[Congressional Record Volume 165, Number 57 (Tuesday, April 2, 2019)]
[House]
[Pages H2976-H2980]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
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AFFORDABLE HEALTHCARE
The SPEAKER pro tempore (Mr. Malinowski). Under the Speaker's
announced policy of January 3, 2019, the gentleman from California (Mr.
Garamendi) is recognized for 60 minutes as the designee of the majority
leader.
Mr. GARAMENDI. Mr. Speaker, as I often do these Special Order hours
here on the floor, I want to start by stating the fundamental reason I
am here and my Democratic colleagues are here. I harken back to a very
famous American, Franklin Delano Roosevelt. This is actually etched in
stone down at his memorial on the other end of the plaza here. He said:
``The test of our progress is not whether we add more to the abundance
of those who have much; it is whether we provide enough for those who
have too little.''
That ``we provide enough for those who have too little,'' a
fundamental value, a fundamental statement of purpose, a fundamental
statement of why we seek elective office, not to provide more for those
who have much, but, rather, for those who have too little.
In that regard, Mr. Speaker, I do not understand why a man who says
he has much would purposely set out to harm those who have too little.
Why, Mr. Speaker, would the President of the United States put in
place a policy to take healthcare away from Americans? Obviously, he
has much, or at least he says he does. But millions of Americans rely
upon the Affordable Care Act for their insurance, for their health
insurance, literally for their ability to stay alive.
Why would the President of the United States ask the court to repeal,
to find unconstitutional, the Affordable Care Act that has provided
insurance coverage to more than 20 million Americans and healthcare
benefits to millions upon millions more?
Why would our colleagues on the Republican side of this aisle fall in
lockstep to support the President's effort to take away healthcare from
Americans?
I do not understand this. Where is the compassion? Where is the
empathy? Where is the concern for Americans, not one or two, but
millions upon millions of Americans who have come to rely upon the
Affordable Care Act to give them their basic insurance?
More than 20 million Americans found insurance coverage through the
expansion of the Medicaid program, not in every State, because there
were State Governors who were willing to go along with the President
and the Republicans and not institute the Medicaid expansion. But there
are still 20 million more Americans who have comprehensive healthcare
coverage today.
Why? We must ask the question of the President and any of his
sympathizers: Why would you do that?
It is not just those people who have been able to get coverage in the
Affordable Care Act, but it is every senior who is on Medicare who will
lose coverage. Every senior on Medicare has an annual visit to a doctor
to determine if they have any medical problems, a free annual check-up.
That, too, would disappear.
For seniors who had hundreds of dollars, if not thousands of dollars,
in annual expenses for drugs because of the Medicare drug doughnut
hole--yes, the infamous doughnut hole that was created in the expansion
of the Medicare program in 2003--that doughnut hole is literally closed
as a result of the Affordable Care Act.
Eliminate the Affordable Care Act, Mr. President, and seniors who
rely upon expensive drugs are going to, once again, pay billions of
dollars of additional costs right out of their pocket.
Here it is: ``Whether we provide enough for those who have too
little.''
Think of seniors who are in nursing homes. Most of the Medicaid
dollars are for nursing home care. The expansion will affect them, if
it is repealed.
Remember the bad old days when your insurance policy had a cap, a
$50,000 lifetime cap, maybe a $100,000 lifetime cap? If you had a bad
car accident, you would blow right through that. If you had cancer,
guaranteed within the first month of treatment, you would blow through
that cap, and it would come right out of your pocket.
Remember the bad old days when the great majority of personal
bankruptcies were a direct result of medical expenses?
Mr. Speaker, does the President remember those days, that now he
wants to eliminate the Affordable Care Act? Is that where we are in
this country? How mean-spirited.
Maybe his test of progress is whether we add more to those who have
much.
Look at this. The Affordable Care Act actually raised taxes on the
superwealthy. Maybe that is what the President wants, to, once again,
give a massive tax cut to the superwealthy. If the Affordable Care Act
is repealed, the average tax cut for the superwealthy, the top one-
tenth of 1 percent of Americans, will be nearly $200,000 a year. Is
that what our President wants?
Apparently, he took the first half of Franklin Delano Roosevelt's
statement about values and said: Oh, yes, we want more for the wealthy.
