[Congressional Record (Bound Edition), Volume 156 (2010), Part 8]
[House]
[Pages 10587-10592]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentlewoman from Ohio (Ms. Fudge) is recognized 
for 60 minutes as the designee of the majority leader.


                             General Leave

  Ms. FUDGE. Mr. Speaker, I ask unanimous consent that all Members be 
given 5 legislative days to revise and extend their remarks into the 
Record on this topic.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Ohio?
  There was no objection.
  Ms. FUDGE. Mr. Speaker, I appreciate the opportunity to anchor this 
Special Order hour on health care for the Congressional Black Caucus. 
Currently, the Congressional Black Caucus is chaired by the Honorable 
Barbara Lee from the Ninth Congressional District of California.
  I would now yield to our chair, the Honorable Barbara Lee.
  Ms. LEE of California. Thank you very much. First, let me thank my 
friend and colleague, Congresswoman Marcia Fudge of Ohio, for anchoring 
tonight's Congressional Black Caucus Special Order on the immediate 
benefits of health care reform. Also, let me just thank and salute 
Congresswoman Fudge for her consistency and her commitment to hold 
these Special Orders so that we can bring attention to some of the most 
pressing issues confronting our country that often don't really make 
the headlines. So I would especially like to thank Congresswoman Fudge 
for leading tonight's Special Order once again on the immediate 
benefits of health care reform and for continuing to keep our caucus 
focused on addressing the key issues facing our Nation. She has many, 
many of the same problems and issues in Ohio as I do in California, as 
all of the members of the Congressional Black Caucus have, whether we 
come from rural districts or urban districts. I just want to thank you 
very much for your leadership and for once again sounding the alarm.
  As chair of the 42-member Congressional Black Caucus, I rise tonight 
to talk about the health care crisis in America and to inform the 
American people about our actions and agenda working with President 
Obama, Speaker Pelosi, Leader Reid, and what we're doing to make us a 
healthier and stronger Nation.
  Since Teddy Roosevelt almost a century ago, President after President 
has sought to deliver health care for the American people, but to no 
avail. This year, under the leadership of President Obama and Speaker 
Pelosi, the United States Congress took a major step toward delivering 
on the promise of health care for all Americans in a comprehensive and 
fiscally prudent way.
  This is a very important investment in the health and wellness of all 
Americans. For too long, quality and affordable health care, which I 
believe is a fundamental human right, was way out of reach for far too 
many Americans and was really the province of the wealthy or those who 
were fortunate enough to have a job that provided health care benefits.
  It was a very long and arduous struggle, but I am pleased that we 
continued to push to reform our health care system. It took clarity of 
purpose. It took moral authority. It took determination and commitment 
of President Obama, the brilliant and focused leadership of Speaker 
Nancy Pelosi and Senate Majority Leader Harry Reid, and the will of the 
majority of my colleagues in the House and the Senate, but most 
importantly, the will of the American people to make this a reality. 
Together, we fought against the insurance industry to say that we will 
no longer, no longer mind you, be held hostage to the denial of 
benefits for those who continue to pay their premiums. We won't be held 
hostage any longer to escalating health care costs.
  Just as Social Security was in the 1930s and with the passage of 
Medicare and, of course, the civil rights and the voting rights acts of 
the 1960s, the passage of health care reform is a defining moment of 
our era, and I am so pleased that this happened on our watch.
  As I cast my vote, I was thinking of all the people that I see in the 
emergency rooms and in the hospitals when I'm there with my 86-year-old 
mother or with my sister who has multiple sclerosis. They have health 
care, but I worry so much about the people that I see who don't have 
health care and who are just struggling to survive and who land in the 
emergency room because they don't have primary care.
  As I cast my vote, I was thinking of all of those who died, mind you, 
because they didn't have preventive care and they couldn't see a doctor 
and they died an early death.
  I was also thinking about my children and my grandchildren and future 
generations of Americans who will now live longer and will now live 
healthier lives because of the legislation we passed. I am so glad that 
this happened on our watch.
  Members of the Congressional Black Caucus worked tirelessly to ensure 
that this bill holds insurance companies accountable and included a 
number of cost-saving provisions. We were

[[Page 10588]]

