[Congressional Record Volume 160, Number 53 (Wednesday, April 2, 2014)]
[House]
[Pages H2833-H2839]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
AFFORDABLE CARE ACT
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 3, 2013, the gentleman from Texas (Mr. Castro) is recognized
for 60 minutes as the designee of the minority leader.
General Leave
Mr. CASTRO of Texas. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days to revise and extend their remarks
and include extraneous material on the subject of my Special Order.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. CASTRO of Texas. Today, we are here to talk about the Affordable
Care Act, and especially the big week that we have had in this country
in making sure that millions of Americans will now enjoy access to
quality, affordable health care.
Last week, we had a chance to talk about this and had other Members
from all over the country who represent wonderful districts come
forward and talk about how the Affordable Care Act has been very
beneficial to their constituents. Part of the discussion last week and
in the previous months, really since October, has been about whether
Americans would accept the Affordable Care Act and how many people
would enroll and how many States would expand Medicaid.
The numbers are very clear that, despite all of the advertisements
and the millions of dollars that has been spent on television promoting
misinformation about the Affordable Care Act, demonizing this as
socialism and other bad things, that despite all of that, the American
people have clearly rejected that narrative, that they believe the
Affordable Care Act and what it is doing for this country are good
things and that in the wealthiest nation on Earth, as we are, that
people should be able to afford health care, that they should not be
denied because of preexisting conditions, that students should be able
to stay on their parents' plans after college, and that Medicaid for
low-income Americans should be made more readily available.
Let's look at some of those numbers. We know, for example, that 7.1
million people ended up signing up for the Affordable Care Act in the
exchanges. Now, that is on top of the 3 million students who can now
stay on their parents' plans because of this act. That is on top of all
of the States that expanded Medicaid to make sure that folks who don't
make a lot of money, the vast majority of these people working hard day
in and day out, that they are going to be covered, too.
There are still about 19 States, including my home State of Texas,
that have chosen not to expand Medicaid. That has been such an
incredible blow to the people of my State. For example, we have the
highest percentage of people in the Nation that have no health care
coverage.
On Monday, I was back home in San Antonio and there was a large
enrollment fair, as there was in many cities throughout the country on
Monday. It was probably about 6, 7, and this fair was going to close at
8. So I went over to see how it was going and to say hello to folks.
There was a long line of people waiting. Families were there, two and
three and four and five family members. People brought their young kids
to enroll them in insurance.
[[Page H2834]]
One of the narratives during this debate has been this idea that has
been pushed that this is just benefiting people who may be lazy or not
working. One of the things that struck me when I was making my way
through that line was that there were so many people there that had the
insignia of the company that they work for or their uniform on. They
told me that they had just come straight from work and how grateful
they were that this was going to go on until 8 so that they had time to
come after work.
It was really a stark reminder that--despite all of the stories or
this idea of the makers and the takers in this country, or 47 percent
of people versus 53 percent--the vast majority of people who are
benefiting from this law, benefiting from things like Medicaid, are, in
fact, not just takers, but are hardworking Americans who are powering
our economy. All they want is a fair chance at the American Dream.
We talk a lot about freedoms in this body. The United States Congress
is, of course, one of the main bodies in government that is entrusted
with protecting American freedoms. So we talk about our First Amendment
rights, whether it is freedom of expression, freedom of speech, freedom
of religion, or Second Amendment rights, other amendments, the right
against self-incrimination, all of these things, all of the Bill of
Rights enshrined in the Constitution. But I pose the question to those
who continue to want to repeal the Affordable Care Act: What good are
any of those rights that we are entitled to as Americans, that previous
generations of Americans and this generation of Americans have fought
so hard to preserve, what good is freedom of expression, freedom of
religion, freedom of speech if you are stuck in a hospital bed sick,
broke because you can't pay your hospital bills, worried about your
family and your future?
Remember, that is not an uncommon situation for Americans over the
years.
{time} 1545
The biggest reason for personal bankruptcies before the Affordable
Care Act was the fact that people were racking up these huge health
care bills that they couldn't pay, and this happened for a few reasons.
Sometimes people just couldn't afford the insurance for their primary
care physicians--the doctors they would go see--or emergency room
doctors, not doctors in some clinic or private practice. Sometimes,
even if they could afford insurance, they were hitting lifetime caps--
somebody with cancer, somebody with MS--somebody like my grandmother
and my mother with diabetes, who suffer from complications. My
grandmother, before she passed away from congenital heart failure
because of diabetes, had her leg amputated.
There are so many people who can't enjoy the freedoms that we are
supposed to be able to enjoy because they can't afford health care
coverage, so they have ended up not going to the doctor for many years.
They have put off going to the doctor for a long time because, if they
went without insurance to the doctor, then they wouldn't be able to
make their mortgage payments or to pay their rent or pay their car
bills, cars that they need in order to get to work. These are the
common experiences of millions of Americans, not just of low-income
Americans--certainly, low-income Americans--but also of Americans in
the middle class, who power our Nation and power our economy.