That is precisely what will happen if the Affordable Care Act is
repealed, to the tune of more than $197,000 for the top one-tenth of 1
percent of America's wealthy.
What in the world? What is going on here in America that the
President of the United States, in league with many of our Republican
colleagues, would rip out of the hands of Americans a healthcare
program that is working?
That is not where we are on the Democratic side of this aisle. We
have fought this fight for 8, 9, 10 years. The Affordable Care Act
passed in 2009 and 2010, and here we are. Our Republican colleagues
gained control of this House and the Senate, and we fought the fight
over those years to stop the repeal.
Now, the President, once again, is going around Congress, this time
to the courts, asking the Supreme Court of the United States to rip out
of the hands of Americans the healthcare that they have come to rely
upon.
We will continue this fight. Not only will we continue this fight,
but we are stepping up to improve the Affordable Care Act, and we
intend to do it with a piece of legislation. We call it the
Protecting Pre-Existing Conditions and Making Health Care More
Affordable Act of 2019, H.R. 1884, protecting preexisting conditions.
You heard my colleague, just before I stood up here, talking about
preexisting conditions. 130 million Americans have preexisting
conditions: high blood pressure, being a woman who might get pregnant,
you name it. We all, at least 130 million of us, have preexisting
conditions.
Here is what we intend to do: improve the Affordable Care Act and
reduce premium costs for consumers by expanding the eligibility for the
premium tax credit, expanding affordability for working families,
protecting comprehensive coverage for small businesses and workers, and
eliminating junk insurance policies.
I was the insurance commissioner in California for 8 years, and I can
talk for hours and hours about insurance companies that sold junk to
people. They worked until they had an illness, and then it failed to
work. We would
[[Page H2977]]
make those junk insurance policies unavailable in America.
We would ensure that there would be comprehensive benefits, like
maternity care. If you talk about family values, you better talk about
maternity care.
We would make sure that the programs to make people aware that they
can get insurance would be in place.
We would help the States as they carry out their coverages. We would
make sure that the exchanges were not eliminated, that they would be
strong. Unlike the President who would eliminate the exchanges, we
would strengthen them.
We have work to do. We are here to make things better for America,
for the people, and we intend to do so.
Joining me tonight are a couple of my colleagues.
Mr. Speaker, I yield to the gentleman from South Carolina (Mr.
Clyburn), a fellow who has worked on this for years.
Mr. CLYBURN. Mr. Speaker, I thank the gentleman for yielding.
Mr. Speaker, back in 1966, at a healthcare conference, the late
Martin Luther King, Jr., said: ``Of all the forms of inequality,
injustice in healthcare is the most shocking and inhumane.''
I often think of the debate back in 2009 and 2010 when we were trying
to pass the Affordable Care Act. I remember one day I was conducting a
call-in program on the local radio station. A gentleman called in and
said to me: I want you to keep your hands off of my health insurance. I
like what I have got, and I don't want you and President Obama messing
with it.
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I assured the gentleman that we were going to do nothing to interrupt
his relationship with his insurance company or his policy.
But then a little while later, a lady called in, and she said,
Congressman, I don't have a question, but I would like to say something
to the gentleman who just called in. I want to say to him that I had
insurance for 30 years, and I thought I liked it, until I tried to use
it. When I went for my second treatment for breast cancer, I got a
notice, she said, from the insurance company that I had used up my
lifetime of benefits.
And then she said, I would like to say to that gentleman, Maybe he
likes what he has because he has never tried to use it.
And that is what you have reference to here when you talk about junk
policies. What we did with the Affordable Care Act was to make
healthcare accessible and affordable for all American citizens.
We created the possibilities of States expanding Medicaid so that
low-income people could have access to healthcare.
And if you want to know a little bit about what can be done if we
were to, in some way, get rid of the Affordable Care Act, just look at
the States that have refused to expand Medicaid; the number of low-
income people today who still do not have access to healthcare.
Think about those middle-income families who had a family member get
sick and find out that they are in bankruptcy because they are trying
to pay the bills.
The Affordable Care Act is an attempt, like everything else ought to
be here.
If we are talking about education, it ought to be accessible and
affordable.
