[Congressional Record (Bound Edition), Volume 155 (2009), Part 21]
[Senate]
[Pages 28781-28783]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. BROWN. Mr. President, we just did one of the most important 
things I have ever done in my professional life, and I join my 
colleagues in noting that. We have taken a major step in doing several 
things today--in providing health insurance to tens of millions of 
Americans who don't have insurance, in building consumer protections 
around 80 percent of Americans who are insured so people will no longer 
be disqualified from preexisting conditions, no more discrimination 
based on gender.
  As the Presiding Officer knows from his work in Minnesota, women pay 
significantly higher health insurance premiums than men on average. 
Those days are behind us. There will no longer be lifetime caps so if 
somebody gets sick and their cost of treatment--from physician care, 
from hospital visits--so high, the insurance company chooses to do what 
they call rescission, cutting their insurance coverage off, those days 
are behind us, once we move forward with this bill.
  Tonight is the first step. Even though none of my Republican 
colleagues, not 1 of the 39 who voted, not 1 of them wanted to proceed 
with the debate, clearly the country wanted us to move forward. Now 
everybody has a fair shot. If they don't like the public option, they 
can try to get rid of it. If they don't like the way we are paying for 
it, they can try to change it. If they don't like what we have done 
with biologics, those opportunities are in front of us now for the next 
2 or 3 weeks.
  I have come to the Senate floor leading up to this debate, since 
July, sharing letters from people in my State who have a few things in 
common. Almost every single letter I get comes from somebody who a year 
or two ago was pretty satisfied with their health insurance. Then maybe 
they had a baby with a preexisting condition or they lost their 
insurance or they owned a small business and 1 person out of 50 
employees got cancer and their premiums spiked so high, the insurance 
was either terminated by the company or it was so expensive they 
couldn't afford it. Someone got so sick and the costs were so high, the 
insurance cut them off. In almost every one of these letters, people 
were generally satisfied with their insurance.
  I get letters from a lot of people in their early sixties, people 
from Springfield to Troy to Zaynesville. These people in their early 
sixties who have lost their insurance, their job, or they had

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a preexisting condition, can't wait to be 65. It is a pretty bad 
commentary on how we do this when a 62-year-old is so anxious to be 65 
so that they have insurance. Then they have the security and the 
stability of Medicare. Why shouldn't we instead give them the security 
and the stability of the public option, if that is what they choose, if 
they are uninsured and in their sixties or forties or any other age.
  The last thing I have found in these letters is an overwhelming 
sentiment in support of the public option. The public option does 
several things. The public option is only an option. If you want CIGNA 
or WellPoint or Medical Mutual, a not-for-profit company in Ohio, you 
can choose that or the public option. The public option, even with 
these reforms, will help keep the insurance companies honest. Nobody 
gets eliminated from Medicare because of a preexisting condition. 
Nobody will lose their health insurance with the public option because 
of a preexisting condition. Too many times, they have, if they had 
CIGNA or if they had WellPoint or Blue Cross or Aetna. That is the 
second reason the public option is so important.
  Third, the public option is going to keep costs in check because in 
southwest Ohio, in Cincinnati, and the three surrounding counties, two 
insurance companies have 85 percent of the insurance policies.
  What does that mean? It means lower quality and higher cost. Put the 
public option in as a competitor, people in Lebanon and Batavia and 
Middletown and Butler and Cincinnati don't have to choose the public 
option, but its very existence will discipline the market. It is good, 
old-fashioned American competition, and it will mean that the private 
insurance companies will act better. They will provide better quality 
at a lower price. That is the whole point of the public option.
  Let me share a couple letters this evening. Debbie from Clark County:

       In May, I suffered a serious ankle injury. After an ER 
     visit and then a consultation by a specialist, I was told not 
     to bear weight on my foot and that I needed major surgery.
       Up until June 1, I was covered by my husband's employer-
     based plan. His company then changed its insurance policy and 
     stated that any spouse of an employee who worked full time, 
     and had access to insurance, would no longer be covered.
       At the time, I was still employed and had access to an 
     employer plan. But shortly after my injury on May 29, I 
     couldn't work, and asked that I be put on my husband's plan.
       The insurer initially declined, but after weeks of 
     fighting, they agreed to put me back on his plan, but only 
     during open enrollment in March 2010.
       My surgery is critical and needs to be done immediately; I 
     have to wait until March 2010--nearly ten months after my 
     injury.
       I have researched private insurance, but we can't afford 
     it. Nor can we afford the surgery without insurance.
       We have worked hard and raised our four children to believe 
     that nothing worth having comes easy. But now, I feel like 
     I'm somehow letting my family down.
       How can this happen when living in the United States of 
     America?

