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Published: 24 March 2017 24 March 2017

WASHINGTON ' As the U.S. House of Representatives prepares to vote on President Trump and Republicans' legislation to increase costs and cancel health care for hundreds of thousands of New Mexicans and millions of Americans, U.S. Senators Tom Udall and Martin Heinrich joined a group of 42 senators in sending a letter to House Speaker Paul Ryan warning that he will not have their support in the Senate. Udall, Heinrich and the Democratic senators specifically stated that they will not vote for any legislation that guts the essential health benefits of the Affordable Care Act - benefits that cover services like maternity care, emergency services, and mental health treatment.

Udall and Heinrich have spoken out strongly against the dangerous legislation, unveiled by President Trump and Speaker Ryan, which is currently being considered in the House. The nonpartisan Congressional Budget Office reported that Republicans' health care bill would cancel health care for 14 million Americans next year, and 24 million Americans by 2026. As Udall and Heinrich have said, the bill would have particularly devastating consequences for New Mexico, eliminating the Medicaid expansion that allows hundreds of thousands of New Mexicans to get care, and costing the state thousands of jobs and billions in funding. But now, President Trump, Speaker Ryan and House Republicans are considering adding even more damaging provisions to win support from the far-right, including eliminating the essential health benefits of the Affordable Care Act. Udall, Heinrich, and the 42 Democratic senators said that any proposal to cut the essential health benefits or other critical protections will not have the support for passage in the Senate.

"We will oppose efforts to eliminate the ACA's essential health benefits that ensure insurance companies cover maternity care, emergency services, substance misuse and mental health treatment, prescription drugs, pediatric dental and vision care and other vital services," Udall, Heinrich and the senators wrote. "We will also oppose any efforts to lessen our constituents' access to basic preventative and primary care. Americans reasonably expect that the premiums they pay cover such basic needs, but before the ACA, consumers were often surprised to find their insurance did not. Undermining the value of insurance and requiring that insurance plans cover rudimentary health care services is simply shifting more costs onto patients and taxpayers. Eliminating the ACA's essential health benefits would merely force the same Americans to pay more out of pocket rather than actually reducing their costs and should not be the 'solution' to the premium increases the ACHA will create."

Washington Republicans are attempting to pass Trumpcare using a process known as budget reconciliation, which enables a bill to be passed without clearing the 60-vote threshold in the Senate to cut off debate. However, in order to be considered under budget reconciliation, a bill must have a direct impact on the federal budget, limiting which health care proposals the Republicans can include in their bill. Speaker Ryan has repeatedly promised House Republicans that broader proposals and changes not included in their bill will be passed through regular order at a later date - meaning they will need to clear the 60-vote threshold in the Senate. The letter from Udall, Heinrich and 40 other democratic senators clearly shows that, contrary to President Trump and Speaker Ryan's assurances, there will not be sufficient support in the senate to pass further provisions to scale back coverage in a later vote.

"We have always supported sensible improvements to the ACA and believe in working together to improve our health care system for the good of the patients it serves. Instead of supporting a fatally-flawed, incomplete, partisan bill, we hope you will take us up on our sincere offer to improve health care for all Americans," Udall, Heinrich, and the senators wrote.

In addition to Udall, Heinrich and Senator Jeanne Shaheen (D-N.H.), who led the letter, it was signed by: Tammy Baldwin (D-Wis.), Michael Bennet (D-Colo.), Richard Blumenthal (D-Conn.), Cory Booker (D-N.J.), Sherrod Brown (D-Ohio), Maria Cantwell (D-Wash), Ben Cardin (D-Md.), Thomas Carper (D-Del.), Robert Casey (D-Pa.), Chris Coons (D-Del.), Catherine Cortez Masto (D-Nev.), Tammy Duckworth (D-Ill.), Richard Durbin (D-Ill.), Dianne Feinstein (D-Calif.), Al Franken (D-Minn.), Kirsten Gillibrand (D-N.Y.), Kamala Harris (D-Calif.), Maggie Hassan (D-N.H.), Mazie Hirono (D-Hawaii), Tim Kaine (D-Va.), Angus King (I-Maine), Amy Klobuchar (D-Minn.), Patrick Leahy (D-Vt.), Edward Markey (D-Mass.), Robert Menendez (D-N.J.), Jeff Merkley (D-Ore.), Chris Murphy (D-Conn.), Patty Murray (D-Wash.), Bill Nelson (D-Fla.), Gary Peters (D-Mich.), Jack Reed (D-R.I.), Bernie Sanders (I-Vt.), Brian Schatz (D-Hawaii), Debbie Stabenow (D-Mich.), Chris Van Hollen (D-Md.), Mark Warner (D-Va.), Elizabeth Warren (D-Mass), Sheldon Whitehouse (D-R.I.), Ron Wyden (D-Ore.).

The senators' letter can be read in full below:

The Honorable Paul Ryan
Speaker U.S. House of Representatives
Washington, DC

Dear Speaker Ryan,

As a vote nears in the House of Representatives to repeal the Affordable Care Act (ACA), you have repeatedly stated that consideration of the American Health Care Act (AHCA) is only the first phase in your plan to replace the landmark law that has resulted in the lowest uninsured rate in our country's history. More specifically, you have promised consideration of several legislative proposals you falsely argue will help alleviate the devastating impact of the AHCA.

As we understand your plan, you will seek to enact these proposals after Congress uses expedited procedures to consider the AHCA, a bill the Congressional Budget Office estimated would cause 24 million Americans to lose their insurance coverage. Given your plans to pass subsequent legislation through regular order in Congress, we want to correct any misimpression you may have that we will support proposals you have cited as key to your effort. Simply put, these subsequent bills will worsen the damage the AHCA will cause.

Any assurances to your colleagues that future legislation to further scale back insurance coverage will pass through regular order if the AHCA is enacted are based on the flawed assumption that the Senate Democratic Caucus will vote to further erode the health care system and strip our constituents of coverage. We are writing today to inform you that our caucus will not support any efforts that jeopardize the consumer protections our constituents rely upon when they purchase insurance.

For example, we will oppose efforts to eliminate the ACA's essential health benefits that ensure insurance companies cover maternity care, emergency services, substance misuse and mental health treatment, prescription drugs, pediatric dental and vision care and other vital services. We will also oppose any efforts to lessen our constituents' access to basic preventative and primary care. Americans reasonably expect that the premiums they pay cover such basic needs, but before the ACA, consumers were often surprised to find their insurance did not. Undermining the value of insurance and requiring that insurance plans cover rudimentary health care services is simply shifting more costs onto patients and taxpayers. Eliminating the ACA's essential health benefits would merely force the same Americans to pay more out of pocket rather than actually reducing their costs and should not be the "solution" to the premium increases the ACHA will create.

Before you move forward with floor consideration of the AHCA, we urge you to choose another path. For many years, we have acknowledged that despite its successes, the Affordable Care Act is not perfect and it needs improvement. We have always supported sensible improvements to the ACA and believe in working together to improve our health care system for the good of the patients it serves.

Instead of supporting a fatally-flawed, incomplete, partisan bill, we hope you will take us up on our sincere offer to improve health care for all Americans.

Sincerely,