[Congressional Record Volume 163, Number 6 (Tuesday, January 10, 2017)]
[House]
[Pages H290-H296]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WHO GETS THE BREAKS FROM REPEALING THE AFFORDABLE CARE ACT? THE
SUPERWEALTHY
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 3, 2017, the gentleman from California (Mr. Garamendi) is
recognized for 60 minutes as the designee of the minority leader.
Mr. GARAMENDI. Mr. Speaker, indeed, we do have an extraordinary
country. Down through the last 230 years, this Congress has met, has
discussed, decided, voted upon, and set in place policies that advanced
our country. And we are so very fortunate, all of us Americans, to be
living here with all the promise that this incredible history has given
us.
But at this period of time, we also have some profound questions
about where this country is going. We wake up and we say: What is
happening here? What is happening in the international scene? What is
all this about Russia hacking? What is all this about trying to
influence the American election? Did they really, and did it really
happen, and was it effective?
Well, we know it really happened. The American public is scratching
their head and they are saying: What is it?
And then all this talk about change, all this talk about we are going
to change things; we are going to repeal ObamaCare, and we are going to
replace it with something great. Hmmm. I wonder what that might be. And
I suspect all across this Nation there are men, women, families that
are also wondering: What do they mean it will be great? What is it that
is great?
Well, if you were to go around the Capitol, if you were to talk to
Members in the House of Representatives or over in the Senate and say:
So it is gonna be great; what is it?
Well, we will tell you tomorrow or we will tell you later, but it
will be great.
Maybe, maybe not.
Right now, the Senate is working on a piece of legislation that will
set the stage for the repeal of the Affordable Care Act--and some would
derisively call it ObamaCare. Repeal it.
Oh, yeah, get rid of that thing. But not to where it is going to be
great as soon as it is gone.
Really? I don't think so.
I know that in my part of California, a lot of people--in fact, more
than 20,000--don't think it is great at all. They are going to lose
their health care. And there are a whole lot of seniors in my community
that are going: Wow, it is going to be great.
Really?
But I will lose my annual check-up. And that awesome drug doughnut
hole that was so frightening just years ago is going to come back? That
is not so great.
I drove into town or into the Capitol today. I don't live so far
away, but it is 20 degrees, and I decided I would rather drive than
freeze. So I drove in and an advertisement came on the radio, and it
said: You are going to get a trillion-dollar tax cut. Wonderful. The
middle class will have a trillion-dollar tax cut. I said: Well, that is
not what I saw last night when I read the statistics about the great
repeal of the Affordable Care Act. In fact, I read something quite
different from the tax committees, from Americans, various people.
Let me put something up here. Here it is. Who gets that trillion-
dollar tax cut? Who is it? Is it the middle class? Well, I don't think
so, because when you look at the numbers, it goes to the very wealthy.
They are the ones who are going to get the tax cut with the repeal of
ObamaCare.
When the Affordable Care Act is repealed the way it is presently
going, the bill that is over in the Senate will require that the taxes
that were put in place to support the Affordable Care Act and to
provide insurance for 20 million people--that is both the government
insurance, the Medicaid, Medi-
[[Page H291]]
Cal in California, and the subsidized insurance from the various
programs that exist State by State--that money was raised from the
wealthy.
When the tax cuts come into place, here is the real story. The top 1
percent--do you remember the 1 percenters? Do you remember all that
discussion about the 1 percenters and the 99? The 1 percenters get 57
percent of that trillion dollars, and everyone else gets to split the
remaining 43 percent. The top one-tenth of the taxpayers in
California--we are talking about the superwealthy. We are talking about
the folks that are actually going to be in the President-elect's
Cabinet, you know, the billionaires that he is going to put in the
Cabinet. We are talking about those guys--oh, roughly a $200,000-a-year
tax break. But after all, they are hurting. They need a few more
hundred thousand dollars along the way.
So the trillion-dollar tax break that is the foundation of the
repeal, if you eliminate the money, the program is not working. There
will not be annual visits for seniors so that they can stay healthy, so
that they can control their blood pressure, diabetes, mammograms, and
all the rest that go with it. There won't be money for the 3.7 million
Californians that presently are able to get coverage under the Medi-Cal
program. There won't be money for the almost 2 million Californians
that are in the subsidized pool called Covered California. That money
won't be there. Those folks are going to be out.
And by the way, the repeal will remove the insurance for 30 million
Americans all across the country. But who gets the real benefit here?
The superwealthy, the top 1 percent will get 57 percent of that
trillion-dollar tax break, and the rest of us will share in the 43
percent remaining.
Another way to look at it, folks. It will be great, but for whom?