I want us to consider the success of the Affordable Care Act. Of
course, there was the Web site that had a tough rollout, and a lot of
people doubted whether the program would be successful. This has shown
also that the Affordable Care Act is about more than just a Web site
that had a glitch. Again, the fundamental reason that this law has
passed is that America is the wealthiest nation on Earth, and for
generations, other countries with a lot less money have been able to
provide and make available health care to their citizens a lot better
than the United States of America has.
Consider this: with the Affordable Care Act, up to 129 million
Americans who have preexisting health conditions, including up to 17
million children, no longer have to worry about being denied coverage
or being charged higher premiums due to their health statuses. Again,
you might have a woman who is 55 years old or 60 years old. She loses
her job that gave her insurance, so now she tries to find another job,
and tries to buy insurance, and she is rejected. She tries to go on to
the individual market, and finds that she can't afford the prices on
the individual market.
What is that person to do? A lot of them are suffering from chronic
diseases.
In south Texas, for example, we have an incredibly high rate of
diabetes. In other parts of the country, in other communities, it is
other diseases, but whatever it is, these ailments are common, and they
are forcing people oftentimes into bankruptcy, into not being able to
pay their bills or in not being able to get health care coverage. So
lifting the lifetime caps has made a mountain of difference for people.
It has helped ease their minds, and it has also made things more fair.
Yesterday, the President was pretty very forceful in his comments. I
think they did the press conference in the Rose Garden, but I was on an
airplane, so I couldn't watch the press conference, but I got to see
some of the clips. He made a comment that really struck me, which is
that the Affordable Care Act is here to stay. This law is not going
anywhere despite all of the opponents and despite the millions of
dollars that have been spent on television for misinformation and
demonizing this law.
The reason it is not going anywhere is not just because of the
political reality. I mean, the politics, really, are tough on both
sides. The country had been evenly divided for a long time. The reason
that it is not going anywhere is because of the human reality, because
we want fewer people going bankrupt because they are hitting lifetime
caps and their insurance companies won't pay for their bills anymore.
It is because you want more people who are not using the emergency
rooms as their only way to get medical care and putting off ailments
and diseases because, if they go to the doctor, they know that a month
later or 3 weeks later they are going to run up these huge bills, and
they know they can't pay them.
By the way, many folks have pointed this out, but certainly, when we
had a dialogue last week, I pointed out again that there is a measure
here also of personal responsibility, of people getting insurance in
the same way that many States require you to get auto insurance. Why do
States require you to get auto insurance? It is because, if you rear-
end somebody, somebody has got to fix his car. In many public hospitals
throughout the Nation, certainly in Texas--in San Antonio, for
example--what happens routinely, oftentimes not from San Antonio but
from surrounding counties, is that these folks come in, and you can't
deny anybody emergency room coverage. You have to treat them. Then you
send them a bill, and they can't pay the bill. They don't have
insurance, and they can't pay the bill. Guess who pays the bill? That
bill has to be paid somehow. The taxpayers end up paying that bill.
Somebody has to eat that cost, and it is not the hospital. They pay a
fraction of it, but those costs are spread, and all Americans have to
pay them State by State, county by county. So this is a way that people
can not only benefit from the Act but can also take a measure of
personal responsibility for their own health care coverage.
That is why in the 1980s and in the 1990s, which was before this
issue became so political and before President Obama was inaugurated in
2009, that originally the kind of legislation that we now know as
ObamaCare, or the Affordable Care Act, was actually legislation that
was promoted by the very conservative Heritage Foundation. It was
considered to be a conservative idea in the same way that somebody
getting car insurance--taking personal responsibility in case you hit
somebody on the road--is thought to be a conservative idea. You are
going to own up to your responsibilities. It has been very interesting
over the last 4 years and even over the last few months to see the
evolution of the arguments about health care coverage and about the
Affordable Care Act and about how politics sometimes and often has
trumped public policy.
In a minute, I would like to yield to my good friend from California,
Mark Takano, but before I do that, I want to share with you just a few
stories of
[[Page H2835]]
people from my area, from Texas, who said that I could share their
stories with them and how grateful they are that they are now able to
afford health care.
The first one is a woman named Magdalena. She is a substitute teacher
and had a hard time transitioning to San Antonio since moving from Del
Rio. Del Rio is a city right along the Texas-Mexico border. It is about
2\1/2\ hours from San Antonio. She has dedicated herself to taking care
of her family, and she often puts her family in front of herself. Like
many mothers, she was worried about her health as she moved into her
senior years. She was skeptical about trying to fill out an
application, but she eventually came to an Enroll SA event. Many cities
had Enroll SA or Enroll Austin or Enroll Dallas. After sitting down
with a counselor, she was able to get a plan for 5 cents a month. This
is a woman who had previously been unable to get health care coverage.
She returned to the registration table and wept tears of joy, with her
eyes filled with hope, and the volunteers wept along with her. Her face
just lit up because now her life was truly changing.
Like many others, Magdalena is a hardworking American, somebody who
has taken care of her family, who is going to work day in and day out,
who is not asking for very much--just a chance to enjoy the freedoms
that we talk about here in Congress a lot.
