[Congressional Record (Bound Edition), Volume 156 (2010), Part 3]
[House]
[Pages 3429-3432]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Ohio (Mr. Ryan) is recognized for 
the remaining time until midnight.
  Mr. RYAN of Ohio. Thank you, Mr. Speaker.
  I appreciate the opportunity here to respond to some of the 
criticisms that have been made here, unjust as they seem to be to me, 
and try to straighten the record out just a little bit.
  It is our belief on this side of the aisle that the United States 
Government and the government of many of our States have a moral 
mission to protect our citizens, a moral mission to empower our 
citizens, and a moral mission to improve the lives of many of our 
citizens. The issue of health care reform to us on this side of the 
aisle is a moral issue, and it is an economic issue.
  When we see throughout our country the level of abuse that has been 
put upon the people of this country through the insurance system, that, 
my friends, that, Mr. Speaker, is a moral issue. Nobody is saying that 
this health care reform bill is a perfect bill. Nobody says that it is 
going to be a panacea, that it is going to fix all of our problems in 
this country. But this is a major step forward for our country. And we 
have as a country a moral obligation to stand up between what the 
insurance industry is doing to the American people, somebody has to 
intervene. And there is nobody left because average people who are in 
Ohio or Iowa or some of these other States have no recourse. They 
cannot battle the insurance industry.
  This has been going on for years and years and years, where the 
insurance industry kicks people off the rolls when they need coverage 
or when they get sick, when they deny people coverage because they have 
a preexisting condition; and so they therefore can't get any insurance 
at all. And they have created a system here over the past few years, 
past 5, 10 years where we see 20, 30, 40, 50 percent increases in 
health care costs for individuals and small businesses, and large 
businesses in many instances and the government.
  So we have a situation where we are that far from addressing one of 
the great moral issues of our time. And we are that far from addressing 
an economic issue that will continue to strangle the economy of the 
United States of America if we fail to act.
  Now, I think it is very convenient for our friends on the other side 
of the aisle and those in the insurance industry to say let's start 
again. Let's start all over. Let's start from scratch. Well, if the 
insurance industry wants to go back and revoke 10 years of increases 
that they have bestowed upon the American people, if they want to start 
over, then maybe we will start over. If they want to eliminate all of 
the increases that they put on the American people, eliminate them all. 
Let's go back to 1995 or 1994 rates, or even just cost of living from 
1994 or 1995 when we tried to do this the last time. Why don't the 
insurance companies start over, Mr. Speaker, and go back and erase 
their increases that they put on the American people. Then we may 
consider starting over.
  Now, for those people, Mr. Speaker, who have been listening to this 
debate, they need to recognize that maybe this process isn't pretty, 
and maybe we could have done a better job explaining what is going on. 
And many people, and our friends on the other side were talking about 
polls, and at the same time would lament the fact that we are governing 
by polls.
  So when you look at what has happened over the course of the past few 
years and what has happened to average people--I want to find the poll 
that we had here when you pull out the issues from the poll. So the 
general consensus is, do you want the health care? And they hear on the 
news, Mr. Speaker, about different things that are going on and they 
say, well, it doesn't sound like such a good idea.

                              {time}  2310

  But then when you pull out specific provisions of this bill, of this 
health care reform proposal, most of those issues, most of those 
reforms poll at 60, 70, or 80 percent support.
  Are you for getting rid of preexisting conditions and allowing 
insurance companies to not cover you because you have a preexisting 
condition? Sixty-seven percent of the American people support that.
  Do you support eliminating lifetime caps so that when you get sick 
and you really need the insurance, you can get it? Sixty to 70 percent 
of the American people support that.
  Do you support not being able to deny every child in the United 
States of America because of a preexisting condition? Seventy, 80 
percent of the American people support that.
  Do you support giving small businesses tax credits to cover their 
workers? Significant support for that.
  So we are moving forward with a proposal that addresses the major 
needs of the American people.
  When you ask seniors, are you for closing the doughnut hole? More 
than a majority of seniors say, Yes, that is something that what we 
want included in the health reform proposal. And it is included in 
here. And many of these reforms will go in effect within the next year.
  And so when we pass this, Mr. Speaker, and our friends campaign in 
November about repealing this, they are going to have to go to all the 
moms and dads in the country and say, No, you know how your child, if 
they get sick or you want to get insurance, they can't be denied 
because of a preexisting condition, they want to run a campaign saying, 
No, we want to repeal that. Our friends on the other side of the aisle, 
when we say, You can't be denied coverage for a preexisting condition, 
they are going to want to run a campaign saying, No, we want to repeal 
that. When we close the doughnut hole and start moving in the direction 
of fully closing the doughnut hole that the Republican Party put in 
here when they passed the prescription drug bill that they didn't pay 
for, we had to borrow money from China to pay for it, and it has a 
doughnut hole in it, and we attempt to close it, our friends on the 
other side of the aisle are going to run a campaign in November saying, 
We want to repeal the closure of the doughnut hole.
  Those are the issues that are in here, that are in this reform 
proposal, and