If you are talking about housing, it should be accessible and
affordable.
Healthcare; accessible and affordable.
And we all know that until we passed the Affordable Care Act,
healthcare was not accessible and affordable for all Americans.
We hear the slogan that takes place throughout this country. We don't
need to Make America Great Again. America is great. It has always been
great. That is not our challenge.
Our challenge, it seems to me, is to make the greatness of America
accessible and affordable to all Americans; apply it fairly and
equitably.
That, to me, is what this country is all about.
So I want to thank you, my friend from California, Mr. Garamendi, I
want to thank you for all the work that you are doing on H.R. 1884,
because I think before we go home this week, we are going to pass a
resolution, a resolution to condemn this administration for attempting
to legally take away healthcare from so many citizens.
And I want to close with this: You talk about preexisting conditions.
I think that people tend to think about preexisting conditions in a way
that deals with people that they know or can relate to. I want all of
our listeners, and those looking on, to just think of what you are
doing.
If you say to a child born with diabetes, a child who didn't ask to
come here, and even if that child could ask to come, they certainly
wouldn't ask to come sick. Diabetes; born with it.
And then the insurance company says that it is a preexisting
condition and you cannot come on to your family's insurance policies.
If we cannot see the wrongness in that, I am not too sure anything
anybody says about anything can be ever wrong in your eyesight.
So I want to thank you so much for the work that you are doing here.
I want to thank the American people for keeping our focus on making
healthcare accessible and affordable for all Americans.
Mr. GARAMENDI. Mr. Speaker, I thank the gentleman (Mr. Clyburn) so
very much. He has been working for those qualities and values all of
his life, and I really appreciate his coming to us and bringing us the
awareness of what Dr. Martin Luther King said about America and about
where the role of healthcare fits into justice in America.
I see Mr. Cicilline from Rhode Island here, the chairman of the
Democratic Policy and Communication Group.
Would you like to communicate with us?
Mr. CICILLINE. I would be honored to. I thank the gentleman from
California (Mr. Garamendi), my friend, for organizing this Special
Order hour and for giving us an opportunity to speak more about what
seems to be a recurring fight here in Congress between Democrats who
are committed to preserving access to high quality, affordable
healthcare and to our Republican friends who are committed to undoing
the progress we have made.
I know the gentleman will remember this. In the last Congress, I
think, we were confronted with 50 or 60 votes to repeal the Affordable
Care Act in its entirety. And we were able to defeat each of those
efforts.
Then President Trump was elected, that effort continued, and the
administration began to administratively sabotage the Affordable Care
Act, and even proposed TrumpCare, which would have cost 23 million
Americans their healthcare in its entirety.
So now having lost that battle, Democrats ran an agenda for the
people of this country.
The first item on that agenda was driving down healthcare costs,
driving down the cost of prescription drugs, and preserving coverage
for preexisting conditions.
We won the election. We were put into the majority, in part because
the American people rejected the Republican's relentless effort to
destroy healthcare in this country and wanted Democrats to come to
Congress in control to build on the success of the Affordable Care Act
and make sure that we continue to protect access to quality, affordable
healthcare.
Having lost in this body on this issue, now what do the Republicans
do? They take the battle to the courts. Let's use the courts to strike
down the Affordable Care Act.
And we should be very clear, as I know the gentleman from California
knows, President Trump has claimed over and over again that he wants to
protect access to healthcare.
In fact, just in the last couple of days, he now claims he has a
secret plan. It is so good he is going to share it with the American
people after the 2020 election.
But what we know is, unfortunately, what the President says and what
he does aren't always the same. Because the truth is, the President has
asked his Justice Department to go to court and fight to eliminate
every single protection and benefit that the Affordable Care Act has
provided.
So that means if President Trump gets his way and our Republican
colleagues, there will no longer be caps on out-of-pocket expenses,
there will no longer be savings by closing the donut hole, so
prescription drug costs are reduced for our seniors. Medicaid expansion
will end. The limits that prevent
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insurance companies from limiting the total coverage over your
lifetime, that ban will no longer exist. You will be able to deny
access to healthcare for people with preexisting conditions. And the
insurance company will be free to sell junk plans that offer little or
no real coverage at all.
