Rob Portman

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Committee on Veterans' Affairs be discharged from further consideration of H.R. 2288 and the Senate proceed to its immediate consideration.

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Isakson substitute amendment at the desk be considered and agreed to; the bill, as amended, be considered read a third time and passed; and that the motion to reconsider be considered made and laid upon the table.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 2210, which was received from the House.

Mr. PORTMAN. I ask unanimous consent that the bill be considered read a third time and passed and the motion to reconsider be considered made and laid upon the table.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the applicable committees be discharged and the Senate proceed to the immediate consideration of the following resolutions, en bloc: S. Res. 203, S. Res. 194, S. Res. 214, S. Res. 215, S. Res. 231, S. Res. 213, S. Res. 233 and S. Res. 221.

Mr. PORTMAN. Mr. President, I ask unanimous consent that the resolutions be agreed to, the preambles be agreed to, and the motions to reconsider be considered made and laid upon the table, all en bloc.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, we have some work to do this evening.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the motion to reconsider be considered made and laid upon the table.

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 116, H.R. 601.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the bill be considered read a third time and passed and the motion to reconsider be considered made and laid upon the table. The bill (S. 717) was ordered to be engrossed for a third reading, was read the third time, and passed, as follows:

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Senate proceed to the en bloc consideration of the following Senate resolutions which were submitted earlier today: S. Res. 239, S. Res. 240, and S. Res. 241.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the bill be considered read a third time and passed, and the motion to reconsider be considered made and laid upon the table.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that when the Senate completes its business today, it adjourn until 10 a.m., Wednesday, August 2; further, that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and morning business be closed; further, that following leader remarks, the Senate proceed to executive session and resume consideration of the Kaplan nomination, with the time until 11 a.m. equally divided between the two leaders or their designees.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 95, S. 190.

Mr. PORTMAN. Mr. President, I ask unanimous consent that the bill be considered read a third time and passed, and the motion to reconsider be considered made and laid upon the table.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 23, S. 178.

Mr. PORTMAN. I ask unanimous consent that the motion to reconsider be considered made and laid upon the table.

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Grassley amendment at the desk be considered and agreed to, and the bill, as amended, be considered read a third time.

Mr. PORTMAN. Mr. President, I know of no further debate on the bill.

Mr. PORTMAN

Mr. PORTMAN. I move to concur in the House amendments, and I know of no further debate.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, if there is no further business to come before the Senate, I ask unanimous consent that it stand adjourned under the previous order.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, I ask unanimous consent that the committee-reported amendments be considered, the Johnson amendment at the desk be considered and agreed to, the committee-reported amendments, as amended, be agreed to, the bill, as amended, be considered read a third time and passed, and the motion to reconsider be considered made and laid upon the table.

Mr. PORTMAN. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 93, S. 582.

