WASHINGTON, D.C. – U.S. Senator Rob Portman (R-OH) delivered remarks on the Senate floor tonight following his vote to begin debate on health care reform earlier in the day. Portman discussed his goal to lower costs for Ohio families and small businesses and a new Portman-led effort designed to help low-income Americans get access to affordable health care.

Transcript can be found below and a video can be found here.

I rise tonight to talk about the Portman amendment and about the broader substitute that repeals and replaces the Affordable Care Act, otherwise known as Obamacare. Is this replacement perfect? No, I don’t think any replacement is. But it’s a big improvement over the status quo. And the status quo on health care is simply no longer sustainable. It isn’t working for Ohio. We hear a lot about the middle-class squeeze in Ohio and it’s real. Wages are flat and yet expenses are up. And for most folks the biggest single expense is health care costs. It’s the fastest growing expense because of higher premiums and higher deductibles.

“It wasn’t supposed to be this way. In fact, when the Affordable Care Act—Obamacare—was enacted in 2010 we heard a lot of promises about lower costs. A promise that Obamacare would bring down premiums costs $2,500 for the average family. But we now know that families have seen their premiums skyrocket. According to the Ohio Department of Insurance, health insurance premiums on the individual market in Ohio have nearly doubled. Nearly doubled since the Affordable Care Act went into effect seven years ago. Small business premiums have gone up 82 percent. Premiums for this year are up double digits and next year we all expect the same. No one can afford that.

“To make matters worse, we’ve seen a sharp increase in deductibles. For a lot of people they’re covered by insurance, but they feel like they really don’t have health insurance at all. Why? Because their out-of-pocket expenses are so high, their deductibles are so high they really can’t access it. These higher premiums and deductibles have already made health care unaffordable for a lot of hardworking Ohioans. 

“But it’s not just about cost. It’s also about choice. Some people are losing their coverage altogether because the policies established in the Affordable Care Act were set up for failure. Fifteen out of the 23 nonprofit insurers set up around the country as co-ops under the Affordable Care Act have now gone bankrupt. One was in Ohio. 

“Last year in my state, 22,000 hardworking Ohioans lost their coverage because our co-op declared bankruptcy. Many of them, by the way, have already paid up their deductibles on that and they lost that as well. Worse than that even, right now there are 19 counties in Ohio without a single insurance company. In the exchange market, the individual market, not one insurance company. Another 27 counties in Ohio have only one insurer. That’s not competition. That’s not choice. Far too many Ohioans, thousands of them, if they want health insurance, are told you have to move out of your county to another county.

“Less competition has also meant fewer choices and higher costs for Ohio families and cost shifting on to employer-based plans. In other words, as these insurance companies have lost money, some of them haven’t left Ohio but have shifted their costs to other people. That’s why so many people’s costs have gone up. Without competition and choice in the market, we’re never going to be able to lower health care costs for families and for small businesses. That’s one more reason why the status quo on health care, the system we have now, is not sustainable. 

“The Affordable Care Act has failed to meet the promises that were made, but we can do better and we’ve got to do better. It’s our job to do better, but we should do it in a way that protects low-income beneficiaries of Medicaid, that protects the most vulnerable in our states. And we can do that too. 

“At the outset of this debate and consistently throughout this debate I said my goal was to create a more workable health care system that lowers the cost of coverage and provides access to be affordable care while protecting the most vulnerable. This most recent version of the Better Care Reconciliation Act, as my colleague has just called it, BCRA 3.0, is an improvement over the House bill. But it’s also an improvement over the previous Senate bills. This measure includes reforms that will help lower premiums on families and small businesses. The number-one priority out there should be to lower those costs. This bill will help lower those premiums. 

“Throughout this process I’ve expressed my concerns about how we deal with Medicaid, which is a critically important federal program that provides health care benefits to about 70 million Americans who live below the federal poverty line. The Affordable Care Act allowed states, including Ohio, to expand Medicaid eligibility actually above the poverty line up to 138 percent of poverty and to cover single adults. With our growing debt and deficits, we know the current Medicaid program is not financially sustainable over the long-term and we’ve got to look for innovation and reform to protect and preserve it now so that Ohioans can count on this program in the future, so that those who need it will have it. 

“My point all along is that these reforms can and should be done in a way that doesn’t pull the rug out from people and gives states time to adjust. So in this Senate bill, I’ve worked to put Medicaid expansion on a glide path really for six years with the current law for three years and a transition for another three years. That transition would be to a new health care system. 

