have Grandma and Grandpa getting nickeled and dimed for the basics in home care that they rely on.
When it comes to Medicaid, Trumpcare would effectively end the program as it exists today, shredding the health care safety net in America. And it wouldn’t only affect seniors in nursing homes.
It puts an expiration date on the Medicaid coverage that millions of Americans got through the ACA. For many of those people it was the first time they had health insurance.
And Trumpcare is going to cap Medicaid budgets and squeeze them down until vulnerable people’s health care is in serious danger.
If low-income Americans lose their coverage through Medicaid, it’s a good bet that the only Trumpcare plans they’ll be able to afford will be worth less than a Trump University degree.
Then there’s the effect of this bill on opioid abuse. By slashing Medicaid, Trumpcare is going to make America’s epidemic of prescription drug abuse-related deaths even worse. Medicaid is a key source of coverage for mental health and substance use disorder treatment, particularly after the ACA, but this bill would take that coverage away from millions of people who need it. Even Republican state lawmakers have spoken out about this issue, as well as a few members of the majority in Congress.
Just about every big health care organization out there is telling the Congress not to go forward with the Trumpcare bill, from physicians to hospitals to AARP, and that’s just the start. But still the majority is charging forward, rushing to get this done as quickly as they can.
Eight years ago, the Congress held dozens of hearings on health reform. The Senate bill sat out in the open for three months before it came to the floor. Committees met in public, debated amendments, and marked up legislation. This time around – particularly here in the Senate – it looks like this bill will be sped straight to the floor, and the majority will cut off the debate using procedural tricks. Fortunately, by then it looks like Americans will be able to get the numbers on Trumpcare from the Congressional Budget Office. They’ll be able to get a sense of how much their costs will rise, how many millions of Americans will lose coverage, and how many hundreds of billions of dollars will be stacked up in a tax cut for the wealthy and big corporate interests.
It’s also fortunate that the public will get a look at this information in the days ahead, given how few specifics they got from Ms. Verma in her Finance Committee hearing. If confirmed, she’ll be the head of the Centers for Medicare and Medicaid Services (CMS), an agency that’s all about the nuts and bolts of health care policy. It oversees the health care for more than 100 million Americans. If Trumpcare passes, she’ll be working hand-in-hand with her boss, Secretary Price, to implement it.
Members on the other side are making the case that their Trumpcare bill is the first step in a three step process when it comes to health care. Part two will be squarely in the jurisdiction of the next CMS administrator – it’s supposedly all about using regulations to undermine the Affordable Care Act’s protections and guarantees.
So Ms. Verma was asked a lot of questions about how she would oversee these vital programs and how she’d use the power that comes along with being CMS administrator.
For example, I asked about what Medicare can do to bring down the cost of prescription drugs. I asked how Medicare can do more for rural health care providers to help them succeed when it comes to new payment rules. I asked about how CMS’s actions undermining the Affordable Care Act square with the president’s goal of more coverage for everybody at lower costs.
I raised these issues because it’s clear that Ms. Verma’s Republican colleagues, from the President to Secretary Price on down, have a whole host of health care ideas that will end the guarantee of Medicare for seniors, gut Medicaid and make it harder for millions of Americans to get health care. I thought Ms. Verma should have an opportunity to lay out her own views and reassure the committee that she planned to protect these programs and work on behalf of vulnerable patients.
What the committee got in response was a lot of happy-talk that didn’t amount to much substance at all. I will oppose Ms. Verma’s nomination to head CMS. I urge the Senate to do the same.
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