Well, if you break the American public into the five sectors, the first
20 percent, next 20, next 20, next 20, and then the top 20--so these
are the real poor down here in the lower 20 percent, and these are the
superwealthy in the top 20 percent.
So what happens? When you repeal the Affordable Care Act, as is now
happening in the Senate--and it will be over here either this week or
early next week; and then this House will take it up and it, too, will
vote on that very same budget bill that will create a trillion-dollar
tax cut over the next decade--who will get the money? There you go. The
top 20 percent will wind up with a full 74 percent of that.
{time} 1930
Despite that little advertisement that I heard on the radio, which
said, ``Oh, the poor and the middle class are going to get it,''
really?
Let's see. Of the bottom 20 percent--6.7--oh, and the next will get
5.9 percent of it--do you have any idea what they are going to lose?
They are going to lose the subsidies on their insurance programs.
They won't be able to afford it. They will lose their insurance. For
some of them, they are on the Medicaid or the Medi-Cal program in
California, and they will be out of luck unless, of course, the State
of California can find $16.8 billion to replace the money that just
disappeared with the repeal of the Affordable Care Act, and that money
is then transferred to the top 20 percent.
These folks down here, the bottom 20 percent--actually, the bottom 60
percent of the American public are the losers.
Who are the winners?
The ones who are already able to buy insurance. I love this trick. I
was the Insurance Commissioner in California. I loved this little
trick: ``Not to worry. We are going to give an opportunity for people
to buy their own insurance and give them a tax break.''
Do you mean these people down here have enough money jingling around
in their pockets that they are going to be able to go out and buy the
insurance and get the tax break?
Uh-uh. It is the folks up here on top who will, once again, benefit.
This really is a massive shift of $1 trillion from those people who
are now insured, for those people who are now able to get care in the
clinics that have been established across America--in outlying areas
and in rural areas in my district. It is a massive shift from the
ability of those people to get health care, for those people who are on
the exchanges and are able to get subsidized insurance so that they can
afford it, for those people who are seniors and are able to get their
free annual checkups and have their drug costs reduced as the doughnut
hole shrinks. It is a massive shift of money being taken directly out
of their benefits and their pockets and going to the wealthy of
America. That is what is happening. That is what this repeal of the
Affordable Care Act is.
Then you look at the implications of that. What about the hospitals
that have been able to ramp up their services? What about the reforms
that were in the Affordable Care Act--the insurance reforms--that said
to the insurance companies: ``Oh, no, no, no, you can no longer
discriminate because that person happens to be a woman or has a
preexisting condition''?
This is important, Mr. Speaker. If you are scratching your head and
wondering what is going on here, listen carefully because this super
rapid train is about to come into the House of Representatives and
sweep through here, wiping out the healthcare benefits of 30 million
Americans. For those who are not directly affected, they, too, are
going to wind up in a very precarious situation because the reforms
will also be repealed.
Joining me tonight to discuss this and Social Security--oh, by the
way, Social Security is also on the chopping block--are two of my
colleagues: Marcy Kaptur from Ohio, who has been an extraordinary
leader on the issues of manufacturing, of making it in America, of
looking out for seniors, and for people who are in need of help and
support.
Congresswoman Kaptur, would you care to join us and share with us
your thoughts on what is happening in Washington?
Ms. KAPTUR. Thank you, Congressman Garamendi. You are such a rare and
talented Member. I thank the people of California for sending you here.
You serve them every day of the week, 7 days a week--24/7. It is a
privilege to appear with you tonight and also with Congressman Paul
Tonko, one of our most talented Members from upstate New York--a region
like my own that has just been battered by the global economy and the
outsourcing of jobs. We all are just honored to serve in this Congress,
and we respect it and its history and its potential.
Mr. Speaker, as I travel my own district and State, I am finding I
have to reassure people. Anytime there is a change, I guess, in public
life, people need to be bolstered that everything is going to be okay.
We are here to be that squad and to say to the American people that
they have power, too, and that it isn't just the super rich of this
country or the billionaire class.
We can label them ``wealth power.'' And that has power; yes, it does.
Sometimes extraordinary power. But there is also ``people power.'' I
consider myself having been lifted here by people power over many
years, and I appreciate the people of my region for allowing me to
serve our country and to learn every day, to learn from them, to learn
how to make the instruments of the Nation work better for them.
There is also ``spiritual power.'' I am amazed at how people's
spiritual groundings help them through difficult situations and
transitions.
Then there is ``intellectual power.'' We hope to use some of that
here once in a while. That is a power in and of itself. We think about
the power of liberty of a free people to improve their Nation, to heal
their Nation, to expand opportunity in their Nation.