  Debbie is like so many Ohioans and so many Americans who have worked 
hard, paid their taxes, played by the rules, and something happened 
with their insurance. They lost their insurance. She was victimized by 
a set of circumstances that simply shouldn't happen. Under our bill 
this will not happen. They will not be allowed to take people's 
insurance away. People will not fall through the cracks. She will be 
able to get insurance by buying on the insurance exchange. If she 
chooses to, she could choose the public option.
  Robert from Lake County:

       In 1986 my wife was terminally ill with cancer and several 
     other illnesses. When I switched jobs and looked for new 
     insurance, we were denied because of her pre-existing 
     condition.
       In 2001, when I was 58, I lost my job. When COBRA ran out, 
     I was denied insurance based on my pre-existing conditions of 
     diabetes and heart disease.
       I managed to limp through until I turned 65 and became 
     eligible for Medicare.
       I'm sure the fear and anxiety I suffered over health 
     insurance hasn't been at all beneficial to my overall health.

  We don't think about that in this body. Most of the people we hang 
around with have insurance. Most of the people we hang around with as 
Senators don't have a lot of these problems. We certainly have sick 
relatives and friends who have disabilities and illnesses. But rarely 
do they have to worry so much before they turn 65 and can get the 
stability of Medicare, the same stability we want to give people in the 
public option. When you think about that, think of all the people who 
have insurance and they go to the doctor or hospital and get a medical 
treatment. They then apply to their insurance company to get their 
benefits paid for their expenses. Thirty percent of the time insurance 
companies deny claims--30 percent of the time, often on appeal to the 
insurance company, though they will pay the claim on the second round.
  Think about putting people through that. You are sick, you have a 
$14,000 medical bill. You are making $35,000 a year. You can't afford 
anything close to that. Your insurance company turns you down. You go 
back and fight with them, you argue with them, or your spouse argues 
with them. Where does that leave you?
  In difficult times with their health, the anxiety makes it even 
worse. That is why we need to change this model of the private 
insurance companies finding all kinds of reasons to not insure people 
with preexisting conditions, to discriminate because of gender and then 
to refuse to pay claims. That is what the public option will do, inject 
competition so they would not be able to do that.
  The last letter I wish to share is from Shelly from Coshocton County 
in sort of eastern-southeastern Ohio:

       I have no health insurance coverage for myself or my son. 
     My husband is disabled and receives Social Security 
     Disability and Medicare.
       My son was born with a congenital heart defect and has 
     already had one open heart surgery. Along with my pre-
     existing condition, neither of us can afford private 
     coverage. Pre-existing conditions should be illegal for 
     insurance companies to use to delay health care for 
     Americans.

  A public option would protect Shelly. She asks for a public option. 
She says: A public option would protect me from preexisting condition 
exclusions. That is exactly right. The insurance industry model--you 
think about how it works.
  They first hire a bunch of bureaucrats to keep people from buying 
insurance if they are sick. So they deny people the ability to buy 
insurance because they might be expensive, on the one hand. And then, 
after you do have coverage, and you get sick and you submit a claim, 
they hire a bunch of bureaucrats on that end to stop you from getting 
payment, to stop you from getting reimbursed for your claim.
  That is why the CEO of Aetna was able to make $24 million last year. 
That is why insurance companies have seen profits increase 400 percent 
in the last 7 years. When you have a business model where you hire a 
bunch of bureaucrats to keep people who are sick from buying your 
insurance, and on the other end you hire a bunch of bureaucrats to deny 
payment of their claims, those are companies that are going to make a 
lot of money.
  That is a pretty good business model. It works for them. The CEOs of 
the top 10 insurance companies in the country average $11 million in 
pay. It works for them. It works for their shareholders. It works for 
their profitability. It is not working so well for Shelly. It is not 
working so well for Debbie from Springfield. It is not working so well 
for Robert from Wickliffe or Willowick, in that part of Ohio.
  So it is clear we have our work cut out for us tonight. It is a major 
step. I am sorry none of my Republican colleagues wanted to even debate 
this, wanted to even move forward and put this bill on the floor. But I 
am confident as we process these amendments, the dozens and dozens of 
amendments--I know the Presiding Officer has a great amendment on 
making sure the drug companies that advertise do not get subsidized by 
taxpayers through a tax deduction, which they do now. There are a lot 
of amendments that are coming to this floor that will make this bill 
better.
  There are some amendments that will not make it better. But everybody 
is going to have a free shot--all 100 of us. That is the way this 
system should

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work. That is why open debate is good, even though some of my 
colleagues did not want us to do that. But that is why, in the next 
month or two, we are going to get a bill through the Senate, through 
the conference committee, to the President's desk, and it is going to 
change Americans' lives.
  Those who have insurance, who are satisfied with it, will be able to 
keep their insurance with consumer protections. It will help small 
businesses so they can insure their employees. And it will help those 
people who do not have insurance get some help and get some insurance. 
The public option will improve the system all up and down in other 
ways.
  Mr. President, I yield the floor.

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