Mr. PORTMAN

Mr. PORTMAN. Mr. President, 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 is a big improvement over the status quo. The status quo on healthcare is simply no longer sustainable. It isn't working for Ohio. We heard a lot about the middle-class squeeze in Ohio, and it is real. Wages are flat and expenses are up. For most folks, the biggest single expense is healthcare costs. It is 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. They promised that ObamaCare would bring down premium costs by 2,500 bucks 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 since the Affordable Care Act went into effect 7 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 have seen a sharp increase in deductibles. For a lot of people covered by insurance, they feel as though they really don't have health care insurance at all because their out-of- pocket expenses are so high and deductibles are so high, they really can't access it. These higher premiums and deductibles have already made healthcare unaffordable for a lot of hard-working Ohioans. But it is not just about costs, it is 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 of the 23 nonprofit insurers set up around the country as co- ops around the Affordable Care Act have now gone bankrupt. One was in Ohio. Last year in my State, 22,000 hard-working Ohioans lost their coverage because our co-op declared bankruptcy. Many of them, by the way, had already paid 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 1 insurer. That is not competition. That is not choice. Far too many Ohioans--thousands of them--if they want health insurance, are told they have to move out of their county to another county. Less competition has also meant less choices and higher costs for Ohio families and cost shifting on to employer-based plans. As these insurance companies have lost money, some of them haven't left Ohio, but they shifted their costs to other people. That is why so many people's costs have gone up. Without competition and choice in the market, we are never going to be able to lower healthcare costs for families and small businesses. That is one more reason why the status quo on healthcare, 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 have to do better. It is 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 State. We can do that too. At the outset of this debate and consistently throughout the debate, I have said my goal was to create a more workable healthcare system that lowers the cost of coverage and provides access to affordable care while protecting the most vulnerable. This most recent version of the Better Care Reconciliation Act--as my colleague just called it, BCRA.3--is an improvement over the House bill, but it is also an improvement over the previous Senate bill. This measure includes reforms that will help lower premiums on families and small businesses. The No. 1 priority out there should be to lower those costs. This bill will help lower those premiums. Throughout the process, I have expressed my concerns about how we deal with Medicaid, which is a critically important Federal program that provides healthcare 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, 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 have to look for innovation and reform to protect and preserve it now so that Ohioans can count on this program in the future and so that those who need it will have it. My point all along has been that these reforms can and should be done in a way that doesn't pull the rug out from under people and gives States time to adjust. So, in this Senate bill, I have worked to put Medicaid expansion on a glidepath for 6 years, with the current law for 3 years and then a transition for another 3 years. That transition would be to a new healthcare system. This is a big improvement over the House bill, which had a cliff in 2 years without a glidepath. Just as important, in this 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 populations. One issue I have 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 from heroin and prescription drugs and the new synthetic heroins, such as fentanyl. Unbelievably, I will tell you that about half of the funds we spend in expanded Medicaid in Ohio go for one purpose, and that is mental health and substance abuse treatment, primarily driven by addiction to heroin and prescription drugs and fentanyl. We have to deal with this issue in a smart way. In this latest version of the substitute, that is why I fought to provide not only 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 am pleased to say that in the legislation we are 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 have been working on is to ensure that those on expanded Medicaid are able to find affordable healthcare options under a new system, whether it is under the new Medicaid structure or affordable healthcare options in the private sector on the private market. Over the past few weeks, I have worked with the President, the Vice President, administration officials, and many of my colleagues on 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 is why this proposal before us, the Portman amendment, is so important. By the way, it is called the Portman amendment, but it is the result of the work of a lot of different Senators, some of whom I saw on the floor earlier and one I see here tonight. Senator Capito, who has been a leader on this, and Senators Hoeven, Gardner, Sullivan, Cassidy, Young, Boozman, Heller, Murkowski, and others, have worked on this proposal. I am pleased that we have received a commitment that the Senate will vote tonight on this approach to help those on Medicaid expansion and other low-income Americans get access to affordable healthcare 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 copays, thus ensuring that those who transition from Medicaid expansion into 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, it is a Medicaid wraparound 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 States could use this flexibility in combination with this long- term stability fund increase--the additional dollars I am talking about--to assist individuals with their deductibles, out-of-pocket expenses, and copays. It would also allow the States to capture Federal Medicaid matched dollars to supplement the tax credits under the Better Care Act without having to seek and renew existing waiver authority. This Medicaid wraparound is already available through a waiver, but we think it is critically important to put it in a statute so that other administrators and the current ones--Seema Verma has said she supports this waiver being granted--but others will grant it, and you don't have to renew this waiver or beg for a waiver. It is a commonsense way to help get people who are going into private plans the help they need to be able to afford the premiums, deductibles, and copays. This is a commonsense 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 have heard a lot. There is a lot of passion. I understand that. But it is interesting, the common denominator in many of these discussions is that doing nothing is not sustainable. Pretty much everybody acknowledges that 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's families, give up on Ohio's small businesses, and I am not willing to do that. We all know the Affordable Care Act has not lived up to its promises to the American people. Today, after 7 years of consistently calling for repeal and replace, I am supporting a sensible plan to do just that. Is it perfect? No. I don't think any substitute is. Replacement is hard. But it is an improvement on the unsustainable status quo, and it does help keep our promise to the American people to do better. I urge my colleagues to support the legislation before us. I yield back my time.