[Congressional Record Volume 165, Number 114 (Tuesday, July 9, 2019)]
[House]
[Pages H5292-H5293]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      AFFORDABLE CARE ACT LAWSUIT

  The SPEAKER pro tempore. 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, I just put this placard up to emphasize 
what our Democratic Caucus is attempting to do. We have a program 
called ``For the People,'' and we are trying to deal with the issues of 
healthcare across this Nation.
  We know, as do basically all the American public, that healthcare is, 
in many cases, not affordable. So how can we deal with this?
  Well, one way is to deal with the cost of prescription medicines. We 
have a program. We have actually voted it off the floor. It is over in 
the Senate where it will linger as the Grim Reaper, Senator McConnell, 
kills legislation that would be for the people. So this is one example 
of many that we Democrats are trying to address.
  Back in 2010, we addressed this issue, at least in part, with the 
Affordable Care Act, which was promptly called ObamaCare by our 
Republican colleagues at that time. They campaigned against it and, 
ultimately, succeeded in winning the House in the 2010 election, and 
then spent 2011, 2012, 2013, 2014, 2015, 2016, and 2017 in an effort to 
repeal the Affordable Care Act. Fortunately, they did not succeed.
  When the new President, Mr. Trump, came to office, they tried, once 
again, to repeal the Affordable Care Act in 2017. They failed, largely 
because a Senator from Arizona, who was then suffering from cancer, 
voted no in the Senate. So I thank Senator McCain for having the 
courage and the understanding of what it meant to have a preexisting 
condition.