With that, I would like to yield to my colleague from California,
Congresswoman Loretta Sanchez.
Ms. LORETTA SANCHEZ of California. Thank you so much to the gentleman
from Texas, San Antonio, and New Braunfels.
Mr. Speaker, today, we are talking about the Affordable Care Act.
This is so, so important as we have seen this week 7 million-plus
American enrollees, and I know there are still some who tried to get in
at the very end and are in the pipeline. I am hoping we push even
closer to 8 million new enrollees into the Affordable Care Act.
It is interesting because we over here on the Democratic side have
really been working to enroll people--we have been working to talk to
people about how important it is to have a health care plan--while at
the same time we have seen from the other side 50-plus votes to try to
undercut, to undermine, to eliminate the ACA, but here we are. They
were repealing. We were enrolling.
California's enrollment numbers surpassed 1.2 million people this
past Monday, which is more than double of any other State. On top of
that, the expansion of Medi-Cal, which is our Medicaid piece of this,
has covered another 1.5 million low-income families, so we are pretty
excited. California looked at this and said, this Medi-Cal plan--this
plan of having a health care plan for lower income families, for the
members in these lower income families--is so important. For the first
3 years, it is paid 100 percent from the Federal Government.
So, if you are sitting in a State like California and if you have 1.5
million new families who didn't have health care before that was paid
for, they were putting up with being sick, doing what we call in
Spanish ``aguantamos.'' If you got sick, you wouldn't go to the doctor.
You wouldn't go and you wouldn't go, and you would work through. You
would go to work, and you would be sick. You wouldn't go until,
finally, you couldn't take it anymore. You were really, really sick.
Then where would you go? You would go to the emergency room, which is
the highest cost place in the entire health care system. Instead of
putting up with not having health care--instead of aguantamos--we now
have 1.5 million families who are in Medi-Cal and, again, as of Monday,
1.2 million people who are in what we call our exchange, Covered
California.
This is very, very important, but there is also another piece of this
that is incredibly important, which is that now we have to work with
people. Now that we have enrolled them for the year, we need to work
with people who have never before had a health care plan. They don't
know what a primary doctor is. They don't even know what a specialist
is. They don't know what the process is to go. They don't know about
getting a baseline. Go and get an annual physical for free under these
plans. This is for free. We have to teach them.
So you go in. You get a relationship with a doctor. You get a
physical. You get a baseline. You get your blood drawn. For someone
like me, that is incredibly important because, for example, diabetes
runs in my family. My granddad died of it, my grandma, my aunt, her
five kids. It is 3\1/2\ times more likely to be in Latinos than in the
average Anglo in America. It is being able to go and get blood work
done so that can you see where you are, whether you have the propensity
to get diabetes, for example, because diabetes in over 50 percent of
the cases can be stopped; it can be turned back. It is about having
some nutritional understanding, being able to eat the right way,
sequencing your food, exercising after you eat--just a 15-minute walk.
There were just two studies that were released this past May that said,
if you have a propensity for diabetes but if you walk 15 minutes after
you eat, you can cut that propensity by almost 50 percent.
This is information that our communities do not have. Low-income,
immigrant communities in particular are less likely to have this kind
of information. Now, if they have health care plans and if we teach
them how to go and get that baseline--get their annual physicals, get
their pap smears, get their mammograms--and if there is something
wrong, let's work on fixing it, and it takes personal responsibility to
do that.
{time} 1600
I have to get up early in the morning and go and run. I have to go to
the gym to ensure that, since the propensity is high for me, I don't
get that because it takes some personal responsibility--personal
responsibility not to eat pizza all the time, and things of that sort,
yes, personal responsibility.
It takes a health care plan, it takes knowledge, it takes access.
These places have to be close by. We have to have clinics and doctors
signed up into these plans so we can go to them. It takes cultural
knowledge, as you know, being from San Antonio. Some of it is a
language barrier. Some of it is just understanding how our community
works and how we spread it by word of mouth, rather than go to
computers to find our information.
Knowing all of this will help us ensure that, now that people are
enrolled, they begin to use the plans effectively, and when they use
them effectively, we drive down that cost curve that was happening. In
California, on average, it was a 17 percent increase in medical health
care costs on an annual basis. That was not sustainable.
The only people who could have liked the old system were the wealthy
or the healthy. If you got sick, you had the money, or you never got
sick; but today, we can fix these things.
Today, we can fix these things by moving forward with these health
care plans and with teaching people how to use them efficiently and
effectively, so that all of society becomes stronger and healthier, and
that is why we voted to put this in. That is why we have worked so
hard.
I am so thrilled that the gentleman from Texas wanted to discuss this
issue today.
Mr. CASTRO of Texas. Thank you, Congresswoman. Thank you for your
passion over the many years on health care and many other issues, and
you raised several wonderful points, but there are a few in particular
that I wanted to mention.
