[Congressional Record Volume 156, Number 129 (Thursday, September 23, 2010)]
[Senate]
[Pages S7412-S7415]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           SIXTH MONTH ANNIVERSARY OF THE AFFORDABLE CARE ACT

  Mr. HARKIN. Mr. President, today marks exactly 6 months since the 
Affordable Care Act became law. And this truly is a banner day, because 
a key feature of the new law, the Patient's Bill of Rights, goes into 
effect--cracking down on the worst abuses of health insurance companies 
and giving Americans important new protections. These reforms are long 
overdue, and represent a new day in American health care. We are 
creating a reformed health insurance system that works in the interest 
of working Americans and their families--the healthy and the sick--and 
not just to boost the profits of insurance companies and the bonuses of 
their executives.
  Starting today, insurance companies will no longer be allowed to 
cancel your policy if you get sick. They must end their abusive 
practice of scouring your health records for an excuse--any excuse--to 
cancel your coverage and leave you high and dry when you need insurance 
the most. One major insurer actually targeted women who were newly 
diagnosed with breast cancer. No longer will insurance companies be 
allowed to reward employees with bonuses for cancelling policies in 
order to pad company profits. This cruel practice, at long last, is 
illegal.
  Starting today, children with preexisting conditions can no longer be 
denied health insurance. This will ensure that all children receive 
access to preventive care and needed treatments and healthy start at 
life.
  Beginning today, lifetime benefit limits on your health insurance 
plan will be banned, and annual benefit limits will be restricted. Over 
100 million Americans have health plans that include a lifetime limit, 
which, in times of serious illness, can cause the loss of coverage when 
patients need it the most. No longer will a diagnosis of an acute 
illness such as cancer or ALS lead a patient to rapidly max out their 
health benefits.
  Starting today, parents will no longer have to worry that their 
children will be kicked off their health insurance plan when they turn 
19 or finish college. Today, millions of American families with young 
adult children who don't receive health insurance through their 
employer will be able to keep their children on their family plan until 
age 26. I know that in my State of Iowa, this will help over 8,300 
young adults this year.
  Today, Americans receive yet another protection against health 
insurance company abuses. Starting today, if an insurer refuses to pay 
for your test or treatment, you are guaranteed the right to appeal that 
decision. If your appeal through the company is not favorable, you have 
the right to an independent appeal by a third-party reviewer. This is 
one of many new reforms that will keep insurance companies from 
boosting profits at the expense of sick patients.
  And finally, today is a landmark day in the effort to transform our 
current sick care system into a true health care system--one focused on 
wellness, prevention, and public health--keeping people out of the 
hospital in the first place. That is why I am particularly pleased 
that, starting today, health plans must cover proven preventive 
services at no cost to the patient. This means that, starting today, 
you can visit your doctor for tests such as mammograms and 
colonoscopies for prenatal care, or for immunizations such as the 
seasonal flu shot, without paying a deductible, co-pay, or coinsurance. 
This represents an enormous benefit to the health of Americans, and to 
the well-being of this country. Because there is no better way to bend 
the cost curve downward than by keeping people healthy and catching 
illness in its earliest stages.
  As I travel around the country, I hear from so many folks who have 
already benefitted from health care reform, and look forward to the 
many additional improvements still to come. I hear from mothers who are 
relieved their children can no longer be denied coverage for their 
asthma, from working families who will no longer have to worry about 
the cost of a co-pay for their annual flu shot, and from seniors who 
have received a $250 rebate check to help with the cost of their 
prescription drugs.
  Starting in January, seniors will also receive free preventive 
services--plus an annual wellness visit--through Medicare.
  I talk to small business owners who have benefitted from the tax 
credits that make providing health coverage to their employees more 
affordable.
  I would like to take a moment to share how health reform is helping 
everyday Americans by putting people ahead of profits. I recently 
learned about the case of a young Iowan from Cedar Falls, Sarah 
Posekany. She is just one of millions of Americans who have been 
plunged into financial ruin because their insurance company cut them 
off after they got sick.

[[Page S7413]]

  Sarah was diagnosed with Crohn's disease when she was 15 years old. 
During her first year of college, she ran into complications from 
Crohn's, forcing her to drop her classes in order to heal after 
multiple surgeries. Because she was no longer a full-time student, her 
parents' private health insurance company terminated her coverage.
  As Sarah puts it: ``They didn't want to help, so I had to let the 
medical bills pile up.''