We are aided and abetted by a very curious media--sometimes more
ridiculous than it needs to be--but also of people digging, trying to
find that elusive truth that should lead us all forward. So we find
ourselves helping to heal our Nation by being Members here, and we all
hope for the best for our people and for our country. I think the
Members here are very well motivated.
I rise to defend, really, and to support two foundational programs of
our society: Social Security and Medicare. I will try to be brief so
others can comment.
I am very proud to say that our family is one of those families who
would have been completely destroyed had it not been for Social
Security and Medicare. Those didn't exist when my parents were born and
grandparents were
[[Page H292]]
living in our country. But in 1935, after our country crashed
economically and there were major bank failures and the stock market
crashed and wiped out the savings of millions of Americans, the Nation
turned to the Federal Government, to the President, to guarantee for a
large segment of our society--senior citizens--decent incomes.
The Social Security Insurance Act was enacted at the urging of
Democratic President Franklin Delano Roosevelt. He was regarded as a
saint in our household because what happened around our country was
that seniors before that time--many of them--were living in what we
called poorhouses. They were dying in terrible circumstances, and there
was no security as a person aged.
Can you imagine how revolutionary it was at that time to create a
social insurance program--probably the largest insurance program
America has ever had--to ensure that as people aged or if workers
became disabled in the workplace or if they died that their children
would have sources of income?
The program did all of that. In thinking back, gosh, over 70 years,
how transformational was that?
As for our grandpa, who died in a county hospital in Ohio before the
enactment of Medicare, I know the conditions that he died under. And I
know that, when our mother died, it was a different situation. She had
Social Security and Medicare, and we were able to take care of her. The
same was true with our father.
Intergenerationally, I see our country getting better. I am proud of
that. I am also proud to be a Democrat and a member of a party that has
created Social Security, which has become an indispensable part of our
way of life. As I have said to seniors and to workers, it is an earned
benefit. People pay for it every time their paychecks are nicked, and
their employers match it.
Obviously, to survivors--and, obviously, I have neighbors who have
lost spouses, whose children then benefit from the survivor benefit--
what an incredible gift this idea is to the American people. There are
35 million people today in our country who depend on Social Security--
one out of every six Americans. Every day, Social Security lifts 20
million people out of poverty--people who used to live in poverty.
Can you imagine what that was like?
We don't ever, ever want to go back to that world.
In 2014, the latest data show us that more than 6 million children
under the age of 18 live in families who receive income from Social
Security, lifting more than a million children out of poverty. Social
Security has never been a welfare program. It is an earned benefit, and
all Americans who contribute to it during their working lifetimes
receive benefits. Social Security is a compact of trust between
generations. It is the ever-present sentry at the economic security
gate for retirees, for those hurt on the job, or for their survivors,
and it is America's greatest insurance program ever.
I happened to be living when Lyndon Johnson helped to create the
Medicare program, which provides health insurance coverage now to over
55 million people in our country--essential health security for
seniors. Today, only 2 percent of the elderly in our country lack
health insurance compared to 48 percent--half the people of this
country--in 1962, after World War II, before Medicare even existed.
That seems sort of modern times, the 1960s; yet it really was not. I
would say that that is a ``wow'' by any measure.
Yes, people are living longer. Thank God the program is working.
People are getting free preventative healthcare screenings and are
lowering the long-term costs of care because of early diagnosis.
Seniors don't have to pay for mammograms or diabetes or cancer
screenings, thanks to the Affordable Care Act; so we keep trying to
make the system better.
Since House Republicans won the majority in 2011, every House
Republican budget has tried to end the Medicare guarantee and turn
Medicare into a privatized voucher program.
Do you know what that is going to do?
It is going to shut out millions of Americans who are elderly--or who
are about to be elderly--from insurance. The reason we have Medicare is
that insurers weren't insuring seniors--that is the reason it exists in
the first place--or they will make the price so high that people won't
be able to pay for it; or they will cherry-pick only the healthy
people. Then those who have diabetes, those who have had prior cancers,
those who have multiple sclerosis, those who have Parkinson's will be
cast aside.
What kind of a country would this be, for heaven's sake?
The American Association of Retired Persons and the National
Committee to Preserve Social Security and Medicare completely opposed
the Republicans' plan to voucherize and let every senior go out there
in the market and try to find a plan of his own, because they know what
that means. These two programs are the most pro-life programs this
Nation has ever created. We should be so proud of what we have been
able to do as a country over the last century.
The Republican attacks on Social Security and Medicare need to stop.
They are America's bulwark for millions and millions of people, and
they have proven themselves to be America's most important, lifetime
security programs.
I thank Congressman Garamendi and Congressman Tonko for being down
here tonight. I know how passionately you care about the people of our
country way beyond just your districts and why we are here. We are here
to stand with them.