We debate our national debt and deficit here a lot. Since the
Affordable Care Act was passed, as we know, health care has been the
biggest driver of our debt. The Affordable Care Act has actually slowed
the cost of health care, the slowest growth that we have seen in
decades.
So this is something that has actually been good and will be good for
our fiscal health in this country. Thank you for alluding to that.
Also, you mentioned that in many of the communities we represent--not
only in California or in Texas, but many places--ailments like diabetes
are things that affect so many people in our neighborhoods and our
cities, but it is not just diabetes.
In other places, it could be cancer or sickle cell anemia or multiple
sclerosis. All of those patients will now find a lot more relief
because the United States Congress passed this bill.
[[Page H2836]]
Ms. LORETTA SANCHEZ of California. I couldn't agree with you more.
There are pockets of this.
I just want to leave with one story. A few years ago, we had this one
company who was a lensmaker kind of company. It was somebody who had
retail stores, and you would go in and get your eyes checked. They
would grind lenses and get glasses for you. Usually, they could do it
in one stop, in 2 or 3 hours, et cetera.
They said: Let's do this in your area, Loretta; let's hold a health
care fair.
We had a lot of different types of people offering services, and they
said: For the first 400 people who show up, we will have
ophthalmologists there--medical eye doctors--and we will take a look
and see what is going on with people. If we need to grind lenses, we'll
grind lenses for them and give them free glasses.
Because even if you had a health care plan, most people didn't have
vision or dental, so people were not buying glasses. They couldn't
afford it.
I got there at 7:30 in the morning to this health care fair. It
started at 8. There were 600 people in line already, so we gave coupons
for these people to be able to walk into one of those retail stores and
get the service for free. We kept the first 400.
One of the young ladies that worked with me stayed all day with one
of the doctors, making sure the patients were coming in and out, giving
him the things he needed, et cetera. At the end of the day, the doctor
turned to her and said: Do you know that 80 percent of the people that
we saw today had diabetes or were about to get diabetes?
They didn't even know it because one of the first symptoms for
diabetes is blurry vision, so these people were thinking they are
getting old and their vision is kind of going, but the reality was they
were sick.
They didn't know it because they did not have health coverage, and,
like I said, that is a disease that you can really get rid of or
eliminate in your life if you work at it.
These people need that knowledge. These people need that ability to
walk into the doctor and to get their blood tested and to see what is
going on, so that we can tell them: if you don't change what is going
on in your life, you are going to be diabetic.
By the way, the plans before, if you had diabetes and you had to have
your leg chopped off, for example, we would pay for that. You see what
I am saying?
We wouldn't be paying to let them know you may be getting diabetes or
you have diabetes; we would pay after the fact to chop off their legs.
Or, if they went blind, we would have them at home because, now, they
couldn't work.
So it is going to make Americans healthier. When Americans are
healthier, they will be more productive. They will have less sick days.
It will be good for industry.
So I am really thrilled to have voted for the ACA. I am really
thrilled, 4 years-plus now, and that we are seeing it now, at the
ground level, with people signed up for plans; and now, we have just
got to make sure they go and use these, so that we can get them
healthy.
Mr. CASTRO of Texas. Thank you, Congresswoman Sanchez.
Now, I would like to yield to my friend from Houston, Texas,
Congresswoman Sheila Jackson Lee.
Ms. JACKSON LEE. Let me thank the convener of this Special Order and
the colleagues I have heard since I have come to the floor, like
Congresswoman Sanchez.
Congressman Castro, thank you very much. Coming from similar
territory--the State of Texas--I just hope that you will allow me, just
for a moment, to juxtapose the present pending bill on the floor.
I heard you speak of the bill, H.R. 2575, as well, and with all due
respect to the proponent of the bill, it is confusing. It is confusing
in the backdrop of the number that you have standing alongside of you,
7 million Americans and growing.
Because there were many Americans who were in the queue--in the line,
when March 31 came, and because of President Obama, they will now have
extended the opportunity to finish the work, and I was with a lot of
navigators and people enrolling over the weekend. They were excited
about being able to finish the task.
In Texas alone, that was the epicenter of unemployed. I keep saying,
``unemployed.'' Certainly, it has unemployed persons as well. There are
164,000 without unemployment insurance, which really is what baffles me
about this effort at repeal and this effort of determining that, with
30 hours of hard work, you can't get health insurance.
In the State of Texas, 5.198 million individuals on private insurance
have gained coverage for at least one preventative health care service,
such as mammograms, birth control, and immunizations. That is for
people with private insurance.
Also, 10.695 million individuals with preexisting conditions like
asthma, cancer, or diabetes, including 1.6 children, will no longer
have to be worried about being denied coverage in our own State alone.
As well, 5.189 million Texans have gained expanded mental health and
substance abuse or use disorder benefits, and 4 million-plus uninsured
Texans will have new health insurance options through the idea of going
into the marketplace.
Also, 233,000 seniors and people with disabilities have saved $866 in
prescription medications, and 357,000 young adults have gained health
insurance, and 7 million Texans will no longer have to worry about
annual limits. That is, of course, those who are uninsured and who can
access the new Affordable Care Act insurance.