[[Page 3430]]

these are the issues that are going to bring some justice to the health 
care industry in the United States of America.
  This isn't about whether the government is going to run health care 
or the insurance industry is going to run health care. This is about 
whether doctors can make decisions. And our friends on the other side 
want to talk about life and liberty. Let's talk about life and liberty. 
Let's have this debate.
  You want to talk about freedom? How free are you when you are sick 
and you can't afford health insurance? You can't get out of bed to go 
to work. You have to give up your job because you don't have health 
insurance. How free are you? I cannot be convinced that the Founders of 
this great country thought that freedom is somehow the government not 
protecting individual citizens from underhanded practices from a 
corporation. I can't believe it.
  I believe that the definition of freedom is about being healthy and 
empowered in 2010 in America. And if there is a corporation or an 
industry that is limiting your freedom by their underhanded practices, 
then the government has a moral responsibility to intervene and to 
protect the individual citizen and protect the rights of the individual 
citizen. Let's have this debate all day long, Mr. Speaker, telling me 
some boogie man is being created here that is going to come in to 
Washington, D.C.
  My one friend said nationalizing our bodies. One of our friends on 
the other side said that this was about nationalizing our bodies. What? 
Talk about fear mongering, Mr. Speaker. Nationalizing our bodies? This 
is about protecting individuals in the United States of America who 
can't protect themselves, and the government has a moral obligation to 
do it. If it is a foreign terrorist, moral obligation to do it. If it 
is crime in the streets and our cities, moral obligation to do it. If 
it is an unruly industry that has underhanded business practices, moral 
obligation to stop it. That is what we have here. That is why we are 
here. That is how this country was founded, to protect the individual 
freedoms.
  To say to small business people, You have to go out into the shark-
infested waters to try to get health insurance and have 40, 50, 60 
percent increases and do nothing about it because of some warped 
concept of freedom that is made up, how free is that business person 
who takes money continually out of wages, out of capital investments 
into their factories, into their machine shops, into their businesses, 
into their technology, into training their workers? They are not free 
to make good business decisions. They probably have all kinds of good 
ideas about what kind of investments they would rather be making than 
paying to some health insurance company that doesn't give us value 
added.
  You want to help manufacturing in the United States of America? Help 
fix some of the health care burdens that our manufacturers are plagued 
with day in and day out. And how many factories were shuttered because 
they couldn't make the capital investments because they had to put so 
much money into health care? How many?
  We have seen the decline in manufacturing over the last 10 or 20 
years. We have seen stagnant wages over the last 10 or 20 years because 
businesses had to absorb health care costs while simultaneously trying 
to compete with China and India and manufacturing all over the globe. 
And our friends on the other side want to start all over. And they want 
to tell all these people who are getting denied because they have a 
preexisting condition we need to start all over and wait another 
hundred years to do it, or at least another 15 years, the last time 
someone had the courage like President Clinton had to try to do this.
  We have an obligation to fix these problems. We didn't get sent here 
to take polls. We were sent here to do the right thing. And it is my 
hope that this week--you know, it was great today. We were in Cleveland 
with the President. And he was in the middle of his speech, and he said 
something like, What we need, or, We need, and there was a pause. And a 
woman shouted out, ``We need courage.''
  We need courage. That is what people are feeling. They feel like 
there's no one there to help them. They get stuck in situations where 
they don't have anywhere to turn. And imagine the United States 
Government passing a law that says, when you get sick, you can't get 
kicked off your insurance.