And so we are back to the same fight. Democrats have legislation that
has already been introduced to build on the success of the Affordable
Care Act:
To drive down premiums; to expand access for more working men and
women; to drive down the costs of prescription drugs.
But we are back at it where our Republican friends are now joining
this Republican President in an effort to use the courts to undo all
the progress we have made on the Affordable Care Act.
This is going in exactly the wrong direction. We remain committed to
make sure that we do everything we can to protect access to care and
drive down costs, because we believe healthcare is a right.
It is not a privilege for a small group of people. It is a right of
every single citizen of this country.
And I thank the gentleman for convening this Special Order hour,
because amidst the noise, people should know there is one party here in
Washington, the Democrats, who are fighting to protect and expand
access to healthcare and drive down costs. There is another party that
is continuing their effort to repeal the Affordable Care Act in its
entirety, to take away coverage for preexisting conditions, to drive up
the cost of prescription drugs. And the American people have the right
to know who is fighting for them and who is not.
Mr. GARAMENDI. Mr. Speaker, I thank the gentleman (Mr. Cicilline).
It is extremely important that we continue this fight we fought
successfully for 8 years, 9 years. And here we are once again.
The general public, keep in mind, Protecting Preexisting Conditions
and Making Healthcare More Affordable Act of 2019, H.R. 1884.
I turn to the gentleman from the State of New York (Mr. Morelle). If
you would like to join us and tell us how all of this affects your
constituency in New York.
Mr. MORELLE. Mr. Speaker, I thank the distinguished gentleman from
California (Mr. Garamendi) for his eloquence and his leadership on this
critically important issue.
I rise to express my strong opposition to the Trump administration's
efforts to repeal the Affordable Care Act and pull the rug out from
millions of Americans who rely on the ACA for essential health
coverage.
Quality, affordable healthcare should be a right for every American,
and we should make it easier, not harder, for individuals and families
to get the insurance they deserve.
The House majority made a promise to always offer protections for
individuals with preexisting conditions and fight back against those
who seek to dismantle their fundamental protections.
That is why I am proud to cosponsor a resolution to reverse the
administration's cruel attempts to sabotage care for Americans in need,
and I thank Mr. Garamendi for his leadership with House Resolution
1884.
We will not allow people with preexisting conditions to go back to
the days where they were denied coverage when they needed it the most.
And I might also say, parenthetically--and I appreciate very much the
gentleman from California's leadership as the superintendent of
insurance in the State of the California--I had the privilege of
working on legislation in New York back in the early nineties as a new
member that introduced community rating in the State of New York and
offered protections for preexisting conditions.
Subsequent to that, I had an opportunity to serve as the chair of the
Insurance Committee in the New York State Assembly.
In that role, I was responsible for helping to implement the
Affordable Care Act in the State of New York.
Many of the protections in the Affordable Care Act were already part
of New York law. I am very, very proud of that; and continued to work
on that as majority leader of the State Assembly.
But the protections which we, I think, rely on in New York are not
available to all Americans, and to those plans which we are not able,
as a state, to regulate, self-regulated plans and other plans protected
by ERISA, don't have those protections.
So I think it is critically important as we continue to move forward
that we work tirelessly. And I will work with my colleagues to protect
and expand the Affordable Care Act, to lower costs and ensure
hardworking families everywhere in America have healthcare that they
can rely on.
Mr. GARAMENDI. Mr. Speaker, if the gentleman could stand by for a few
seconds.
I knew that he had been in the New York legislature as a leader in
the assembly there. And I had some recollection of the work he did on
insurance matters.
If he could just talk about the experiences he had when he tried to
protect people with preexisting conditions, and those issues that he
dealt with in the early nineties, some of the work that was done and
the experiences that he had there.
Mr. MORELLE. Mr. Speaker, I thank my colleague and friend from
California.
You know you understand how it is for many of us who are blessed to
have either employer-offered health insurance or are in a situation
where you don't think as much about the costs or the issues that
involve health insurance. But what you find from talking to people, as
many people are not as privileged as I might be, and really faced
critical decisions about whether they could have medicine to treat
chronic illnesses or had to make the decision between that and rent.