The other point is that, over these last 2 days, we have seen the
reality of Americans clamoring for health insurance, with 4 million
people accessing the healthcare.gov Web site.
And let me make this as breaking news--because this is what we were
hearing from those opposing it--80 to 85 percent of those who have
enrolled have paid their first premium. This is not a story of I have
enrolled and you never hear from me again; this is a story of serious
decisions being made by serious persons.
Let me offer, as well, some of the tragedies over the years--and I am
very pleased to have cast that vote for the Affordable Care Act. I have
been to any number of townhall meetings to share it with my
constituents, some of whom who did not understand or agree.
In the course of the hearings, I have heard of so many stories that
we don't repeat anymore, like the little girl that had leukemia. Her
parents took her over and over again to the insurance company to get
the opportunity for her to be covered. She had a preexisting disease.
She had no coverage. She ultimately lost her life.
I believe--I don't want to call up facts that are not accurate--they
even took her to the insurance company's office to plead for her to be
covered. It was at that point near the end of her life, which she
shortly thereafter lost.
We have the mother who came to us and said yes, her son had a
difficult history. He was a trained lawyer. He was doing pro bono work.
He was in Atlanta, Georgia. Frankly, he had gotten hepatitis. Because
he had no health care, the only coverage he could get was from going
into an emergency room. He had waited too long.
He was going into the emergency room, being the only source of health
care. If he had had the ability to go to a doctor, in spite of his
history of drug abuse at that time--a trained lawyer--he would have
been able to maintain his life.
My last one is the issue of a young resident who took a summer
position in Atlanta, Georgia, but his health care was in a 25-mile
perimeter around Washington, D.C.
He fell ill with kidney disease during that summer. His father was a
doctor. He was a student. He didn't have the ability to stay on his
parents' insurance. His insurance was a school-based insurance that
said it could only be around the school.
Congressman, his father had to drive hours to pick him up and put him
in his car and pray for his survival and get him back into the
perimeter of his health insurance.
This is what we lived with before the Affordable Care Act in 2010 and
before the President ultimately signed it, and so I am baffled as to
why, for the 52nd time, there is an attempt to repeal the Affordable
Care Act with H.R. 2575.
Let me just say that the importance of this Special Order is to
emphasize whose side Members are on. I am on
[[Page H2837]]
the side of those who are clamoring for good health care and who have
children who need good health care. I am on the side of those who need
the expanded Medicaid and ask the State of Texas to do it.
As I close, just on this bill, H.R. 2575, I am still trying to
understand what it means to tell someone who works full time, 30 hours
a week, in a company that has 50 employees, that you cannot get health
care.
So to the employers out there, frankly, I believe that some people
are speaking for you that may not be really speaking for you. Because
when you pay your employees and they get health care, they have more
cash to buy your goods.
More people have income to come back to the grocery store, come back
to the restaurant, come to the small clothing store, or to buy flowers.
Why would you deny employees health care so that they can get sick,
go to the emergency room, and have days off? It doesn't make sense.
I think this bill is way before its time. There is no evidence that
we need to reduce the hours of working Americans. There is evidence
that we should pass unemployment insurance for those who are
chronically unemployed. We need to do that.
There is evidence to raise the minimum wage, but there is no evidence
that this is a problem of catastrophic moment that we are debating it
for 4 hours on the floor.
So I want to congratulate the gentleman for his leadership on this
question.
{time} 1615
Mr. CASTRO of Texas. Thank you, Congresswoman Jackson Lee. Thank you
for all of your work on this and many other issues. You are one of the
most tireless folks, Republican or Democrat, who is involved in all the
floor debates and amendments and proposing legislation. So thank you.
Just a few things that you mentioned. You were talking about the bill
that we just discussed, and it was essentially saying that for sizeable
businesses, not small businesses, because the small businesses are
exempted from the requirements of the Affordable Care Act. That is
worth repeating again. Small businesses are exempted from the
requirements of the Affordable Care Act, so this was about larger
businesses.
Instead of requiring that they offer health care coverage to their
employees at 30 hours, the Republicans wanted to move it up to 40. One
of the myths has been that all of these employers are reducing hours
and cutting employees hours and this is hurting the workers. Well, the
Congressional Budget Office, which both sides use as a neutral resource
to figure out what's what, said that there is no evidence of that.
There is no trend that says that part-time work versus full-time work
is increasing because of the Affordable Care Act.
I also pointed out earlier in the discussion that part of the
challenge in this economy is that American business has bounced back,
but ordinary Americans still have not fully bounced back.
So, when we see that the stock market every other week, if not every
other day, is hitting alltime highs and at the same time there are
millions of Americans still struggling to find work, I think it is fair
to ask why an employer shouldn't offer health care coverage to somebody
that is working 32 or 35 hours a week.
Under the Republican plan, somebody that was working 39 hours a week,
as Steny Hoyer mentioned earlier, you wouldn't be offered health care
coverage necessarily. And we believe that that is wrong. We believe
that the freedoms that we would otherwise enjoy as Americans, those
freedoms are harder to enjoy if you are sick and unhealthy and broke
because of medical bills.