  Four years later, she found herself $180,000 in debt, and was forced 
to file for bankruptcy.
  Sarah has undergone seven surgeries. And here is what is most 
disturbing: Two of those surgeries came as a direct result of her not 
being able to afford medication.
  Sarah said: ``When I don't have any insurance, and can't afford to 
treat myself, the disease progresses to the point where I need 
surgery.''
  Sarah still wants to pursue her dream of becoming a nurse. But her 
bankruptcy and crippling debt will follow her wherever she goes, all 
because her parents' insurance company cancelled her coverage exactly 
when she needed it most.
  Today is the day that we put a stop to these kinds of tragedies--
experiences like Sarah's, that are a stain on our past. Today, our 
health system takes another giant step toward working not just for the 
healthy and the wealthy but for all Americans.
  These reforms represent such enormous progress, such a dramatic 
improvement in the daily lives of millions of Americans. Frankly, I am 
astounded that my colleagues on the other side of the aisle continue to 
call for the repeal of these historic reforms.
  In fact, just this past weekend, a major contender for their party's 
Presidential nomination publicly stood up for insurance companies to 
defend one of their most egregious practices: discriminating against 
people based on preexisting conditions. He said that health insurance 
companies shouldn't be obligated to cover preexisting conditions--and 
let's not forget that insurers include pregnancy and domestic violence 
on their list of preexisting conditions--because paying for the care of 
the sick is like insuring a building that is on fire.
  If that's how they characterize the millions of Americans with heart 
conditions, the millions of Americans who are cancer survivors, and the 
millions of Americans born with health conditions they have no control 
over--comparing them to burning buildings--then I can understand why it 
is so easy for them to lock arms with insurance companies and defend 
their discriminatory practices.
  What this sort of thinking indicates to me is that many Republicans 
are sadly out of touch with the priorities of the American people. They 
continue to argue for repeal of a bill that puts an end to the most 
appalling health insurance company abuses.
  They want to drag us back to a day where a bad diagnosis not only 
meant a health challenge but potential financial ruin.
  They have spent months using scare tactics like claiming the bill 
cuts Medicare and hurts seniors when it actually strengthens Medicare. 
So far this year, seniors have seen prescription drug price relief, and 
very soon they will enjoy free preventive care and lower Medicare 
Advantage premiums.
  Do my friends on the other side of the aisle really want to repeal 
the ban on denying coverage to children with preexisting conditions?
  Do they want to overturn the provision allowing children to stay on 
their parents plan until they are 26 or can receive coverage through an 
employer?
  Do they really want to turn to our youth at a time when they are most 
vulnerable and starting out in life and say, ``Sorry, when you get 
sick, you're on your own?''
  Do they want to repeal the ban on insurance companies cancelling your 
policy if you get a serious illness like cancer or heart disease?
  Do they want to repeal the ban on lifetime benefit limits and allow 
insurance companies to cut off your coverage when they determine your 
care hurts profits too much?
  I can't for the life of me understand why Republicans think that 
repealing these new protections and benefits, and going back to the bad 
old days when health insurance companies held all the cards, is what 
Americans want.
  And what about the health reform law's reduction of the deficit? I am 
just at a loss as to why Republicans are calling for the repeal of a 
law that ends insurance company abuses, expands access to care, and 
reduces the deficit by $143 billion in the next 10 years, and by nearly 
$1 trillion in the years after that.
  There are so many good things in the health reform law, and there is 
much more to come. Just this week, a Families USA report highlighted 
the benefits this law will bring to my State of Iowa. When the full law 
kicks in, in 2014, over 261,000 Iowans will qualify for tax credits to 
help them purchase health insurance. These tax credits, which amount to 
one of the largest middle-income tax cuts in American history, will 
reduce Federal income taxes for Iowans by $974 million in the first 
year alone. And these tax breaks are targeted toward working families 
who have long struggled with the increasing cost of health insurance.
  We have reached a historic moment in the history of American health 
care. A moment where the promise of health reform is becoming a reality 
for Americans. A moment where all patients--not just the healthy and 
the wealthy--have the rights and protections they need and deserve.
  The Patient's Bill of Rights--the critical new protections that take 
effect today--is a giant step forward for the health and economic 
security of the American people.
  Health reform is off to a very strong start. As many predicted, the 
new health reform law is growing increasingly popular as people get 
better acquainted with its broad array of benefits and protections. 
