[Congressional Record Volume 156, Number 129 (Thursday, September 23, 2010)]
[Senate]
[Pages S7407-S7409]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. CASEY. Mr. President, I rise to talk about two basic topics 
today. But first, for today, in light of the news that so many people 
have been discussing today and reporting on today, which is the 
implementation today of some parts of our health care bill, the 
Affordable Care Act, which we passed back in March after many months of 
debate and work on that legislation, one of the most popular but 
essential elements to that bill was a whole series of consumer 
protections which in some ways does not fully describe what they are. I 
would rather use the phrase ``family safeguards,'' to give families 
some peace of mind not just on the broader question of insurance 
coverage for those who get sick and need coverage. We all need health 
insurance at some point in our life, sometimes more than others, but 
especially if you are a child with a preexisting condition.
  For so many years we have allowed a system to say to that child and 
to his or her family: We know you have a preexisting condition. It 
might be something serious and life threatening, but the system does 
not allow you to be covered for one reason or another.
  Finally, at long last, in 2010, we said no to that denial. So now we 
are able to say that fear that a child would feel, especially his or 
her family, can now have peace of mind to know that if a child in the 
United States has a preexisting condition, that will not be a bar to 
coverage, therefore, to treatment. Of course, it also impacts adults. 
We have seen stories about adults who will benefit from the bill on the 
preexisting condition problem that so many people find themselves in. 
The implementation of the children's provisions goes into effect now. 
The adults will come later. But even in the short run, the bill allowed 
for and developed a high risk pool, even for adults with preexisting 
conditions. Of course, the full protection won't be in effect for a 
couple of years. But at least and at long last children will have that 
protection.
  The other protections among what I call family safeguards are some 
basic protections that we should all have a right to expect but, 
unfortunately, a lot of families haven't had these protections. For 
example, preventing insurance companies from arbitrarily throwing 
people off their insurance coverage or denying them coverage for 
reasons that do not make a lot of sense, but I guess they made sense to 
big profitable insurance companies over many years. They won't be able 
to do that any longer. They will not be able to put lifetime limits on 
one's coverage or treatment. The limits annual in nature will be more 
limited. It will be more difficult for insurance companies to place 
annual limits.
  One of the provisions that has received a lot of attention and speaks 
right to a need a lot of families have is when a young person, say 
someone who is finishing college and needs some coverage between the 
time they are in college and the time they reach the age of 26, they 
will now be covered. So if we go down the list, it is a long and 
substantial and significant set of consumer protections which does 
provide some degree of safeguard and some degree of peace of mind to 
our families.
  Unfortunately, in the midst of all that, in that ocean of good news 
on these consumer protections, we have some bad news which is 
disturbing. When we were debating health insurance in Washington and 
around the country, we would have a lot of fights with insurance 
companies. Some of them came around and worked to pass the bill. Some 
did not.
  But there was an attempt to work together constructively to develop 
good legislation.
  Well, unfortunately, a few--not all but a few--took a step the other 
day which was outrageous, insulting, egregious, and harmful to what we 
are trying to do to make sure children and families have that peace of 
mind I spoke of earlier.
  Several health insurance companies have announced they are going to 
stop offering child-only health insurance plans because they are no 
longer allowed to discriminate against children with preexisting 
conditions, such as, for example, asthma, just to name one.
  Why would insurance companies do that? Right before this provision 
goes into effect, at the eleventh hour so to speak, they start dropping 
this kind of coverage. It puts hundreds of thousands of children at 
risk. The Obama administration estimates that 100,000 to 700,000 
children could be affected by these changes.
  I believe it will be outrageous if one child is affected by this--
literally one child--when we have provisions going into effect that are 
going to at long last protect kids; that a couple insurance companies 
that make a tremendous profit--which I will get to in a moment--take 
this step to change their strategy as it relates to kids. Many of the 
children who will be affected by this adverse decision by these few 
insurance companies are in families who are struggling just to get by 
now and cannot afford to pay for insurance for their whole family, but 
they are trying to keep their kids insured.
  A lot of parents do that all the time. They forego their own coverage 
and their own health care and sometimes, literally, their own health in 
order to protect their children, in order to provide a child with some 
treatment, some care, some protection. Yet we have these few insurance 
companies that are taking this action, which is outrageous and 
disturbing, and that is an understatement.
  Several of the companies that have decided to take this action--this 
action that is harmful to America's children--some of these companies 
have operations in States such as Pennsylvania. Aetna is one of them. 
The companies that have decided to stop offering health insurance to 
children are few. I mentioned Aetna. Another is Cigna and another is 
Anthem Blue Cross. As we know, Anthem Blue Cross is owned by WellPoint.
  Listen to this: In 2009, these three health insurance companies that 
are discontinuing their child-only plans had $7.3 billion in profits. 
That is not gross revenue, folks. That is profit, $7.3 billion. 
WellPoint, which owns Anthem Blue Cross, $4.7 billion in profits; 
Aetna, $1.2 billion in profits; and, finally, Cigna, $1.3 billion in 
profits. They are firms that are doing this, taking this action just 
before today's provisions to protect kids on preexisting conditions 
take effect.
  So it is my hope--and I believe they will do this--the Department of 
Health and Human Services will take every step necessary to have this 
decision by these companies reversed. I hope there is some way to 
sanction or punish insurance companies that do that. I am not sure that 
is possible. There are a lot of debates about what can be done. But I 
would hope--short of action by a