So the Affordable Care Act is not perfect and, quite frankly, nothing
this Congress does, from health care to education to any other issue,
is ever going to be perfect. If anybody is expecting perfection from
this place, they are always going to be disappointed. But this is a
bill that is absolutely a step in the right direction and one that we
are going to continue to improve with the help of the American people,
with the voices of the American people.
But I will tell you what. As I mentioned earlier, this law is not
going to be repealed. We are not going to go backward. We are not going
to go to the way things were because the way they were was not good,
and this is much better.
Thank you, Congresswoman.
Ms. JACKSON LEE. Thank you.
If I could just make one final point. First of all, I am excited
about the embracing by new Members like yourself who came out of State
legislatures and knew how difficult it was to provide health insurance
for our fellow Texans. But the embrace that you are now offering is one
that gives us confidence that it will not be repealed, even though this
is the 52nd time that it has been offered to repeal.
I just want to leave these facts for you as you continue your debate.
This is a values question. This is a fairness question.
As you stand on the floor right now, the Budget Committee is meeting,
with a budget as its underpinning, the underlying bill, that will give
millionaires a $200,000 tax cut, and yet we have a bill here on the
floor that wants to take the living substance from under the feet of
workers working 30 hours a week, that gives them the stability and the
confidence that they have health insurance for companies that are 50
and above, 50 persons and above. That is not a small company. I can
tell you, I would ask that employer: Are you going to get rid of Mrs.
Smith, who has given you 10 years of hard work, and put her at 29 hours
because you don't want to give Mrs. Smith health insurance?
I think we are on the right side of the issue on this. The Affordable
Care Act has helped seniors, it has helped single parents, it has
helped individuals with preexisting disease, and it has helped young
people who have surged into buying it. We should continue to embrace it
and recognize that it has a value and it is going to turn lives.
My message to our Governor, if I can end on this note: Governor
Perry, it is time to opt into the expanded Medicaid, which is part of
the Affordable Care Act, which will give millions of others in the
State of Texas their opportunity to benefit from good health care--
being healthy and being able to work.
That is our challenge, and I look forward to working with you on
these issues.
Mr. CASTRO of Texas. Thank you.
I yield now to a wonderful legislator from California (Mr. Takano).
Mr. TAKANO. I thank the gentleman from Texas for yielding time.
I rise today to stage an intervention, an intervention for Speaker
Boehner and the House Republicans. Now, this intervention is not
because they are wearing goofy hats or are spray tanning too much. This
intervention is over their obsession with repealing or delaying the
Affordable Care Act, also known as ObamaCare.
Now, just this week, the open enrollment period ended, and it is
estimated that more than 7 million Americans signed up for private
health coverage through healthcare.gov or their State exchanges. That
number does not include the millions of young adults who are staying on
their parents' plans or those getting coverage through Medicaid for the
first time. The open enrollment period was one of the final pieces of
ObamaCare.
Now, millions of Americans finally have access to affordable coverage
that can't be taken away just because they get sick. Despite that,
Speaker Boehner and the House Republicans are committed to fighting a
battle that they have lost and have scheduled the 52nd vote to repeal
or delay ObamaCare.
The Affordable Care Act passed the House. It passed the Senate and
was signed by the President and has been upheld by the Supreme Court.
Despite millions of dollars being funneled into misleading ads that
discouraged people from getting covered, this is a law that millions of
Americans have embraced and have benefited from. We saw an incredible
surge in the final days of open enrollment, with consumers reportedly
lining up around the block at some sign-up centers.
But if you talk to Republicans, it is clear they are still in the
first stage of denial, denial of the facts, denial of the benefits,
denial that our health care system is finally doing what it is supposed
to do for the first time in a long time. My Republican colleagues must
[[Page H2838]]
stop making excuses and blaming others. They have put themselves in
this position.
Even in the first few days of the rollout, when the system was
admittedly struggling, Republicans were predicting ObamaCare's complete
and total failure. John Boehner called the initial numbers ``a symbol
of the failure of the President's health care law.'' My colleague from
California, Congressman Darrell Issa, said, ``It is time for the
President to finally acknowledge ObamaCare isn't working and to delay
the law.''
Funny how they believed the numbers then, because they seemingly have
doubts about what is being reported now. According to Senator John
Barrasso, the administration was ``cooking the books.''
To my Republican friends, I want to say: this is a safe place. We are
here to help. Your addiction to repealing ObamaCare and peddling
conspiracy theories about the law are not doing any good for yourselves
or for the American people.
Stop standing on the wrong side of history. Let's move on. Let's
accept that ObamaCare is the law of the land. Let's get back to being
productive as a legislative body.
Mr. CASTRO of Texas. Thank you, Congressman. Thank you for your
comments, and also thank you for all of you in California who have been
one of the States that has shown the Nation what is possible in helping
to offer insurance to the hardworking men and women of your State.
We, as Americans, we appreciate that.
