[Congressional Record (Bound Edition), Volume 155 (2009), Part 16]
[Senate]
[Pages 21731-21732]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. BROWN. Mr. President, as others of my colleagues have done, I 
have come to the floor periodically--pretty much every day we have been 
in session in the last couple months--and shared letters from people 
from Ohio who are in the midst of a personal health care crisis--small 
businesspeople who want to cover employees but simply cannot afford to, 
and individual young people who are removed from their parents' 
insurance when finishing school or who come back from the Army and 
cannot get insurance, and people who have preexisting conditions--all 
kinds of people who, in many cases, thought they had good health care 
insurance, and they got very sick, it got expensive, and they lost the 
insurance.
  I wish to share some letters again tonight. These are new letters and 
stories I have heard. Over the last month or so, I have done townhall 
meetings in Cincinnati, where 1,500 people showed up, and this is the 
most conservative part of Ohio. Two-thirds of them supported the 
President's health care effort and about a third opposed it. I did a 
large townhall meeting also in Columbus, and I did roundtables--135 or 
so--around Ohio in the last couple years, where I have listened to 
people talk about issues and what we can do to make my State better. I 
have been in all 88 counties doing that. I did an electronic townhall 
meeting the other night, where several hundred people were on and I 
took questions and explained the health care legislation; and I 
especially tried to answer questions about some of the misinformation.
  It is important to understand that the insurance industry has a lot 
to lose with this health care bill. They like the system the way it is. 
It works for them and they are immensely profitable. Their executives 
are making $10 million, $20 million a year. Some of their CEOs and top 
management put out some significant misinformation about this bill to 
protect their economic interests. That is important to remember.
  Elizabeth is from Clermont County, along the Ohio River, east of the 
Cincinnati, a fast-growing suburban county. She writes:

       I am 25 years old and unemployed. Years ago, I was 
     diagnosed with a blood disorder. Up until I turned 25, I was 
     covered under my father's health insurance through his work.
       When I turned 25, I had to find my own health insurance, 
     but because of my pre-existing condition, I was denied by 
     most insurances.
       The best one I could get is of very poor quality and it's 
     very expensive.

  That happens with a lot of young people. They are under their 
parents' insurance and they finish school and move out and the 
insurance companies drop them when they are 22, 23, 24 years old, even 
when they are employed, because people at that age--similar to the 
pages in front of us--are probably on their parents' insurance, but 
when they finish school and get jobs--and they are probably not going 
to be the kind of jobs, in many cases, that have health insurance--
except that, by that time, we are going to have passed this health 
insurance bill. But one of the things our bill does is says no 
insurance company may drop you from their plan until you turn 26. So a 
young person who finishes school and is trying to get on their feet or 
who goes to the Army for 3 years and then comes back out and maybe is 
living at home trying to get on his or her feet, until he or she turns 
26, he or she can continue to be on their parents' insurance plan. Once 
they turn 26 and they don't have insurance, they can go into the 
insurance exchange, which we can talk about later.
  So this bill will absolutely matter to somebody such as Elizabeth.
  Sharon is from Portage County. She says:

       My husband will turn 65 at the end of the year. He wants to 
     retire, and after working hard for his company for 30 years, 
     he deserves it.
       But I'm only 62 and recently lost my job. If my husband 
     retires, I will have no coverage for three years.

  She has to wait until she is 65.

       We will not be able to afford insurance for me based on his 
     retirement savings.
       Please help us and many others who are struggling.

  Sharon lives east of Akron, the home of Kent State University, near 
Ravenna, Aurora, and other communities there. Sharon's situation would 
allow her, regardless of her income, to be able to go into the 
insurance exchange, which means that if she is fairly low income, she 
will get subsidies from the government to help pay her premium. With 
the insurance exchange, she will be able to choose, under the plan we 
have written so far, whether she wants to go with Aetna, Blue Cross, 
Medical Mutual, a not-for-profit insurance company in Ohio, or perhaps 
into SummaCare in the Akron area or into the public option. The 
legislation provides for an option that is not private--a government 
option--that will do several things. First, the public option will keep 
the private insurance companies honest. They will quit gaming the 
system if they have to compete against a public Medicare look-alike 
plan.
  Second, the public option will help to drive costs down because they 
will compete against these private insurance companies, and that is so 
very important.
  Third, the public option will be available particularly in rural 
areas where there is not a particularly competitive market. In 
southwest Ohio, for instance, two insurance companies have 85 percent 
of the market. A public option would inject needed competition where 
there is not any today.
  Margaret from Greene County in the Xenia and Jamestown area said:

       My husband works for a small business. Although we have 
     health insurance through his employer, my husband has not 
     been to a doctor for a few years.
       I believe he is putting off regular checkups because he is 
     afraid the doctor will diagnose one of those conditions, such 
     as diabetes, that blacklists people from health insurance.
       Small businesses cannot afford to have even one person with 
     a chronic illness on their insurance because it raises the 
     rates so much for the company.
       I understand that the insurance and drug industries have 
     too much money and political power, but my husband can't 
     afford to lose his job.