They like the new law's sharp emphasis on wellness and prevention. They 
want every American to have access to quality, affordable health care. 
They like the tax cuts to help working families afford health coverage.
  And make no mistake: the American people are not going to allow these 
benefits and rights to be taken away.
  Mr. LEAHY. Mr. President, for each of us, our health is among the 
things we care the most about. Certainly one of the most common 
requests any of us regularly make in prayer is for good health. And of 
course it is not only our own health we worry about; we also want good 
health and proper medical insurance for our children, our parents, our 
siblings--for all those who are important to us.
  Medical knowledge and technology have advanced tremendously during 
the past two and a half centuries of American life, and the pace of 
medical progress is accelerating. But health insurance models have not. 
The deck has been stacked in favor of the insurance companies, and 
against the practical needs of ordinary Americans. For much of the last 
century Americans have pointed to the obvious need for insurance 
reform, yet the problems have only grown worse and more urgent, leaving 
millions of Americans exposed to the ravages of sudden illness and the 
wasting effects of declining health.
  Six months ago today, President Obama signed into law the Affordable 
Care Act, which will extend health insurance coverage to more than 30 
million uninsured Americans in the next few years. Reform based on good 
quality, affordable health insurance that has been talked about for 
decades is finally becoming a reality. Over 15 months starting last 
year, Congress debated and then passed the most sweeping and 
comprehensive reforms to improve the everyday lives of every American 
since Congress passed Medicare in 1965. It was an arduous process, but 
in the end the achievement proved that change is possible and that 
voices of so many Americans who over the years have called on their 
leaders to act have finally been heard.
  Americans are already beginning to see some of the benefits of 
insurance reform. First, in states where individuals and families are 
excluded from health coverage because of preexisting medical 
conditions, these Americans can now buy insurance through special 
insurance plans overseen by the states and delivered by private medical 
providers. Second, employers across the country already have applied 
for and have been awarded early retiree reinsurance grants that will 
reimburse employers for retirees' medical claims.

[[Page S7414]]

Third, seniors on Medicare who have high-cost prescriptions typically 
fall within a coverage gap known as the ``doughnut hole.'' Beginning 
recently, beneficiaries who fall within the gap will receive $250 
checks to help cover the cost of their prescription drugs.
  And today, more benefits of real insurance reform go into effect that 
will help consumers take control of their own health care decisions. 
Known as the Patients' Bill of Rights, these new rules protect 
consumers against the worst health insurance industry abuses that have 
prevented millions of people from receiving the health care they need. 
Going forward, insurance plans can no longer deny children coverage 
because of a preexisting health condition; insurance plans are barred 
from dropping beneficiaries from coverage simply because of an illness; 
dozens of preventive care services must be covered at no cost and with 
no co-pay; Americans will have access to an easier appeals process for 
private medical claims that are denied; and adult children can stay on 
their parents' plans until their 26th birthdays.
  Yet another major reform now protects everyday Americans from one of 
the most egregious insurance industry practices: setting lifetime or 
annual limits on health insurance coverage. Wherever I travel in 
Vermont I am often stopped in the grocery store, at church, on the 
street or at the gas station to listen to personal, wrenching stories 
from Vermonters who can no longer get medical treatment because they 
have met their annual or lifetime maximum. Many of these Vermonters 
were perfectly healthy before being diagnosed with cancer or diseases 
that can cost well beyond their means for treatment. Instead of being 
able to focus on getting healthy, patients instead must worry about 
whether or not their next doctor's visit will shove them above the 
insurance company's arbitrary limit.
  Each of these stories is anguishing. Let me describe just one of 
them. A master's student from Saint Michael's College's graduate 
school, Ned wrote my office during the health care reform debate to 
share his story. A car accident when Ned was nine left him a 
quadriplegic. His health care costs since then have necessarily been 
high. In fact, recently Ned found that he had nearly met his lifetime 
limit on coverage from one plan and his only remaining option for 
health insurance coverage not only contained a lifetime cap on coverage 
but also a cap on expenses for durable medical equipment, which he uses 
frequently because of his wheelchair. But beginning today, Ned and 
millions of other Americans who fear reaching their coverage limits can 
rest easier knowing that their insurance will be there when they need 
it the most. Ned, and we, can look forward to a lifetime of the 
contributions that he will make to his community and our country.