Mr. TAKANO. Well, it is a point of pride that even in my area of
California, the Inland Empire, my county has met, has exceeded its
enrollment goals under Covered California, and just a few days ago we
had reached a million in California alone. It is because we have a
State legislature and a Governor who cooperated from the beginning. I
don't understand any Governor or any State legislature that would
intentionally try to keep low-income people from getting coverage.
Mr. CASTRO of Texas. You make a wonderful point. California and
several other States have had the benefit of a State legislature and a
Governor who have been helpful in making sure that the Affordable Care
Act, health care coverage, is available to their residents.
In places like the State where I live, in Texas, you have a Governor,
State legislators, both Senators who are actively working and
campaigning against the Affordable Care Act. So, many of us, not just
elected officials but others who are trying to make sure that people
have health care coverage, have faced a very strong headwind when
trying to get the word out about the Affordable Care Act.
I told a story earlier about a woman who showed up at an enrollment
fair in San Antonio and she ended up being able to provide insurance
for herself and her family, but she went there and she was skeptical at
first. Well, part of the reason she was skeptical is because there has
been so much misinformation about this law and so much demonization
about the law that I am not surprised that a lot of Americans would
say, hey, you know, that thing doesn't sound like a good thing. It
sounds like a bad thing.
Mr. TAKANO. There has been so much distortion. And to my way of
thinking, it is diabolical to spend money on distorting ads to confuse
people intentionally, to get young people to not sign up for the law,
to undermine the law in that way
Mr. CASTRO of Texas. That is right. You bring up a good point.
There was a group that was specifically set up to go on to college
campuses, funneled millions of dollars to go on to college campuses to
convince college students not to enroll in the Affordable Care Act.
That is just amazing to me.
Mr. TAKANO. Fortunately, I can tell you stories of someone who is
under 30, one of those young invincibles, but who was wise enough to
know that it made sense for a young person to sign up because it was so
very affordable, and he convinced his employer that she needed to take
a look at what the exchange had to offer.
As it turned out, he discovered he had a very serious condition, and
he was one of those young people who discovered that they did need
health insurance and that he was facing far larger bills than if he
didn't have any coverage at all.
Mr. CASTRO of Texas. California also, I believe, expanded Medicaid,
and that is something that Texas didn't do. In fact, I remember several
months back, when the State legislative session in Texas was still
going on, and usually it goes to about the end of May or early June. We
went down there and we were doing a press conference, and at the same
time, the Governor and the Senators, Lieutenant Governor, all
Republicans were doing their press conference.
Our junior Senator, Senator Cruz, compared folks who need Medicaid
and accept Medicaid to drug addicts, compared them to drug addicts. And
the State's leadership implied that--not implied, said--allowing
Medicaid to low-income Texans was like getting people hooked on sugar
or drugs.
Mr. TAKANO. Forgive me. I may be speaking--I don't think what I am
saying is an exaggeration, but I see that the denial of the expansion
of Medicaid by some of these States is nothing less than a war on the
poor. I don't know how else to say it.
Twenty-four percent of my congressional district were uninsured
before the ACA. I have seen charts and maps of congressional districts
color-coded, and I have seen many of those districts in Texas that are
at the same level of uninsured as my congressional district.
In my congressional district, we benefit greatly from the expansion
of our version of Medicaid, which is Medi-Cal. And the beauty is that
the expiration is not to end it as of the 31st of March. People who
qualify for Medi-Cal can continue to sign up for it year-round.
But to think that in Texas that it is not available to people who are
low-income, to me, is unconscionable.
Mr. CASTRO of Texas. I appreciate those words. Unfortunately, in
Texas there are a lot of people suffering needlessly, hardworking
people. These are not lazy people. These are people that are going to
work day in and day out, but they are suffering because their State
leadership--even though Texas was going to get up to $90 billion for
Medicaid expansion. The Federal Government was providing the funds
through 2017 and then providing 90 percent of the funds after that.
Despite the fact that it made economic sense, still, the State's
leadership refused to do it.
{time} 1630
I think it is worth mentioning a few other things. A lot of us, we
saw there were long lines on Monday, March 31 of people waiting to
enroll in the Affordable Care Act. It is worth noting that anybody that
started that process on March 31 but was not able to complete it has
until April 15 to actually finish it off. So the 7.1 million number of
the number of folks that have enrolled will very likely, I would think,
go up by at least a few hundred thousand people.
Mr. TAKANO. At least the folks in Texas, who can sign up with the
Federal exchange, can get insurance if they are online, but it is
unfortunate that those low-income Texans have no place to go.
I will just say to the folks in California, those low-income people
who can still qualify for Medi-Cal, that you can still sign up. There
is not a deadline for you. You are presumed qualified if you meet a
certain income test. So the effects of the Affordable Care Act are
still going to continue in my State for those who need health care the
most and those who have heretofore not had access to medical care.
It has been a pleasure sharing this time with you on the floor,
Representative Castro.
Mr. CASTRO of Texas. Thank you very much, Congressman.