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Federal agency or short of action by a State government authority or 
agency--these insurance companies would rethink their policy, rethink 
the action they took, which will be harmful to children because if they 
do not, it calls into question their commitment to what we have been 
trying to do in this country for a long time. We finally got over the 
hump, so to speak, and passed legislation not only to cover more than 
30 million Americans but at long last to provide coverage and support 
for children.
  Of course, one thing we found out in the health care debate last year 
was, this is not just a debate about the uninsured--the more than 30 
million who will be covered--this is as much a debate about the 
insured, the more than 80 percent of Americans who had insurance 
coverage but not the protections they should have a right to expect. 
That is why we needed these consumer protections on preexisting 
conditions, on protecting families from being thrown off arbitrarily--
the annual limits, the lifetime limits--all of those features that we 
had to get enacted into law because that was the way to protect people 
with insurance coverage who thought they had more protection than they 
really did.
  So I hope this is just an egregious example and a decision that was 
implemented by these health insurance companies that will be, in fact, 
reversed because, as I said before, if it is not reversed, it does call 
into question what these insurance companies that are taking this step 
are all about.
  Are they for record profits or are they going to try to help our 
families in a reasonable way?
  We are not asking them to do something that is unreasonable or 
inconsistent with their business model or inconsistent with having a 
profit. We are just saying: Why don't you do what all the others are 
trying to do? Why don't you do what the American people expect you to 
do, which is to take every step necessary to protect our kids, 
especially children who are vulnerable and do not have lobbyists 
standing up to fight their battles and do not have a lot of campaign 
money in the middle of an election year? Vulnerable children--unless 
someone in one of the two Houses of Congress stands up to fight for 
them, or somebody in the administration--do not have much power around 
here. So I would hope these insurance companies would rethink that 
decision, and we are waiting and watching to see what they will do.


                              Unemployment

  Mr. President, let me just shift gears quickly. I know we have 
limited time, but I did want to talk a little bit about the job 
situation that confronts so many families, so many communities in our 
country, as well as some steps that have been taken recently to help 
deal with the unemployment rate and the economic circumstances we find 
ourselves in.
  In Pennsylvania, we have hovered around 590,000 people out of work 
for many months now. Fortunately, it has dipped a little below 590,000. 
But when you are getting close to 600,000 people out of work in a State 
such as Pennsylvania, people are really hurting. Our rate does not tell 
the story. We have been below 10 percent for a while, but almost 
600,000 people out of work is a horrific nightmare for those families 
in a lot of communities.
  I spent, as a lot of Members in the Senate, several weeks in August 
and September traveling to many communities in Pennsylvania. I got to a 
little more than 30 counties, and it was remarkable but also disturbing 
to see the breadth and the scope of the unemployment problem in a State 
such as Pennsylvania.
  Some parts of the State are doing better than others in keeping us 
below 10 percent unemployment, but there are so many communities where 
there is a very high rural population--a lot of small towns--having 
very high unemployment rates.
  Just to give a couple examples of places I visited that are smaller 
communities or smaller counties and to some degree or another largely 
rural--sometimes 100 percent rural or at least half by the way they 
categorize them demographically--Cambria County, where Johnstown, PA, 
is, always has had a high unemployment rate. They are at 10 percent, 
persistently at that level. In that county that means 7,000 people were 
out of work, and that is as of the July numbers. I have not seen the 
latest, but it is in that category; Clarion County, a place I visited 
as well, almost 10.5 percent, with 2,200 people out of work in that 
community; Forest County, a very small county by way of population, 
right in the north central region of our State, 10.6 percent 
unemployment; Jefferson County, a larger but still not a big urban or 
metropolitan community, that county has almost 2,500 people out of 
work, over 10 percent unemployment; Lawrence County, Lehigh County, 
Luzerne County--all above 10 percent unemployment. Luzerne County is 
right next to Lackawanna County, where I live. It is approaching 11 
percent.

