Editor’s Note: The following is a transcript of a speech given on the floor of the Senate today by Sen. Bill Cassidy (R-LA), introducing a plan he’s authored to repeal and replace Obamacare. Cassidy, a medical doctor, has authored two previous pieces of legislation which would scrap the Affordable Care Act for more market-oriented solutions for the health care sector – the Patient Freedom Act and The World’s Greatest Healthcare Plan – and is now fighting to exploit GOP majorities in both the House and Senate as well as a Republican President who takes office in just more than two weeks in an effort to push a redesign through to policy. Video of his remarks is embedded below.
I hear my Democratic colleagues praising Obamacare, saying that it has brought down prescription drug costs. Tell that to the senior who’s paying $6,000 for her medicine that, before, cost a fraction of that. We hear of how great insurance people now have is, but once again, say that to the person that has a $6,000 deductible that they have to pay out of pocket before they get any benefit and is effectively uninsured. I have notice there is a reluctance to use the term, the Affordable Care Act, there should be. When someone’s premium is $39,000 a year with a $6,000 deductible, their insurance is anything but affordable. And by the way those numbers are not an exaggeration. This is someone’s real insurance quote that they sent to me.
I began this speech by calling into question my Democratic colleagues’ defense of Obamacare. But we can have common ground. I applaud the GOALS of the authors of the Affordable Care Act that wanted to have coverage for all.
This is an important issue for me. As a doctor working in a hospital for the uninsured for 30 years, I saw working families with medical bills and pre-existing conditions, which eliminated their ability to buy insurance. All Americans should have health insurance, but Obamacare coerced Americans with mandates and took away their power to choose.
I believe that Republicans and Democrats can find common ground. My replacement plan would give states the option. I am willing to concede that some folks—the Minority Leader—believe that Obamacare is working just fine. In my plan, we repeal Obamacare on a federal level, but if states like California or New York think that Obamacare works for them, then god bless them. Under my replacement plan the state legislatures in Sacramento or Albany, rather than implementing our replacement plan, could make the decision instead to take their funding and maintain an Obamacare system in their own state.
But states like Arizona where they are seeing premiums more than doubling from year to year, and states like Louisiana where Obamacare is simply not working. They should not be forced by the federal government to keep a system that is failing them. So let’s repeal Obamacare and move the power to the states so they can replace it with a system that will work for them.
We will make health care more affordable by giving individuals choice by introducing price transparency to our health care system. Under Obamacare we have seen prices increase out of control. A lack of price transparency keeps providers from having to compete, which takes away a consumer’s power of choice.
If a doctor orders a C.T. scan, a patient could go to one hospital at 7pm and pay $2,500 or they could go to another hospital at 1:30am and pay $250. The problem in our current system is that a patient has no way of knowing how much their procedure will cost until after they receive the bill. You wouldn’t agree to purchase a car before you were told the price. So why do we do this with our health care? Price transparency gives a mom the ability to decide where to take her child so that they can receive the best quality care at the best cash price.
When you give a patient the information and power they need to make the decisions that work best for them, you will see better outcomes.
Under my plan, which is in legislative language we would repeal Obamacare, institute price transparency and return the decision making power back to the patients.
We would repeal the individual mandate, repeal the employer mandate, and prevent the federal government from forcing people to pay a penalty for making a hard financial decision to not pay for Obamacare.
Under the World’s Greatest Health Care Plan (or Patient Freedom Act), we take all the money that a state would receive from the federal government for health care, and we allow the state to give a tax credit to each individual in that state who is eligible. With that, each person would receive a tax credit that can be spent on health insurance premiums or deposited to a Health Savings Account—or HSA—and used to pay directly for health care services. It is both advanceable and refundable. They would also receive catastrophic major medical coverage
That HSA gives patients the power by giving them first dollar coverage. So rather than having to work through a $6,000 deductible, if a mom who needs to take her child to the urgent care center to have an earache treated, she will receive immediate benefit from her HSA and can be confident knowing that she has first-dollar coverage.
Under my replacement plan, we would also cover more Americans than Obamacare by giving states the option of enrolling the uninsured in a basic health plan unless they choose to opt out. This will likely lead to 95% enrollment or more.
This state-based enrollment mechanism will allow those without access to the internet, like the homeless, to have a health savings account for access to first dollar coverage, a pharmacy benefit to help manage chronic conditions, and catastrophic major medical coverage to protect against medical bankruptcy.
The timeline for replacement under my plan would be simple. There would be a two year delayed transition period to ensure that the switch is carried out efficiently and effectively. This would give states through 2018 to decide whether they want to adopt the replacement plan, or if they want, to maintain Obamacare in their state. By 2019 the repeal and replacement plan would go into full effect for states. But, at any time if one of the states that chose to maintain the Obamacare system sees how well the replacement plan is working in other states, they can choose to opt in to the alternative.
Think of the Trump voter with a preexisting condition. She can’t afford the few plans she is offered, but she may have breast cancer and needs coverage to make sure that she receives the treatment she needs. She is relying on us to not only repeal Obamacare, but to replace it with a system that works for her, to make sure that she does not have a gap in her coverage. She is the prism through which we must view our steps going forward.
For people like her, Obamacare isn’t working. That much is clear. So we need to make sure we replace it with something that will. We have had many voices on our side of the isle put up their ideas on how to do this.
I introduced the Patient Freedom Act with 12 senate co-sponsors in 2015 and then teamed up with Representative Pete Sessions in 2016 to introduce the World’s Greatest Health Care Plan. Tom Price, our soon to be HHS Secretary, first introduced his Empowering Patients First Act to the House of Representatives in 2014. Speaker Paul Ryan, Representative Fred Upton and Senators Richard Burr and Orrin Hatch also outlined plans for comprehensive health care reform.
All these plans create a new system that returns power of choice to the patients and states. Simple provisions like Health Savings Accounts and instituting free market values that—if put into a replacement plan now—will quickly have an effect on millions.
Republicans worked hard to lay the groundwork to repeal and replace Obamacare. President-Elect Trump has said he wants repeal and replace to happen at the same time and the Majority Leader has said that we can do a better job covering more people. We have the principles, we have the ideas, and we have plans ready to go. So let’s put them to use.
We owe it to the American people to carry out the replacement now, with a smooth transition, so that we can grow the insured population without anyone losing their coverage in the process. Republicans are committed to creating and passing effective health care legislation to replace Obamacare and bring real coverage to all Americans—now is the time to do so.