[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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