                              {time}  2320

  That is what is in this bill. That is why, when you look at the lists 
of faith-based organizations who are supporting this bill--Sojourners, 
Network, Catholic organizations, Evangelicals for Social Action, Jim 
Wallis at Sojourners, Catholics in Alliance for the Common Good, New 
Evangelical Partnership for the Common Good, former Associate General 
Secretary for U.S. Conference of Catholic Bishops, Sisters of Mercy of 
the Americas. Boston College professors, University of Dayton 
professors, Marquette University professors. On and on and on and on.
  Then, this weekend a huge endorsement for this bill. As my friends on 
the other side were talking about the abortion issue, 25 pro-life 
Catholic and evangelical leaders have endorsed this bill, and this 
weekend the Catholic Hospital Associations endorsed this bill. Do you 
think the Catholic Hospital Associations of America would endorse this 
bill if this was a pro-abortion bill? This is the pro-life bill. This 
may be the most pro-life bill that has passed this House in 20 years.
  How do we define life? How many people die too early because they are 
sick and they can't get the proper care? How many people have a reduced 
quality of life because they can't get proper health care? Aren't those 
pro-life issues? They most certainly are. And to have the Catholic 
Hospital Association endorsing this bill, and then to come out and 
fearmonger, Mr. Speaker, on the abortion issue is wrong. It is wrong. 
Twenty-five pro-life Catholic and evangelical leaders, strong, 
nationally recognized endorsing this bill, because this is a pro-life 
bill, and we should support it as a pro-life bill.
  We talk a lot about freedom, too. How many people in America today 
are out there locked in a job that they probably don't like all that 
well, that they probably would rather go work somewhere else or maybe, 
even better, start their own business? But they can't leave their 
current employment because they know if they go out into the free 
market and they try to get their own insurance, that they won't get 
covered because maybe they have a preexisting condition or maybe their 
spouse has a preexisting condition or maybe one of their kids has a 
preexisting condition.
  So our friends on the other side say, Start over. Don't do that, 
don't give that person who got an idea and wants to start a business in 
America and take a chance--don't help them.
  Are we providing the kind of environment for someone to express, have 
the freedom to express their energy and their talents in America? No. 
We are limiting it if we don't fix this health care system. We are 
limiting it. We have a moral obligation as a country to allow each and 
every individual in this country to express their talents and their 
skills in this country. We have the opportunity here in the next week 
or so to make this happen. We have never been so close, extending 
insurance to 30 million Americans who currently don't have it.
  A lot of people say, too, as we talk about this bill that they don't 
want to pay for these 30 million people. It is important that we 
recognize that we all are already paying for these people who don't 
have health insurance.
  You see, our friends on the other side--and I sat here and I watched 
them, and I listened very carefully, and they were picking these fringe 
issues to try to incite. They were talking about abortion, which, okay, 
I am sure they believe strongly in that. I do as well. I have a pro-
life voting record. But when you have the Catholic Health Association 
and you have 25 national Catholic and evangelical leaders supporting 
this bill, it becomes very difficult to scare the American people about 
that issue.
  They don't want to talk about preexisting conditions. They don't want 
to talk about making sure kids don't get denied. They don't want to 
talk about

[[Page 3431]]