There is another benefit of the Affordable Care Act that I haven't
talked about yet that is also very important to know. We know that 7.1
million people have signed up. Three million or more college students
or young adults are able to stay on their parents' plans because of the
Affordable Care Act. Millions more have benefited from Medicaid
expansion. Millions of Americans also benefit because there is no
longer lifetime caps. You know, you are not going to have somebody who
is suffering from cancer in a hospital bed have a doctor or an
administrative billing person from the hospital come talk
[[Page H2839]]
to you about the fact that you are about to hit your lifetime cap. So
now, not only are you lying there sick in the hospital bed, but you are
also thinking about how you are going to pay your mortgage and keep
your kids in college. That is not going to happen anymore.
So when you hear people talk about repeal--and first of all, repeal
with no plan to replace it. I mean, the only thing coming from the
other side is, just get rid of this whole thing. There is no plan to
replace it.
So I think what we owe the American people is, when we talk about
repealing a law, especially something as important and big as this, I
think it is a very fair and necessary question to ask: What are you
going to replace it with? Are we going to go back to the old system,
where that cancer patient lying in a hospital bed now is going to hit a
lifetime cap with the insurance company so they are going to be told
that they either have to leave the hospital or they are going to get
stuck with $250,000 of bills, and they have to sell their house because
they can't afford it anymore? When you hear the word ``repeal,'' you
should understand that that is what is at stake, that is what we would
go back to, the old system.
Until folks come up with an alternative--and in 4 years, there has
been no alternative, and really, there is no reason to think that over
the next 4 years there is going to be one. Unless you can come up with
an alternative, then we are talking about going back to that time.
But the thing that I wanted to mention and something that is often
overlooked here is that part of the Affordable Care Act, another
benefit of it is that mental health care coverage is vastly expanded
because of the Affordable Care Act. That is extremely important.
Millions of families in this country, individuals and families, have
either suffered themselves or have family members who suffer from
serious depression, anxiety, bipolar disorder, other mental health
afflictions that--quite frankly, in America and many other countries of
the world, for the longest time, we never took mental health issues as
seriously as we have taken physical health issues.
So for a long time, people would tell you, oh, you are depressed.
Well, you just need to snap out of it. Or they treated things like
bipolar disorder very lightly. They thought somebody just had a bad
attitude.
In Texas, in 2011, I and others worked on getting young people with
serious emotional disturbances covered by insurance companies in Texas.
And, you know, the Democrats are in a deep minority in Texas. The whole
time I was there, for five terms, we were in a deep minority. So you
would have a Republican-controlled legislature. And my bill went
nowhere. It didn't go anywhere. It died. So serious emotional
disturbances weren't covered. But under the Affordable Care Act, things
like that will be.
The reason that was important was because families were coming to
me--in my district office, there is one family in particular that came
to me and said, We are scared of our son. Our son is a teenager, and he
has gotten violent before. So we call the cops. The cops take him to
the hospital. There is nowhere to keep him for any kind of long-term
treatment because, by the way, the State provides inadequate resources
for mental health care coverage. They can't really put him in jail
unless he has really assaulted somebody. So there is just this cycle,
where we are having this issue with our son, and we are scared to be in
the same house with him. But we can't really do anything. And the law
offers us no relief.
Well, one of the benefits of the Affordable Care Act is that serious
emotional disturbances and many other mental health issues will now be
taken more seriously, and they will be more covered by health care
companies than they have ever been in the history of the United States.
And that hasn't been a big focus because a lot of this has been about
politics. And a lot of the milestones and, quite frankly, the
celebrations about the more than 7 million people signing up, that has
been the big focus of this whole thing. But we shouldn't overlook some
of the things that haven't gotten as much attention.
For me, as somebody that worked on mental health legislation in
Texas, and I know many other people, Republicans and Democrats, have
worked on things like that--to the families who are dealing with
situations like that, that is a big deal. That means a lot to them. And
that is helping them out.
So, as Americans, when you hear folks talk about repealing this law,
I hope that we all fully understand exactly what we would be going back
to. And those legislators who propose repealing it are irresponsible if
they don't provide to the American people a full alternative and an
explanation for what that alternative would do for them and what it
would cost for the country. You know what the Affordable Care Act is
about. We have seen no plan on the other side.
So as I close, I would like to say ``thank you'' to all the Members
of Congress from different places in the Nation who joined me today in
talking about this milestone for the Affordable Care Act. I am very
personally glad that over 7 million people have now signed up and are
benefiting. And millions more are benefiting through Medicaid
expansion, college students, and all of these people who won't be
kicked off of insurance because they have hit lifetime caps. Or, you
know, somebody that tries to get insurance, and the insurance company
sends them a letter back saying, we can't insure you because you have a
preexisting condition, or your doctor submits a bill to the insurance
company, as it used to be, and the insurance company writes back
saying, Well, you know what, we are not going to cover that $3,000 bill
because you had a preexisting condition. That is what repeal would be
about, going backward.
So with that, Mr. Speaker, I yield back the balance of my time.
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