  But then here are the ones that probably tell the story best.
  Philadelphia is now at about 12 percent unemployment. The rate is 
very high. When we are hovering around 12 percent in that city, we have 
almost 75,000 people out of work--in just one city in Pennsylvania, 
75,000 individuals out of work.
  Then we go to north central Pennsylvania and visit Potter County, a 
county which is categorized as almost 100 percent rural, with a very 
small population, under 20,000 people. They have almost the same 
unemployment rate that Philadelphia has--a little less, but it is about 
11.5 percent. As of July, it was at about 11.2 percent. So it has 
hovered between 11 and 12 percent.
  So in Philadelphia, having an 11- or 12-percent unemployment rate 
means 75,000 people; in Potter County that translates into just about 
900 people, just hovering around 1,000 people. So even in a very small 
county, the loss of one business, one factory, one plant can mean 
devastation for that county and that community. That is whether you are 
in urban Pennsylvania or rural Pennsylvania, even in suburban areas, 
which got accustomed to 5 percent unemployment or maybe 4 percent 
unemployment and are now at 7 percent or 7.5 percent or 8 percent. Of 
course, Pennsylvania's rate is not nearly as high as some across the 
country.
  So people might say: Well, what has the Congress been doing about 
this over the last 18 months, and especially over the last couple 
months? Well, we could point to the Recovery Act, which I realize has 
not been popular around the country. But the Recovery Act created 3 
million jobs. It was one way to directly and positively impact the job 
situation. When we lose 8 million and create about 3 million in the 
Recovery Act, that is a good start but not nearly enough.
  One of the best things we did was just a couple days ago--and we 
should be able to have it signed into law in a few days--was the Small 
Business Jobs and Credit Act, which, by the way, had no deficit impact. 
In fact, it will save a little bit of money over the next 10 years. But 
there is no adverse impact on the deficit.
  Mr. President, there will be $12 billion directly to small business, 
a $30 billion loan fund for our smaller banks, our community banks. 
Most banks in the country are at that level. They are not the big banks 
on Wall Street. They provide direct help to small businesses in 
communities across States such as Pennsylvania and throughout the 
country.
  That bill alone, according to the community bankers, will create 
500,000 jobs. That got voted on last week. Sometimes when things like 
that get voted on, we move on to something else and people do not 
always notice it. I think it is very important for people to know we do 
not believe--I do not believe, and I think a lot of people in this 
Chamber do not believe--we are out of the ditch yet. We are still 
pushing and pushing to get this economy back to a position where we are 
getting the kind of robust growth we need. We are in positive 
territory. We are not losing 700,000 jobs a month or 600,000 jobs a 
month like we were in December of 2008 and January of 2009 and February 
and March and April--month after month, every single month for many 
months losing that many jobs.
  So we are moving in the right direction. But we have a ways to go. I 
would hope that not only next week but when we come back in November 
the other side of the aisle would present some job creation strategies. 
I have not heard much. I think 39 out of 41 members of the Republican 
caucus voted against the Small Business Jobs and Credit Act: $12 
billion of tax breaks for small business, a $30 billion loan fund which

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can leverage hundreds of billions in economic activity and job creation 
activity across the country.
  So we have more to do, and we have a ways to go. We have to keep 
focused and stay focused on strategies that will create jobs in the 
near term and certainly over time, but especially those strategies that 
will create 50,000 jobs or 75,000 jobs or 100,000 jobs. As we go, we 
can continue to create jobs and grow the economy. When we do that--as 
we learned in the 1990s--we can grow the economy and make good 
investments in health care and in our infrastructure and in education 
and in our workers and their skills. We can also do deficit reduction 
and debt reduction over time. But we cannot do those three things until 
we are growing in a way that is substantial enough to do at least those 
three: grow enough to create jobs, reduce the deficit, and even to 
reduce debt.

  So we have a way to go, but I think we are headed in the right 
direction. I am looking forward to seeing the Small Business Jobs and 
Credit Act enacted into law, working to help our small businesses and 
our smaller communities, especially those I have highlighted across 
Pennsylvania and across the country that have had tremendous and 
horrific job loss over the last 2 years to 18 months.
  With that, I yield the floor and note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Burris). Without objection, it is so 
ordered.

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