Mr. GARAMENDI. Thank you very much, Ms. Kaptur.
I loved your talk of the history and how it came to pass that we have
Social Security and Medicare and what happened when we did not. It was
really profound. It reminded me of my own history.
I remember, as a young kid, that my father took me to the county
hospital where the neighboring rancher was--we were out on a ranch in
California--and it was horrible. That is where he was sent to die
because there was no Medicare.
Ms. KAPTUR. If the gentleman would yield, I can remember the stench.
Mr. GARAMENDI. Oh, the stench was unbelievable.
Ms. KAPTUR. I can remember that.
Mr. GARAMENDI. I am sorry your father endured that.
Ms. KAPTUR. My grandpa.
Mr. GARAMENDI. Your grandfather.
Ms. KAPTUR. Our father had to fight to get him in there because there
wasn't enough space for people who were ill and dying. That was before
hospice and that was before Medicare. I remember, as a young girl, that
that was a hard thing to experience, but our mother and father never
protected us from the inevitable.
Mr. GARAMENDI. I was just thinking that I have got more stories to
tell, but I really want to turn to our colleague from New York. Mr.
Tonko and I are often on the floor--with you also--to discuss jobs in
America, how to enhance our American economy with research, economic
development of all kinds, transportation infrastructure, Make It In
America.
Mr. Tonko, tonight we are on a somewhat different subject, but I know
it is one that you are very familiar with, one that you have spent your
entire career addressing in trying to help seniors and others who have
been on the short end of the stick. Thank you so much for joining us,
Mr. Tonko.
{time} 1945
Mr. TONKO. Mr. Speaker, I thank Representative Garamendi for bringing
us together in this Special Order format to talk about some key
critical components that address American families significantly.
Representative Garamendi and Representative Marcy Kaptur, who both do
their homework, are a great addition to the House because they
challenge us with facts, not fiction. They care deeply and passionately
about improving and enhancing the quality of life. So to stand with
both on this issue is a good feeling for me.
Just a couple of observations: I think it is okay for government to
have a heart. We speak to the heart and soul of working families across
this country by understanding that health care is not a privilege; it
is a right.
So let's begin with that fundamental basic observation, a right. What
we have seen with this right is that over 30 million Americans have
been added to the rolls of the insured over the course of the
Affordable Care Act.
Now, Representative Kaptur did a great job of speaking to history of
[[Page H293]]
Medicare, of Social Security, and of the Affordable Care Act, as did
Representative Garamendi. I remember being at the 75th anniversary
celebration of Social Security, and people were talking about the
discrediting going on before Social Security was enacted into law.
There were those who demonized it before it became law. There were
those who have fought it ever since. They don't want that right for
working families.
I would suggest that Social Security, Medicare, and the Affordable
Care Act are rock solid elements of a foundation upon which to grow
quality of life and longevity. It is a basic fundamental additive that,
when brought to our working families across this country, we are
providing a service and we are addressing them with dignity. That is
what this is about.
The demonization of the Affordable Care Act is interesting. Because
if you look at polling, you will find that people say that ObamaCare is
destroying the Nation. Well, what about the Affordable Care Act? That
is working. My friends, it is the same issue, it is the same concept,
and it is the same program.
So what we have tried to do is discredit a program that took on a
major challenge, took on major industries, and needed to provide a
balance and an actuarial outcome that is providing a go-forward and
accomplish what you have enacted as a mission. The actuarial science
has got to be precise.
So for those who want to repeal, they are talking about, in cases,
pulling a brick out of the foundation and having it get wobbly, and it
is going to crash the marketplace. We are going to have all of these
people who have been enrolled or have been forever enrolled in health
care impacted by rising costs and disruptive outcomes that will put
them at risk.
So like the Social Security Program before the ACA, like Medicare
before the ACA, as you floated these boats, as you went forward with
time, you learned where you needed to tweak, and you adjusted, by
amendment format, to make the program stronger. That is what we have
been asking for in a partnership here in the House and with the Senate.
Let's work on those areas that may need improvement, but do not repeal
because repeal without replacement is a disaster. It is a disaster
waiting to happen.
We have provided hope for working families across this country. We
have had the testimony presented to us, anecdotal evidence, that this
is working, that for the first time families have enjoyed a connection
to a system, a standardized approach. What was the program?
People say: Well, I don't want to pay for someone else's health care.
You have been paying for it before the ACA. It was called the emergency
room. It wasn't standardized because whoever you got at that emergency
room in whatever location, as you traveled looking for assistance,
didn't provide a steady flow. It was a wasteful outcome for taxpayers
and an insufficient outcome, a cruel outcome for those consumers who
were impacted by being underinsured or uninsured.