  First, about that last point, 5 years ago I was in the House of 
Representatives. In those days, when President Bush was in the White 
House, he pushed a bill through the Congress to partially privatize 
Medicare. It was a total giveaway to the drug companies and insurance 
companies. Those days are over. With the legislation we pass, the drug 
companies are going to be unhappy with it and insurance companies

[[Page 21732]]

are going to be unhappy with it. I want them to be treated fairly, but 
I don't want them to have the power in this health care system they 
have had in the last few years, and they won't under this legislation.
  Margaret is right about a small business. If you work for a company 
that has 20 employees--say you own a small business with 10, 15, 20 
employees and one of them gets very sick and they have to take 
expensive biologics or go into the hospital and their costs are high. 
The insurance company will do one of two things: It will either cut you 
out of the plan or cut the small business out of the plan or it will 
raise rates so high on that small business--because they have 1 or 2 
really expensive cases, the insurance companies will raise their rates 
so much for that small business that the small business won't be able 
to afford it anymore.
  What Margaret's husband's employer could do, so that Margaret's 
husband could go to the doctor even if he had major health problems to 
be taken care of, is if he chose to take his employees into this 
exchange, again, they could go to Aetna, Medical Mutual, BlueCross, or 
the public option. And the small business is going to get tax credits 
that are not available now to bring down the cost of the insurance.
  Once a small business goes into a larger pool, the rates come down 
because small businesses and individuals always pay more than large 
businesses that can spread their risk to a much wider pool.
  The last one I will share is from Jamie from Fairfield County:

       I am a married 40-year old mother of three sons. I am 
     currently uninsured, but my husband is self-employed and has 
     insurance for him and our children.
       The insurance companies refuse to insure me due to a 
     preexisting condition. My condition does not require any 
     treatment and I haven't followed up on it since my diagnosis 
     4 years ago.
       Without insurance, I am nearly 3 years overdue for my 
     mammogram and 4 years overdue for my OB/GYN exam. I have not 
     had any of the preventive testing that begins in your 
     forties.
       My family is plagued by heart disease, cancer, and 
     diabetes. I fear that without the opportunity for health 
     care, I will not be able to be here for my children and my 
     future grandchildren.
       I ask that you please give me a voice with those opposed to 
     health care reform.

  Jamie, from Fairfield County, a suburban county southeast of 
Columbus, is in a situation in which far too many people are. She needs 
the preventive care, but she does not get the preventive care because 
she cannot get insurance because she has a preexisting condition. 
Imagine that: You are 40 years old--people in this body, it is hard for 
us to be as sympathetic as we should be. We make a good income here. We 
have status in the community. Most Members of this body generally have 
pretty good health insurance, but it is pretty hard to empathize. But 
we need to with people such as Jamie--40 years old, preexisting 
condition, but she does not go to the doctor to get preventive care. 
She doesn't get the OB/GYN exams. She does not get the mammogram. She 
does not get the preventive testing a 40-year-old woman should get. 
What happens? At some point, she may come down with an illness, a 
significant, serious expensive illness that will not only compromise 
her health or worse, but it will mean the health care system will spend 
a lot more money on Jamie than it would have if she had insurance to 
get preventive care.
  That is what is so important about this legislation. One of the 
things our bill does is insurance companies under our bill--the public 
option, Aetna, CIGNA, or any of the insurance providers, public or 
private--the legislation we are passing will say to them--they are 
charged a premium, but they can't make them pay a copay for preventive 
care. Nobody under our plan who goes to a doctor in the health care 
exchange will pay a preventive care copayment. That means more people 
will get mammograms, more men tested for prostate cancer, more men and 
women will get colonoscopies when they turn 50, women will get OB/GYN 
exams. All these exams will help people live longer and more prosperous 
lives and help prevent them from getting huge medical bills that so 
often lead to all kinds of bankruptcies and other financial problems.
  I get hundreds of these letters a week--most of us do--from people 
who simply want a fair shake. With this legislation, as we know, if you 
have insurance and are happy with it, you can keep your insurance. We 
are building consumer protections around that insurance, so no more 
cutting people off with preexisting conditions and no more annual caps 
or lifetime caps if they get sick, and they can't take their insurance 
away, no more discrimination based on gender, age, geography, or 
disability. That will be in the past.
  The second thing the bill does so very well is it provides insurance 
for people who don't have insurance, decent, affordable, high-quality 
insurance.
  Third, it helps small businesses so they can provide insurance for 
their employees, because most small businesses I know, whether they are 
in Toledo, Youngstown, Athens, Gallipolis, Dayton, or Springfield, want 
to provide insurance. Most small businesses want to provide insurance 
to their employees, but so many can no longer afford the insurance they 
provided 10, 20 years ago.
  The last thing our bill does is it provides a public option. That 
means people will have the choice. It is another choice they can make, 
another choice they can make if they don't want private insurance. They 
can go with the public option, and they will see the public option keep 
prices down, provide choice, and keep the insurance companies honest.
  This legislation makes sense. It is time we move this legislation in 
the next few weeks and get it to the President's desk by Thanksgiving.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.

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