“This is a big improvement over the House bill which had a cliff in two years without a glide path. Just as important in the substitute before us, governors would have new flexibility in this legislation to design innovative Medicaid programs that meet the needs of their states and their expansion population. 

“One issue I focused on a lot in this discussion has been the opioid epidemic. In my own state of Ohio, this epidemic has had a devastating effect. About 200,000 Ohioans now suffer from drug addiction, primarily heroin, prescription drugs and the new synthetic heroins like fentanyl. Unbelievably, I will tell you about half of the funds we spend in expanded Medicaid in Ohio go for one purpose, and that’s mental health and substance abuse treatment, primarily driven by addiction to heroin, prescription drugs and fentanyl. So we’ve got to deal with this issue and deal with it in a smart way. In this latest version of the substitute, that’s why I not only fought to provide that transition for those on expanded Medicaid, but also an additional and unprecedented $45 billion in new resources for states to address the opioid epidemic. I’m pleased to say that in the legislation we’re going to vote on tonight, it is included.

“We want those receiving opioid treatment under Medicaid expansion to maintain access to treatment as they work to get back on their feet. This new funding is critical to help with regard to that treatment and longer-term recovery. An additional issue I’ve been working on is to ensure that those on expanded Medicaid are able to find affordable health care options under a new system, whether it’s the new Medicaid structure or affordable health care options in the private sector on the private market. Over the past few weeks I’ve worked with the president, the vice president, administration officials and many of my colleagues about ways to improve this bill further in this regard, to help out low-income Ohioans and others who are trying to find affordable coverage. That’s why this proposal before us, the Portman amendment, is so important. 

“And, by the way, it’s called the Portman amendment but it’s the result of the work of a lot of different senators, some of whom I saw on the floor earlier, one I see here tonight, Senator Capito has been a leader in this. Senator Hoeven, Senator Gardner, Senator Sullivan, Senator Cassidy, Senator Young, Senator Bozeman, Senator Heller, Senator Murkowski and others have worked on this proposal. I’m pleased that we have received a commitment that the Senate will vote tonight on this approach, again, to help those on Medicaid expansion and other low-income Americans get access to affordable health care in the private market. 

“This plan has two parts. First, it provides an additional $100 billion to the long-term stability fund in the Better Care Reconciliation Act to help people with out-of-pocket expenses such as deductibles and co-pays, thus ensuring that those who transition from Medicaid expansion into the private insurance under a new system not only have the tax credit to help them, which is part of the underlying bill, but also have this additional help for affordable coverage options. Second is a Medicaid wrap-around that allows states to provide cost sharing assistance to low-income individuals who transition from Medicaid to private insurance and receive a tax credit on the exchange. The state could use this flexibility in combination with this long-term stability fund increase, the additional dollars I’m talking about, to assist individuals with their deductibles, out-of-pocket expenses and co-pays. 

“It would also allow the states to capture federal Medicaid match dollars to supplement the tax credit under the Better Care Act without having to seek and renew existing waiver authority. This Medicaid wrap-around is already available through a waiver, but we think it’s incredibly important to put it in statute so that other administrators, and the current ones, Seema Verma has said that she supports this waiver being granted, but others would grant it and you don’t have to renew this waiver or beg for a waiver. It’s a common-sense way to help get people who are going into private plans the help they need to be able to afford the premiums, the deductibles and the co-pays. This is a common-sense approach to help ensure that these low-income Americans have access to affordable care. And I urge my colleagues to support it. 

“We must do better than the Affordable Care Act. I have heard from people across Ohio on both sides of this debate. Trust me, I’ve heard a lot. There’s a lot of passion, and I understand that. But it’s interesting the common denominator in many of these discussions is that doing nothing is not sustainable. Pretty much everybody acknowledges the status quo is not working. 

“Ohioans deserve action. In my view, to throw in the towel and give up on finding a better alternative is to give up on Ohio families, give up on Ohio small businesses. And I’m not willing to do that. We all know the Affordable Care Act hasn’t lived up to its promises to the American people. Today, after seven years of consistently calling for repeal and replace, I’m supporting a sensible plan to do just that. Is it perfect? No. I don’t think any substitute is. Replacement’s hard. But it’s an improvement on the unsustainable status quo and it does help keep our promise to the American people to do better. Mr. President, I urge my colleagues to support the legislation before us, and I yield back my time.”

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