So let's set the record straight. We have had a program up and
running for 8 years now. The Republicans have chastised this program
saying it needs to be repealed. We have taken over 65 votes, or 65
votes, I believe, to repeal, but there has never been a replacement
plan. So what kind of gimmick is this to pull away a program that is
working for tens of millions of families added to the rolls but not
replace? That is disaster waiting to happen.
So we challenge our colleagues here in the House and in the Senate
down the hall to be academic about this, to be compassionate about it,
to be passionate in our resolve, and to make a difference by putting
together the improvements that we require and not repealing.
Now, we look at the Affordable Care Act and what it means to our
health care. But if you repeal, you will wreak damage on the budget.
You will destroy our economy. You will have a huge workforce
displacement, and you will slash care for America's working families.
Is this the outcome that we want?
Remember, we were the last industrialized nation to come to the table
and provide guaranteed health care for our families. That is not
something of which we are proud. That was destructive. That was
insensitive. It was not effective. It was a waste of tax dollars the
way we did it.
So now we go forward with a program that allows us to now take a look
at the history, albeit brief, on the Affordable Care Act, but
understanding where we need to fine tune. We do that, and the challenge
is there for all of us: take the cost out of the system for a stronger
future and provide at least the same level of quality, if not enhanced
quality, as we go forward. That should unite us in a common cause,
cutting the cost of the program and enhancing the quality of services
provided. What a great mission for all of us to embark upon.
So let's not play politics with the health care for tens of millions
of people who are new to the system and for all of us who have been
covered routinely by the system. We can do better than that.
Let the lessons of Social Security and Medicare, which, as my
colleagues indicated earlier, address the American public with dignity,
improvement, enhancement, and hope, the best commodity we can deliver
as a government to her people.
So I thank Representative Garamendi for the opportunity for us to
speak to these issues. Frankness is required right now. The lack of
theater would be an improvement. No theater on this. Let's settle for
facts, not fiction, and working together to bring about what is a sound
resolve that allows us to provide stability and success for the
American public. That, I don't think, is too much to ask.
So I thank the gentleman from California (Mr. Garamendi) for bringing
us together.
Mr. GARAMENDI. Mr. Speaker, it is always a pleasure for me to be on
the floor with Representative Tonko because of his passion, his
knowledge, his ability to articulate with clarity, in this case, the
importance of the Social Security program, Medicare, as well as the
Affordable Care Act. The gentleman makes a compelling argument.
I want the public of America to really grasp the importance of what
is happening here in Washington. Yes, we are going to have a new
President, and there will be an inaugural and all of the celebration
that goes with that.
Let me put it this way: When that is done, there is a majority of the
Congress and the Senate, together with the President, that fully intend
to embark on unraveling the very critical safety net for more than 30
million Americans. And for everyone else who has insurance at every
age--Medicare all the way down who has insurance--they will also see a
dislocation and an unraveling of their insurance benefits because this
market could seriously unravel. So as the gentleman said so clearly, be
academic, study the facts, and study the pros and the cons of the
various alternatives that are out there.
I know, as an insurance commissioner and having been dealing in the
issues of health care for many years now, that there are improvements
needed in the Affordable Care Act. There is no doubt. We have been
saying that since shortly after it became law. And even when it became
law, I said this should be done this way or that way a little
differently. We are 8 years into this and, as you say, millions, tens
of millions actually--around 30 million directly--are involved and
benefiting from the program, either through Medicaid, through the
exchanges, or through the various benefits that are out there. So it is
really, really important.
I want to also pick up on something that Representative Kaptur
brought to our attention. I am going to put one more chart up here. I
was surprised and a little bit appalled, just before we broke for
Christmas, that the new chairman of the subcommittee of the Ways and
Means Committee who deals with Social Security introduced a piece of
legislation. We looked at it.
It was just before the Christmas holidays, so I picked it up and
started looking at it. I go: whoa, wait, wait, wait. This is a major
step to unravel the Social Security system. Remember, back in the
George W. Bush administration, in the first 3 years of his
administration, he tried to privatize Social Security. He failed
miserably at that. Thankfully, he failed. Congress wouldn't stand for
it. At least, the Democrats in Congress wouldn't stand for it.
[[Page H294]]
I see this piece of legislation introduced in the last session, in
the last days, and I am going: Whoa, what does this mean? This man
becomes the chairman of the subcommittee that deals with Social
Security, and I am going: oh, no, they wouldn't; they wouldn't go after
Social Security again. But the bill does. It does it in a way that,
once again, gives enormous benefits to the wealthy and not so much for
the others.