Or for people who had--as I have said on this floor before, I,
unfortunately, lost my daughter to cancer, breast cancer, about a year
and-a-half ago.
Lauren had good health insurance, but during her illness, I often
thought about men and women in her circumstance, what challenges they
would face, even if they are able to defeat the illness, whether or not
those preexisting conditions would cause their insurance premiums to be
so high and so unattainable that the idea of having quality, affordable
healthcare would simply not be within their reach.
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This affects millions of Americans. Whether it is women who plan on
beginning a family, starting a family; whether it is the elderly who
have chronic conditions--you mentioned hypertension; or whether you
have diabetes, there are a whole host of conditions. Most Americans
have some form of preexisting condition.
For us to allow the underwriting to be done with those preexisting
conditions in mind would simply put healthcare out of the reach of most
Americans, quality, affordable healthcare. That is why I think this is
so important.
I might also add that the Department of Justice is charged with
defending the laws duly enacted by this Congress and by the President
of the United States. That is the job of the Department of Justice. I
find it reprehensible that this Department of Justice under this
administration would take the view that they will join in a lawsuit
against a law fully enacted that is the law of the land of the United
States and seek to overturn it. It is virtually without precedent.
What is so troubling about it is that this will leave millions of
Americans without coverage and without health insurance at a time when
we should be doing everything we can to ensure that more Americans have
access to quality, affordable care.
Mr. GARAMENDI. Mr. Speaker, I thank Mr. Morelle so much. Actually, I
didn't know that the gentleman had lost his daughter. That tragic
illness is an example of why the Affordable Care Act is so important,
because people will have coverage. There are no lifetime limits.
Although your daughter was unsuccessful in the treatment, many
thousands upon thousands of Americans are able to get treatment and
survive cancer or some other debilitating illness.
Mr. Speaker, I thank the gentleman so much for his experience, and I
thank him for being here and bringing all those years of knowledge and
experience to this House and helping us fight this fight.
Let me now turn to my colleague from New Jersey who often is here
with
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me on the floor, Mr. Payne. He and I talk about a lot of different
subjects. Here, we are talking about one that affects every American. I
thank the gentleman for joining us.
Mr. Speaker, I yield to the gentleman from New Jersey (Mr. Payne).
Mr. PAYNE. Mr. Speaker, I thank Mr. Garamendi for once again setting
aside time to talk about the issues that affect the lives of people
across this country.
I want to start by saying that the contrast between Republicans and
Democrats on this issue of healthcare could not be any clearer.
As the gentleman has described in his discussion of the ongoing legal
case down south, Republicans and the Trump administration want to make
Americans sick again. They want to eliminate protections for people
with preexisting conditions.
Let me just stop there. This Nation was built on a morality that we
held very deeply in this country. But, to me, it feels like it has been
torn apart, is falling apart, that we do not care about people who find
themselves in circumstances that they did not create on their own, that
they should alone be left, because of a preexisting condition, not to
be afforded healthcare.
That is unconscionable. That is profiteering at its worst. It deeply
upsets me that we find ourselves turning our backs on our brothers and
our sisters, our mothers and our fathers, and our aunts and our uncles
in this country to say, no, because you have an illness, we cannot
protect you and give you insurance. It is unconscionable.
They want to take the United States backward, and they are
weaponizing the courts to do what they failed to do in Congress: repeal
the Affordable Care Act.
I arrived here in 2012, and the Affordable Care Act was already the
law of the land. But what I witnessed in my time here was the over 50
times, close to 60 times, that the Republicans attempted to repeal the
Affordable Care Act but could never do it. They could never do it. With
the White House, with the Senate, and with the House, they still could
not do it, because it was too popular with a lot of Americans in this
country. They did not listen to the people. They did not want the
Affordable Care Act repealed.
Now they are trying to go the court and the executive route and do
what they could not do in this body, which is the body that determines
those matters.
Democrats, on the other hand, want to make America healthy. We want
to expand healthcare access. We want to strengthen the Affordable Care
Act. We want to make sure that people with preexisting conditions are
not denied insurance coverage.
Now the Trump administration is fighting to bring healthcare
discrimination back. Well, there is no going back. More than 200,000
people in my State of New Jersey who purchased their insurance through
the Affordable Care Act marketplace have preexisting conditions.