                              {time}  1945

  So here we are today with all kinds of charts that I am not going to 
put up. I am just going to speak directly to this issue.
  As was said just a moment ago by my colleague from Ohio, the 
appellate court in New Orleans is taking up an issue that Republicans, 
including the President, have put before the court. Unable to gain a 
repeal in the Congress of the United States, they are now pursuing in 
the courts of the land a repeal put forward by, I think, 16 attorneys 
general--all Republicans--to use the courts to repeal the Affordable 
Care Act.
  I want us to understand what this means. The fight of the last 8 
years, unsuccessfully, in the court of the people, the Congress and the 
Senate of the United States, being unsuccessful, they are now 
attempting in the courts of this land to do what they could not do 
through the representatives of the people of the United States.
  The cynical effort to do this actually began with the December 2017 
tax cuts that the Republicans rammed through Congress without one 
hearing: not a hearing in the Ways and Means Committee, not a hearing 
in the Senate Committee on Finance, not a hearing at all.
  Attached to that legislation was a repeal of the mandate that was in 
the Affordable Care Act that every American must either purchase 
insurance or have insurance through their employer. That repeal then 
opened the door to the current attempt now in the appellate court in 
New Orleans that could give rise to a decision that might ultimately be 
made by the U.S. Supreme Court that would totally repeal all aspects of 
the Affordable Care Act.
  So what does this mean? Mr. Speaker, what does this mean for you and 
me?
  I hope you do not have a preexisting condition. I do, because I am 
over 65, and 130 million Americans have a preexisting condition. The 
repeal of the Affordable Care Act would remove the protections that 
those Americans have that would guarantee them coverage without 
discrimination.
  Mr. Speaker, I was the insurance commissioner in California in the 
early 1990s and again in 2002 to 2005. I know what it means when the 
insurance companies discriminate based upon preexisting conditions. I 
have seen the documents that they would require men and women to fill 
out before they would issue a health insurance program.
  Every conceivable issue that a human being would have, from high 
blood pressure to, indeed, being a female, was on that list, and the 
insurance companies had unilateral, total discretion to charge more or 
not provide insurance at all.
  So the President of the United States, at this moment, together with 
those attorneys general and, apparently, the support of our Republican 
colleagues are, at this moment, attempting to reestablish a burden on 
130 million Americans who do have a preexisting condition, who are 
protected but, if they have their way in court, would lose that 
protection and face, once again, the onerous and, in many cases, deadly 
burden of having a preexisting condition and not being able to get 
healthcare insurance or having to pay several times more because of 
their preexisting condition.
  Who among us does not have that? Well, perhaps the other 40 percent--
actually, 50 percent of Americans who stand at risk of developing high 
blood pressure, diabetes, or some other illness.
  That is not all. In my district in the Sacramento Valley of 
California, the Affordable Care Act has allowed the creation of what we 
call Federally Qualified Health Centers, which now are the principal 
providers of initial healthcare in my district.
  It is not just for poor people, not just for transients who have 
moved from one job to another, but for people who have been insured for 
years but, because of a lack of medical services, could not get 
insurance.
  These Federally Qualified Health Centers are totally dependent upon 
the Affordable Care Act. Repeal the Affordable Care Act and those 
clinics are gone, and the services that they provide will not be in 
communities, both urban and rural, across America.
  How bad is it that those attorneys general are so stuck on repealing 
ObamaCare that they are ignoring the reality that millions upon 
millions of Americans have come to depend upon these clinics? If the 
Affordable Care Act is found to be contrary to law and the Constitution 
by the courts and by the cynical, diabolical repeal of one section of 
the Affordable Care Act, those people will not be able to get primary 
care services.
  And that is not all. The Affordable Care Act expanded the Medicaid 
program across this Nation, and some 15 million Americans have been 
able to gain healthcare access through the Medicaid programs. In 
California, we call it Medi-Cal. The Medi-Cal program in California 
provides, perhaps, 3 million Californians with access to healthcare 
services. That, too, the expansion will be gone, and the support for 
States across this Nation will be eliminated if the Affordable Care Act 
is found to no longer exist because of court action.
  How cynical, how sad, how harmful, but that is what they are 
pursuing. And that is not all. There is a problem that existed before 
the Affordable Care Act.
  Young men and women found coverage in some universities, in some jobs 
through either the university and the fees or through an employer; but 
most, when they became 18 years of age, lost their family insurance. 
The Affordable Care Act said that is not good. They would be able to 
stay on their family's insurance until the age of 26, where, 
presumably, they would be better able to buy insurance themselves or be 
able to have a job in which insurance would be provided.
  Insurance is expensive, so the exchanges were set up across the 
Nation, insurance exchanges where people could shop for insurance. 
Those exchanges provided not only access to insurance markets, but they 
also provided, through the Affordable Care Act, tax credits that would 
make the insurance affordable to them.
  Nope, it is going to be gone. It is going to disappear if the court 
in New Orleans rules against the Affordable Care Act.

[[Page H5293]]

  And so how will they afford insurance? Well, they won't. And in many 
States where there are Federal exchanges--California not included, 
because California set up its own State exchange. But in those States 
that have a Federal exchange, it won't exist. The ability to shop for 
insurance will be diminished or eliminated and, along with it, the 
subsidies. So those people, some 9 million who now enjoy those 
subsidies, will not receive them.