tax cuts, tax credits for small businesses to provide health care 
insurance. Of course not. They don't want to talk about how the 
Democrats are going to close the doughnut hole. They don't want to talk 
about how seniors will not have to pay for any preventative care at all 
in Medicare. They don't want to talk about how this bill is deficit 
neutral, how it actually reduces the deficit. They don't want to talk 
about how this bill extends the life span of the Medicare program. They 
don't want to talk about any of that stuff. And it goes back to the 
original memo that one of their top pollsters gave them in the spring 
that said: Do not let Obama pass health care reform. Do not let him. 
You will be in the minority for a long time. And so they will do 
anything they can, anything in their power to try to prevent this 
President from passing health care legislation.
  It is good to know, Mr. Speaker, because they are rooting against the 
President. They are rooting against the President. If the President 
fails, we all fail. He has extended his hand, taken all of the 
Republican ideas, put many of them into the health care reform 
proposal, and there still are Republicans who won't vote for it. Just 
like in the stimulus package, we had to put $300 billion in tax cuts in 
the stimulus bill because that is what the Republicans wanted, and we 
didn't get any Republican votes, because there is no benefit for the 
Republican side to support the President, to support the American 
people, because politics has gotten in the way.
  So we have all of these issues that are going to go into effect 
within the year. Within the year small business tax credits, up to 35 
percent of premiums, will be immediately available to firms that choose 
to offer coverage, closing the part D doughnut hole. Immediate help for 
the uninsured now to create an interim high-risk pool. End rescissions 
so insurers can't drop people from coverage when they get sick. No 
discrimination against children with preexisting conditions. Are you 
going to vote against that? Go ahead.
  Extends coverage for young people up to their 26th birthday, so all 
the young people in our country will now be able to stay on their 
parents' insurance until they are 26 years old. So if you want to go to 
grad school, you will be able to stay on your parents' health 
insurance. Times are tough now. You may not be able to find work, or at 
least find work with some decent health care. You can stay on your 
parents' insurance until you are 26 years old.
  Bans lifetime limits on coverage. Bans restrictive annual limits on 
coverage. Free preventative care under Medicare. This is a reform 
proposal that we should have passed 30 years ago. Those are the moral 
issues. But the economic issues are just as profound, just as great.
  Small businesses have seen a 126 percent increase over the last 5 or 
6 years, and the projections as we move forward are even higher for 
families and small businesses: Up, up, up, and away will their health 
care costs go if we do nothing.
  And, as we said, they want us to start over. How about the insurance 
companies start over? How about the insurance companies repeal 10 years 
of increases and they start over? Maybe that would be fair. Wouldn't 
that be nice? We want to start all over in this country, come together 
and figure something out. Repeal 10 years of your health care 
increases. Free preventative care under all the new health care plans, 
new independent appeals process. Help for early retirees, which is 
something that is huge, I know, in Ohio. Creates a temporary 
reinsurance program until the exchange is available to help offset the 
cost of expensive health claims for employers that provide health 
benefits for retirees age 55 to 64. Billions of dollars for community 
health clinics, and it increases the number of primary care doctors by 
making huge investments, making sure that we get that done.
  The Republicans didn't do anything to address any of these issues for 
10 years. Now, all of a sudden, they are late to the game, and they 
still won't support it. They say, Well, we are for repealing 
preexisting conditions. They are not going to vote for this bill. We 
are for tax credits for small businesses. They are not going to vote 
for this bill. We are for closing the doughnut hole. They are not going 
to vote for this bill. We are against preexisting conditions, making 
sure that any child doesn't get denied coverage because of a 
preexisting condition. They are going to vote against this bill. We are 
for children allowed to stay on their parents' insurance until they are 
26. They are going to vote against this bill.

                              {time}  2330

  We're for increased competition. They're going to vote against this 
bill, because they've been told by the people who guide their political 
decisions, their pollsters, the cottage industry in Washington that 
tells political parties what to do, they have been told, Do not let the 
Democrats succeed in this. And we have asked time and time and time 
again for their suggestions. The President has taken many of them, 
implemented them into this bill, and they keep moving the yardstick 
further and further down because they don't want to support this 
because their political leadership, their pollsters, their lobbyist 
friends say we can't do it. We can't let them get a win.
  And it's not about the Democrats winning. This is about the people in 
our districts who are getting hurt; that are getting hurt by the 
current practices. And when you see the number of faith-based 
organizations supporting this legislation--Evangelical, Catholic, 
Jewish, Muslim, Buddhists, I mean, the spectrum of faith-based 
organizations in the United States of America are supporting this. And 
they all say, Is it perfect? No. Of course not. This is a body made of 
human beings who are flawed and make mistakes. But this is a tremendous 
step forward in our country--monumental, historic.
  I'm proud to be here today. I'm proud to support this bill. I'm going 
to be even prouder after it passes and we can point to X, Y, and Z, as 
I am tonight, exactly what is in here and exactly what the benefits 
are. I'll be honest with you: I'm excited to run a campaign in November 
talking about this. I want to see the campaign where all of the stuff 
that I just listed is the debate in the fall. And our friends on the 
other side and our TEA Party folks who haven't done anything in 10 
years to try to address any of these problems are going to want to 
repeal a ban on preexisting conditions for kids--children; a ban on 
preexisting conditions for adults, saying that you shouldn't be able to 
stay on your parents' health insurance until you're 26. They're going 
to run a campaign saying that we should expand the doughnut hole 
instead of closing the doughnut hole, which is what we're doing in 
here. They're going to run a campaign saying that we want to repeal the 
tax cuts that we have given to small businesses to try to make this 
happen. We want to repeal the subsidies that people are going to get to 
help them pay for insurance.
  It's going to be a heck of a campaign. And they're going to scream 
socialism like they have been doing for 7 years. They screamed about 
it.
  This is the same party, Mr. Speaker, that just a few years ago, when 
I first got in the Congress, the early part of this first decade, 
wanted to privatize Social Security. You don't hear anybody here saying 
they want to get rid of Medicare. I remember, we sat on this floor, 
Congresswoman Wasserman Schultz, Kendrick Meek, and myself. Started 
when we first got in Congress. The first issue we were addressing was 
President Bush's idea to privatize Social Security.
  Now, imagine a year and a half ago if you had dumped your 401(k) or 
your Social Security was looking like your 401(k) and you had nothing 
to draw upon. That's the kind of vision we're getting from the other 
side of the aisle. We're talking about tax cuts for small businesses 
and individuals so that employers can provide health care and jobs. 
That's what this is about. Our friends on the other side did not act. 
They led to what is happening here today, and we have got the 
consequences of their inaction that we're forced to deal with today.