This is a little chart about what happens if that piece of
legislation by Mr. Johnson actually becomes law. These are the benefits
that would be received today. In 10 years, these would be the benefits.
This is the top 20 percent rather, and right here is the middle. That
is about a $3,000 a year reduction.
Keep in mind that, I think, well over 50 percent of the seniors in
the United States depend upon Social Security as their principal source
and, in many cases, their only source of income.
So you get a decline. What do they want to do? They want to increase
the age to 69 before you could apply for full Social Security. They
want to radically change the cost-of-living index. I know what I heard
from my constituents when there was no cost of living over the previous
2 years--and a very small one this last year--the cost of care for
seniors continues to rise because they are on the expensive side of
things. There are some other provisions in it. So this is a wake-up
call. This is a wake-up call.
Clearly, the majority party here in the House and in the Senate have
promised to repeal the Affordable Care Act, which we have talked about.
They have also made it clear that in the past--and we believe in the
months ahead--they will attempt to privatize a large portion of the
Medicare program. So Medicaid will be largely gutted, and the increases
that we have seen through the Medicaid program will be wiped out.
The Medicare program will have significant benefit reductions, and,
if they intend to voucherize it, which they have talked about, then as
Representative Kaptur said, they will throw the seniors to the mercy of
the insurance companies.
My basic point tonight was to raise the alarm and to begin to discuss
here amongst our colleagues the reality of what is being planned for
America. Don't look at this as a partisan issue, Republican or
Democrat. Look at this as a personal issue.
Look at this as an issue that was given to me by a woman who is a
farmer in the community I represent north of Sacramento who never had
insurance. She was an entrepreneur, a self-employed farmer. She never
had insurance. If she needed care, she would go to the emergency room.
That worked when she was young, but then she became a little older, and
then cancer.
{time} 2000
The treatments for her cancers were unaffordable. She would go
bankrupt. The Affordable Care Act came along with guaranteed coverage
and an insurance policy through the exchange in California that she
could afford that would provide her with unlimited medical services for
the rest of her life. No cap, no annual cap, no lifetime cap. She got
her cancer treatments, and she has moved along. She said: I still need
care. And if they repeal the Affordable Care Act, I won't get it and I
will die.
That story is repeated across America. It is repeated in my district.
I can give many more examples. So this really is, in her case and in
many others, a life-or-death situation. So, yes, we will be academic as
Mr. Tonko has said. We should be. We should understand the implications
of one policy versus another. We should understand when you start with
repealing a trillion dollars of taxes, that will have a profound impact
on health care in America. And the benefits will go to the wealthy.
That is academic.
But it is also this woman, a small farmer who developed cancer. She
had no hope. The Affordable Care Act comes along, and she is able to
get insurance and she is able to get the chemotherapy necessary to save
her life. She is back on the farm.
Repeal the Affordable Care Act and this woman, along with millions of
Americans, are in serious jeopardy. So be aware. Social Security on the
chopping block; Medicare on the chopping block; the Affordable Care Act
is on the chopping block. Tax reductions for whom? Yes, mom and pop
would get $130 a year from the tax cuts. The billionaires in the Trump
administration would get $200,000 a year in tax cuts. Mom and pop are
likely to lose their insurance.
I now yield to the gentleman from New York (Mr. Tonko).
Mr. TONKO. Thank you, Representative Garamendi.
As you talk about public sentiment about Social Security, the
Affordable Care Act, and hearing the evidence you have provided from
your constituent within your district, it becomes very apparent where
the American public is.
When polled recently, only 20 percent of the American public is in
support of efforts to repeal without replacement--20 percent. So the
great, great majority understands what is going on here.
We have also seen during the recent campaign season, which probably
went a year and a half to 2 years long, a lot of talk about repealing
the Affordable Care Act, undoing the act. That happened in the same
timeframe as 11.5 million people were added to the rolls for 2017. So
there is an appeal here that is drawing the American public toward the
coverage provided by ACA. So the sentiment here is to get things done
and provide, again, the stability.
I am also a cosponsor of legislation entitled Strengthening Social
Security Act that would improve how we calculate the benefits for
Social Security. We are not advancing reducing those benefits or
raising the retirement age to 69 or whatever level; we are talking
about enhancing benefits. When you talk to seniors, they will say we
either have got nothing or we got just a bit of an increase that was
taken away with the other hand for some other purpose.
So, yes, we need to revisit just how we give that green light to a
COLA adjustment, and we need to calculate that approval with items that
are truly essential for the senior citizens, not big screen televisions
or certain items that are adding to a luxurious note, but one that
speaks to their basic core needs to live day to day. So the
Strengthening Social Security Act does just that. It takes into account
all of the essentials in that calculus that will determine whether or
not a COLA adjustment is given that given year. So that is important.