  It goes on and on.
  Are you a senior? Are you on Medicaid? If so, you are in the last 
year in which the doughnut hole will no longer exist, beginning 4 years 
ago. The doughnut hole, the prescription drugs doughnut hole in which 
prior to the Affordable Care Act there was a subsidy, part D, for 
prescription drugs, that ended at about $1,500 of prescription costs.
  Then there was a doughnut hole in which the individual on Medicare 
would have to pay for insurance, and that was somewhere around $4,000. 
And then above that, Medicare would once again pick up the cost or most 
of the cost.
  In the Affordable Care Act, we specifically set up a system so that 
over a 4-year period, the doughnut hole would disappear. It would 
shrink each and every year. It would rise from $1,500 to $2,000, 
$3,000, and so forth. And next year, it would be gone.
  I am sorry for the seniors. The Affordable Care Act, if found by the 
court to no longer be constitutional, would reemerge immediately upon 
an action by either the appellate court or, I suppose, ultimately, the 
Supreme Court. So, welcome the doughnut hole back.
  If someone happens to be a senior, they better start pocketing 
money--which I am sure they don't have, to begin with--to prepare for 
the day when the cynical action of these attorneys general--
Republicans, every single one of them--and the President would once 
again reestablish the awesome, terrible prescription drugs doughnut 
hole.
  How small-minded can you be? Apparently, there is no end to it. So 
here we are. Our effort on this Democratic side of the aisle is for the 
people, not for some ideological mumbo jumbo, but for the people. We 
want a healthcare program that provides solid benefits for Americans.
  The Affordable Care Act takes us a long, long way toward that goal. 
It doesn't achieve it totally, and we have more to do. Many of us talk 
about Medicare for All, and we hope to get there some day. But in the 
meantime, we have the Affordable Care Act, and our Republican 
colleagues are doing everything they can since its institution in 2010 
to do away with it, and they have never, ever provided a substitute.
  Do you remember that repeal and replacement mantra? There has never 
been a replacement program that made any sense whatsoever.
  So, we are for the people. We want to deal with the cost of 
prescription drugs, not to increase them for seniors, as our Republican 
colleagues are attempting to do; not to put Americans out of the 
insurance market, as they are attempting to do, by eliminating the 
guaranteed coverage regardless of your healthcare status; not to put 
people out of insurance if they are 18 to 26 years of age, as our 
Republican colleagues are attempting to do; not to eliminate the 
clinics that millions upon millions of Americans now depend on for 
their primary care, as our Republican colleagues are attempting to do.

                              {time}  2000

  We want it for the people. We want healthcare coverage for every 
American. We want it to be affordable, and we want it to be available.
  So here we are on a day in which the appellate court in New Orleans 
is hearing from the President's lawyers in the Department of Justice 
that 13 million Americans should lose their health coverage and that 
130 million Americans should be, once again, facing insurance 
discrimination because of an existing healthcare issue. We are hearing 
from the President's lawyers that it is good to eliminate the clinics, 
that it is good to eliminate the subsidies that some 9 million 
Americans are able to get to so that they can afford insurance, and 
that the exchanges that provide a marketplace for people to sort out 
what kind of an insurance policy they want should be eliminated.
  The President's lawyers are out there purposely harming Americans all 
because the President has said we must repeal the ObamaCare program.
  I am sorry. I disagree. I want Americans to have healthcare coverage. 
I was an insurance commissioner for years, and I fought the insurance 
companies every single day. Then I came here in 2009 and was able to 
vote, providing on this floor the vote that allowed the Affordable Care 
Act to move out of this House to the Senate and eventually become law--
the 218th vote. I am proud of that vote because I know from my personal 
experience that the Affordable Care Act dealt with real problems that 
Americans had and gave Americans a real opportunity to get healthcare 
and to get healthcare services.
  Here we are with the President of the United States actively this day 
doing everything he could not achieve in the Congress but rather now in 
the courts doing everything he can to harm Americans--how cynical, how 
terrible, and how harmful. But that is where we are.
  We will see what the court does. Hopefully, they will be sympathetic 
to 130 million Americans, to 9 million Americans, to 15 million 
Americans, to children, and to young adults 18 to 25. Maybe they will 
be sympathetic. We will see what happens.
  But if the Affordable Care Act is somehow through the courts repealed 
and there is no replacement, then I want the American people to 
understand who is responsible for the harm that will immediately be 
inflicted upon Americans. It is our President and it is his colleagues 
who have aided and abetted and who today in-State attorneys general are 
arguing for the harm that will come to Americans.
  We haven't given up the fight, and we will never give up the fight so 
that every American has affordable health insurance, whatever that may 
be.
  We have come a long way with the Affordable Care Act, and we will 
fight all along the way. Should we lose this battle, we are never, ever 
going to give up our goal of providing quality, affordable healthcare 
to every American.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. Members are reminded to refrain from 
engaging in personalities toward the President.

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