[[Page 3432]]

  We have got a lot of issues to talk about. This is not going to be 
the last time we're on the floor. We're going to be here all week 
talking about these issues. But, again, our government has a moral 
mission, a moral responsibility to protect our citizens and to empower 
our citizens. This health care reform bill is about protecting our 
citizens. It's not about government-run; it's not about insurance-run. 
That's a false debate. This is about making sure that doctors and 
patients and families make their own health care decisions. That's what 
this is about.
  This is about making sure that seniors have an extended Medicare 
program by making sure we rid it of waste, fraud, and abuse. This is 
making sure that our seniors have prescription drug programs. This is 
making sure that our government protects individuals from the practices 
of the insurance company, being denied a preexisting condition; that we 
protect our citizens from, when they get sick, their insurance company 
says to them, We can't cover you any more. That's what this reform bill 
is about. And those protections will empower and stimulate and allow 
the American people to express their talents in the marketplace.
  How many business people are going to have more money in their pocket 
to reinvest back into their business, into the technology, into the 
capital improvements? How many families are going to have more money to 
send their kids to college, to go on a family vacation, to make sure 
their kids can go to graduate school? How many people who are locked 
into jobs now and fear starting their own business are out there? We 
don't know. It's a hard thing to quantify. But there are thousands of 
them. Who's the next Bill Gates who has a spouse that maybe has a 
preexisting condition so they're stuck in a cubicle somewhere and can't 
start their own business? How many children in our country have been 
denied health insurance because they have a preexisting condition? How 
many people are in a hospital right now, right now, because they didn't 
get the proper health care that they needed? And so their problems, 
their issues, their health concerns got worse and they ended up in the 
hospital.
  We have a moral obligation to step up to bat and to make this happen. 
This reform bill is a good piece of legislation. And I recognize that 
there are some outlets, some people who want to maybe not be quite as 
straightforward with the facts that are presented here in this bill, 
and they want to touch upon those same issues of abortion and 
immigration, all the issues that have been addressed in this bill. When 
you have 25 national pro-life Catholics and Evangelicals organizations 
endorsing this bill, when you have the Catholic Hospital Association 
endorsing this bill, you can honestly say that the abortion issue has 
been taken care of and that this is a pro-life bill. Because the idea 
of pro-life is very broad and should have a very broad interpretation. 
Quality of life, shortened life spans, those are pro-life issues. 
Shortened and reduced quality because they don't have the proper health 
care, those are pro-life issues.
  Freedom to invest in your business, start your own business, those 
are issues that our Founding Fathers talked about a great deal.

                              {time}  2340

  So we do have a moral obligation to pass this piece of legislation. 
When we pull out all of the parts of this bill, you will see that the 
American people support this. And the American people want this 
legislation. Here it is. I will read them real quickly. They would be 
more likely to support the reform if it has tax credits--these are all 
issues that are in here--if it has tax credits to small businesses, 73 
percent more likely to support; if it has insurance exchanges, 67 
percent more likely to support; if you can keep what you have, which is 
exactly how this is set up, 66 percent more likely to support the 
reform; if you ban preexisting conditions and denials, 63 percent; 
Medicaid expansion, 62 percent; dependent coverage through 26 years 
old, 60 percent; close the Medicare doughnut hole, 60 percent; subsidy 
assistance to individuals, 57 percent. These are all things that are in 
the bill. These are all things that are in the bill and are all the 
reasons why we need to pass it.
  This is a basic human rights issue. This will be the most significant 
pro-life piece of legislation that has passed this House in a long, 
long time. This will be the most historic piece of legislation that has 
passed this House in a long, long time.
  I yield back the balance of my time.

                          ____________________