I also believe it is time for us to look at that cap that we have
created, that we have placed on contributions to Social Security. You
know, some people by February 12 or 14, whatever date it is, are done
paying. They are done contributing by that point in the year. Well, the
standards of $118,000, or $127,000 coming this year, are just capturing
most of those revenues. The hardship is placed on the working, middle-
income community, those looking to ascend the middle class. There could
be a far greater contribution from other income strata that we ought to
look at to provide stability.
A point needs to be made that Medicare, Medicaid, and the Affordable
Care Act are all intertwined. There were strengtheners that were
provided for these programs. There was a partnership of revenue stream
that was calculated and assumed that again provides for the quality of
response to the consuming public, and especially those in senior years.
I have a large percentage of senior citizens in the makeup of my
constituency. It is important to recognize that many who are on
Medicare end up getting Medicaid assistance because of situations that
are called upon where they are perhaps placed in nursing homes, adult
homes, or the like. So we have to be cognizant here of the public
sentiment, where is their thinking, and we know exactly what they want.
They want stability for these programs. They want strengthening of the
programs. They want to make certain that all of these efforts that have
lasted for decades, or were introduced as late as 2010, will continue
so they have a future that is that more secure, that more certain.
So tonight we talk and implore our colleagues to please help improve
the Affordable Care Act. Let's not repeal, and certainly do not repeal
without a replacement plan. That is a disaster that will really cause
havoc in the marketplace. It is one that doesn't prove to be
actuarially sound. Also, let's make certain that we don't have these
efforts again to voucherize Medicare, to privatize Social Security.
These are programs that have provided stability.
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When I came into the House in 2009, it was at the lowest point of the
recession which President Obama was handed upon his entering into the
Presidency. There were 700,000, 800,000, 900,000 jobs lost a month in
the deepest, darkest moment of the recession. What did we see? We saw
individuals who took their lifetime's worth of savings and entrusted
them to a marketplace, and they lost everything for which they had ever
worked, and others realized they didn't lose a single cent of Social
Security. Therein lies a tremendous bit of testimony as to the
meritorious achievements of a Social Security system, one that provided
that safety net for all families, one that made certain there was some
sort of continuous flow, a backup, a reinforcement, as you went into
retirement years.
We are reminded of Medicare and what the results were for retirees,
how long they were expected to live and what their quality of life was
like. It was tremendously, favorably turned around with the benefits of
Medicare.
So with an impassioned plea, I encourage this House, the Senate, to
do the right thing: stand for the American public and allow them to be
addressed with dignity with these programs that have proven themselves.
And where there is a need to further assist, as there has been time and
time and time again with Social Security, as there has been time and
time again with Medicare, let's provide that same approach to the
Affordable Care Act.
I thank the gentleman from California for bringing us together and
being able to share our thoughts and advocacy to do the right thing.
Mr. GARAMENDI. Mr. Speaker, I thank Mr. Tonko very much. It is always
a pleasure and learning experience to be on the floor with Mr. Tonko.
I now yield to the gentlewoman from Ohio (Ms. Kaptur). We are about
to wrap it up as we are nearly out of time.
Ms. KAPTUR. Mr. Speaker, I am honored to join Mr. Garamendi and Mr.
Tonko, and I want to place in the Record, since both of you have talked
so eloquently about the Affordable Care Act, you know how you will be
walking through your district, maybe at a parade or some public event,
and someone will break from the crowd and run toward you. I am thinking
about one particular woman who came up to me in one of my smaller
communities. She was in tears. This was during the summertime. She has
cerebral palsy, and she never was able to get care. I don't know why
she didn't qualify for insurance, I don't know all of that, but she
hugged me and thanked me.
And then around the corner from where we live, there is a little
produce market that I go into all the time. I am friends with one of
the women who works there. This little business couldn't afford
insurance, so their employees, when the Affordable Care Act passed,
went to the private marketplace to get a plan. This particular woman
who works long hours and lost her husband to cancer told me: Marcy, why
are people complaining about the Affordable Care Act? Guess what, now I
have cancer.
She said: I was able to go and get all of the tests, and now they
have me on chemotherapy.
So, with cancer, this woman is working. She was only able to get
insurance through the Affordable Care Act. Multiply that times 10,000,
20,000, 1 million, 20 million, whatever the number is. Think about the
number of people in our country who were without insurance. Sometimes I
am speechless when I meet these citizens because I think: Where were
you hiding before? Where were you?
Another place I was, a woman was mixing up. She said: Well, I have
health insurance, right? I pay car insurance.
I said: No. Car insurance doesn't cover health insurance.