  In addition to improvements to our health insurance system that we 
will see this year, over time the Affordable Care Act will insure 95 
percent of our population and make a substantial investment in our 
economic vitality in the years ahead. In addition to ending the 
discriminatory insurance company practices of denying coverage because 
of a preexisting condition or canceling coverage when beneficiaries get 
sick, the new law will lower costs for small businesses and individuals 
who simply cannot afford health coverage. And despite the specious 
arguments from opponents of reform, this bill is the largest deficit 
reduction measure upon which many in Congress will ever cast a vote. 
The Congressional Budget Office estimates that comprehensive reform 
will reduce the federal deficit by $143 billion through 2019, and by 
more than $1 trillion in the decades to come.
  The Affordable Care Act is a tremendous achievement that will improve 
the lives of Americans for generations to come. For decades, we have 
heard heartbreaking stories about the enormous challenges Americans 
face because they are uninsured or underinsured. With each new 
implementation date of the features of the Affordable Care Act, these 
stories are becoming fewer and fewer and are being replaced by stories 
of the success of these reforms, one family at a time, all across 
Vermont and all across America.
  There is still much more to accomplish, and there are still millions 
of Americans who are struggling to buy or keep adequate health 
insurance coverage for their families or themselves. As these reforms 
are implemented over the next few years, I will continue to work with 
Vermonters and the Department of Health and Human Services to help 
Americans have the access to the quality, affordable health insurance 
that each American needs and deserves.
  Mr. JOHNSON. Mr. President, I rise today to recognize an important 
milestone in the effort of delivering meaningful health reform for all 
Americans. Six months ago, President Obama signed the Patient 
Protection and Affordable Care Act into law, and the first major 
patient protections now take effect to help Americans obtain and keep 
meaningful health care coverage.
  I am reminded of all the South Dakotan families and businesses that 
have contacted me to voice their thoughts about health care, share 
their personal experiences, and find out how reform will help them. 
Reforms in place today end some of the worst insurance industry abuses 
by implementing a Patient's Bill of Rights. These provisions protect 
children with a preexisting condition from being denied coverage, allow 
parents to provide insurance for their children through their young 
adult years, prohibit profit-driven insurance companies from rescinding 
benefits as soon as someone becomes sick and eliminate lifetime limits 
and restrict annual limits on benefits.
  As more provisions of the Affordable Care Act are implemented, it is 
important we do not forget the health care crisis facing our Nation and 
the consequences of inaction. The latest U.S. Census report confirms 
that, while some were spinning mistruths about a government takeover of 
health care, more and more Americans were losing their health insurance 
coverage. Last year, the number of insured individuals and families 
dropped for the first time the Census starting tracking that data in 
1987. Nearly 51 million Americans are uninsured, compared to 46 million 
the previous year. The Affordable Care Act puts in place assurances 
that no more Americans will be priced out of the private health 
insurance market or denied coverage by discriminatory insurance 
practices. Americans will no longer pay more every year for fewer 
benefits, be denied coverage for a preexisting medical condition, or 
lose coverage altogether just for getting sick.
  The Patient's Bill of Rights taking effect today eliminates the worst 
practices of the insurance industry that took advantage of American 
families for far too long. But insurance market reforms alone will not 
address all shortcomings of our health care system. The Affordable Care 
Act also includes important investments in strengthening and growing 
our health care workforce, improving access to preventive and wellness 
programs, and addressing waste, fraud and abuse.
  I supported health care reform to give our Nation the best chance of 
improving our system and reigning in costs. One of our biggest 
challenges remains the fact that we spend more on health care than any 
other country, 50 percent more per capita than the next highest 
spender, and yet have poorer health outcomes than most. Health reform 
cannot change that fact overnight, but it does provide us with a path 
forward and the tools to improve the way our system works for everyone. 
Health economists have noted that reform finally implements a myriad of 
bipartisan proposals to rein in costs that have been circulating for 
decades. These commonsense changes to our health care delivery system 
will ensure we are getting our money's worth and ensure citizens have 
access to affordable health care. Health reform has made a significant 
step forward in addressing the drivers behind increasing health care 
costs and placing us in a more fiscally sustainable direction.
  The new law isn't perfect--few major pieces of legislation are--and 
the work is not finished in delivering meaningful health reform for all 
Americans. But with inaction not an option, the passage of the 
Affordable Care Act laid the foundation for improving the American 
health care system. The new law is a product of compromise and in that 
same spirit I will continue to work with my colleagues to ensure health 
reform is delivering for South Dakotans and all Americans.

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