President Trump wants to make it easier for insurers to deny
coverage. He is playing politics with their lives.
What my constituents want and need is for the Affordable Care Act to
be strengthened. The 200,000 New Jerseyans who purchased their
insurance through the Affordable Care Act should not have their
insurance coverage put to risk because of politics. New Jerseyans and
all Americans deserve protection, not discrimination.
Let me be clear: The Trump administration wants to put lives at risk
by undermining people's access to healthcare across this country. The
Trump administration is sabotaging the Affordable Care Act, and
Americans are paying the price.
The Trump administration has made it more difficult to enroll in the
Affordable Care Act by increasing website downtime during open
enrollment and cutting the budget for healthcare navigators, the people
who help Americans determine and figure out what they need in terms of
coverage. They cut that.
The Trump administration has stopped finding cost-share reductions,
which lower people's out-of-pocket expenses.
The Trump administration has launched a full-scale legal attack on
the Affordable Care Act.
In light of those attacks, let me be clear about one thing: Democrats
will keep fighting to ensure that all Americans' healthcare is
protected. We will fight in the House. We will fight in the Senate. We
will fight in the courts.
Once again, I thank the gentleman for his true leadership on the
issues that are facing the American people.
Mr. GARAMENDI. Mr. Speaker, I thank Mr. Payne for his consistent work
here on the floor on multiple issues.
Healthcare issues have always been at the front of his agenda for him
and his constituents, and he has fought fiercely since 2012 to see to
it that the Affordable Care Act remains in place.
Mr. Speaker, I am going to put up one more chart that I think
graphically displays what we have been talking about here. This is
2010, 2011, 2012, and 2013. The Affordable Care Act really took hold in
2013. It took a couple years to set up the administrative systems and
the like.
You can see in 2014, 2015, 2016, and 2017, the number of uninsured in
America went from 44 million down to 27 million, which is just, in
large numbers, a clear description of what the Affordable Care Act was
able to do in bringing insurance to Americans.
Here we have a President who was unable to get his wall and decided
to go around Congress and the Constitution to try to fund the wall by
moving money from one military account to another so that he could
build his wall.
Article I, Section 9 of the Constitution clearly states that it is
the Congress that appropriates money. It says no money shall be
appropriated from the Treasury without law. Congress passed a law that
said $1.2 billion was for border security. That is it. Now the
President wants $8 billion, literally going around Congress and the
Constitution.
He is doing it once again with the Affordable Care Act. He was unable
to get Congress to repeal the law, so now he is going to the court
system to try to get the court to repeal the law.
Hopefully, the court won't do that. But if it does, those 20 million
Americans who will lose their insurance and those 130 million Americans
who have preexisting conditions and will once again be open to
insurance discrimination--not able to get insurance, paying vastly more
because they have a preexisting condition, like being a woman, or blood
pressure, or diabetes, or any number of things--those people will
remember that it was the President who went around Congress to the
courts to ask the court to strike down the Affordable Care Act.
There is so much at risk. Every senior on Medicare will see the
doughnut hole come back, and their drug expenses will skyrocket
billions of dollars. The free annual checkup that seniors are able to
get now will no longer be available. It goes on and on, all gone.
I am going to end with this before I turn this over to my colleagues.
I don't know that I could ever put this up enough, when FDR said:
``The test of our progress is not whether we add more to the abundance
of those who have much; it is whether we provide enough for those who
have too little.''
In this case, probably close to 27 million Americans have too little.
They didn't have healthcare, and today, they do. Those are the
Americans who had too little.
Where do we stand? What are our values? How do we approach this
fundamental question of America as we go into the 2020s? Are we for
those who have much, like the President? Or are we for those who have
too little, like the Americans who were uninsured prior to the
Affordable Care Act?
I will tell you where we Democrats stand. We, without any Republican
support, created the Affordable Care Act. We fought over the last
decade, not only to implement it, but to fight the defensive battle to
see that it would continue.
Now we are going to continue that fight. We are not going to give up
because our values, our purpose, are with those Americans who now rely
upon the Affordable Care Act, and, indeed, with those seniors and with
this country so that we can provide for those in need.
Mr. Speaker, I yield back the balance of my time.
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