People sometimes don't act in their own self-interest. She didn't
even know that because she had auto insurance, that didn't cover health
insurance. Can you believe that? So she was in a job where, with the
Affordable Care Act, she could go out to the exchange and buy a plan.
It is amazing to me some of the things that have happened and how I
see the Affordable Care Act off to a very good start.
As Mr. Tonko said, don't just repeal it until you have something to
replace it with. You cannot pull the rug out from under these people's
lives. It would be unconscionable to do that.
We have several Christians, several other denominations in this
House. It would be very unChristian to do that, for those who are
Christian. And for those of other denominations--pick your
denomination--I just think it would be very cruel.
I thank the gentleman for allowing us to speak out this evening on
behalf of citizens who can't speak for themselves and to try to help
perfect what we as a Republic can do for our citizenry.
{time} 2015
Mr. TONKO. Representative Garamendi, if I just might, I am listening
to Representative Kaptur talk of the interaction she had with her
constituents, and I would just add my similar experience.
Some of the most cherished efforts of the Affordable Care Act are
about preexisting conditions. Being a woman, being a pregnant woman, or
being a woman or a man fighting cancer made it very difficult for
people to get that insurance, and lifetime caps. You know, people being
rolled into surgery, wheeled into surgery, and being told that they
were discontinuing their plan.
So these are elements of the Affordable Care Act that could be at
risk if we start playing around with the actuarial balance that has
been achieved. And preexisting conditions, they rang right up there as
one of the biggest concerns people have about repeal.
Ms. KAPTUR. On that point, another woman came up to me, I was over at
the medical hospital with my brother, and she has epilepsy, and she has
another condition. She told me, she said: You know, Marcy, I have to
cut my pills in half. Can you help me try to find pills so that I can
afford to pay for all the medicines that I need to take care of myself?
Rather than repealing, can't we find a majority of Republicans to
help us, to help our citizens be able to get medicine at prices they
can afford?
Why can't we have competitive bidding for pharmaceuticals? Why can't
we have that? We have it for the VA. We have it for the Department of
Defense. Why can't we have it for the rest of our citizenry so that we
can get the best price?
But I thought: Cutting your pills in half? And so what happens to her
is, if she doesn't take enough of the medicine, then she has a seizure.
But she has got other things wrong with her, so she is trying to cut
this pill and cut that pill. And I thought, this is crazy. This is
crazy.
Can't we do better as a country than this for our people?
I have never understood why the price of pharmaceuticals has shot up
so much. I can't tell you how many cases we get in our office where we
have to call these companies and beg, you know, do you have some
foundation where we can get a few more pills from Lilly or a few more
pills from this company or that company in order to help people in our
district.
It shouldn't be our job to turn into a medical dispensary because the
system isn't working. There ought to be a way to take care of this.
Mr. GARAMENDI. As we look at this issue, this conversation puts
before us and the American people really two paths to travel. The
President-elect recently said: We're going to repeal ObamaCare, and
it'll be great. And our Republican colleagues have bought into that and
are now processing legislation to do that.
The discussion today from my two colleagues here indicates another
path, and that is, make it better. Make the Affordable Care Act better.
The drug issue, there is no reason in the world that the pharmaceutical
companies should be prevented from price competition. They are. It is
the law of the land that prevents the government and other purchasers--
the government from negotiating prices. That is a law that can be
changed.
There are many things that we could do to improve the health care of
America. But two paths: one, working together to improve the Affordable
Care Act and Medicare and Medicaid, and the Veterans Administration,
the programs that provide the health care and the insurance for
Americans; or another one, a path that is going to be extraordinarily
destructive.
[[Page H296]]
The repeal of the Affordable Care Act, which is already underway in
the Senate and will soon be over here in the House, promises Americans
not just the 30 million that have insurance but all Americans with a
very serious health problem in the future.
Final comments, and then we will be out of time.
Mr. TONKO. Just a quick comment. We have talked about much here this
evening. I joined you a bit after you started. I don't know if you
mentioned the hospital situation.
Mr. GARAMENDI. Very briefly.
Mr. TONKO. But representing a number of hospitals, from stand-alone
clinics to some very specific specialty type of health centers, they
are all concerned about the impact of repeal. And certainly, being a
major employer, if not the major employer in some of my counties, as
you reduce that care, you are reducing the workforce. So now we are
creating another impact, and it is why the ripple effect of repeal is
so strong and devastating, and will raise our deficit.
Mr. GARAMENDI. I thank the gentlewoman from Ohio (Ms. Kaptur) and the
gentleman from New York (Mr. Tonko) for joining us. I can assure you,
we will be back.
Mr. Speaker, I yield back the balance of my time.
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