vocal advocates for provisions in the bill to combat health 
disparities, illnesses and diseases that disproportionately affect low-
income and communities of color.
  This bill is a win for all Americans because it makes us a stronger 
and healthier Nation. It contains many immediate benefits that 
Americans will begin to realize before the end of this year. In fact, 
just last week, thousands of senior citizens trapped into the doughnut 
hole prescription drug coverage, they began receiving a one-time, tax-
free check for $250. These checks will continue to be mailed over the 
next several months as seniors enter the coverage gap, with an 
estimated 4 million seniors receiving this relief. Beginning next year, 
seniors will get a 50 percent discount on prescription drugs if they 
are in this doughnut hole.
  Additionally, if you are between the ages of 55 and 64 and thinking 
of taking an early retirement over the next few years--and many in, I 
know, my age group are thinking about this--but if you're in that age 
group and if your employer provides extended coverage, we create a 
temporary insurance program to help protect your coverage and to reduce 
premiums for you and your employer.
  If you currently have private insurance, either purchased 
individually or through your employer, by September of this year all 
new plans will be prevented from denying coverage to children with 
preexisting conditions, dropping your health care coverage if you get 
sick--I mean, this is mind-boggling to think that you pay your premiums 
for health care and then the insurance companies can drop it if you get 
sick. My God, just for that reason alone everyone should have voted for 
this bill. It will take the lifetime cap on the amount of coverage you 
can receive away. Also, in addition, new plans will also be required to 
cover preventive services so that you don't have to pay a copay, and 
the cost of the service will be exempt from consideration as part of 
your deductible. This is a big deal.
  It will set up an accountable and effective internal and external 
appeals process to allow you to challenge arbitrary decisions made by 
your health insurance company. I know my family, myself, my 
constituents, they get jerked around many, many times by insurance 
companies. They get put through so many changes. They have to jump 
through so many hoops just to find that their claims have been denied. 
Well, no more of that.
  The plans on the individual market, we also tightly regulate the use 
of annual coverage limits and then move to full prohibition of such 
limits by 2014. 2014 seems like a long time, but it's really not, and 
so the steps that we're taking between now and 2014 I think are going 
to immediately help those who need this type of help.
  Within one year of enactment, by next March, insurance companies will 
also have to ensure that they are spending at least 80 percent of the 
premiums that they collect from the individual market and 85 percent of 
premiums collected from large group market plans on actual health 
services. That would, for the first time, guarantee that insurance 
companies can't raise premiums just to provide huge salaries and 
bonuses to their CEOs. They actually need to ensure that they are being 
used to provide health care for people. Most people believe that that's 
what they're paying for, that's health care, not to provide these huge 
CEO salaries, and so finally we're going to begin to do the right 
thing.
  If you're a small business owner, let me just say, with less than 50 
employees, you will never have any obligation under this bill. You 
won't be required to buy health coverage for your workers, and you 
won't pay a penalty if you don't provide health care coverage, 
regardless of what you heard during the debate. This is a fact. But if 
you do provide health care and if you are a small business, you will 
get a tax credit this year up to 35 percent of the cost of your share 
of the insurance premium. If you continue to provide health care to 
your employees, then by 2014 you will receive a tax credit of up to 50 
percent of your premium contribution. Believe you me, as a former small 
business owner, I know how important this is. Requirements on 
businesses that are larger than 50 people do not kick in until 2014.
  That's plenty of time to get ready for this. That's when we will 
actually provide those subsidies to people that might not have coverage 
and when the national- and State-based health exchanges are officially 
launched. That's in 2014.
  Now, if you're uninsured right now as a young person and maybe you're 
just looking for a job or between jobs, and if you are younger than 26 
years of age and if your parents have insurance, then you will be, of 
course, added to their insurance plan, and it's like your parents won't 
have to drop you from their plan until you are 26.
  If you are uninsured because you have a preexisting condition--and 
mind you, we learned during this debate that, unfortunately, victims of 
domestic violence--domestic violence was a preexisting condition. Can 
you believe that? Just being a woman had been a preexisting condition 
until now. That's shocking and pretty disgusting, really.

                              {time}  2015

  So, once again, if you have a preexisting condition, nobody, mind 
you, no company will be able to deny you your benefits, but you don't 
qualify for Medicare. If you don't qualify for Medicare or Medicaid, 
then you will be eligible to buy into a temporary high-risk pool at the 
State level, which will price coverage at the average going rate in 
each State. These temporary high-risk pools will continue to offer 
coverage through 2014, until the subsidies and the exchanges kick in. 
So there are immediate benefits.
  By no means is this a perfect bill--or a perfect law. We're so 
accustomed to saying ``bill.'' This is a law, and we were working so 
hard on the legislation. Some people really think that it is hard to 
believe that this was signed into law, but this is a law now.
  No doubt it has flaws. Many of us would have preferred--me 
personally, I would have preferred a single-payer system. I think my 
constituents would have preferred a single-payer system or at least a 
strong public option which we're going to continue to pay for because 
we have to have some kind of a competitive program so that insurance 
companies can begin to bring their costs down.
  However, this bill offers virtually every important advance for 
health care that we could make at this point, making coverage more 
affordable and expanding access to much-needed services. This was a 
good bill. It is now a good law that will have real impact in the lives 
of millions of Americans. But it was a foundation. It was just the 
beginning, so we have to continue to fight and to make sure that any of 
the provisions that weren't included get included.
  I just have to say this in closing: This law does not discriminate 
between Republicans who don't have any insurance, Democrats who have no 
insurance or who pay too much for their insurance coverage, or tea 
party activists, Independents; it does not discriminate against anyone 
with any political affiliation. Whether your Member of Congress voted 
for this bill or not, you will benefit from this bill.
  Each and every American soon will learn that this is not a government 
takeover. It is not socialized medicine. And due to the hard work and 
commitment of Democrats, we will finally bring the United States of 
America into the column of industrialized nations, mind you, which 
provide affordable and accessible health care for all. This, my 
colleagues, I think is a remarkable step in the right direction. And so 
I have to just thank all of those who voted for the bill and thank 
President Obama for signing it into law. And I want to thank the 
Congressional Black Caucus, especially our Health Task Force, led by 
our physician, Congresswoman Dr. Donna Christensen, who really fought 
each and every day to make sure that we expanded community clinics, 
ensured that we begin to close these health disparities in communities 
of color, that our minority medical schools finally receive some equity 
in terms of the ability to train more minority medical professionals. 
So this was a big deal. It is

[[Page 10589]]

going to kick in over the years up until 2014, but I think that the 
American people will see why this was well worth fighting for.
  Once again, it doesn't matter whether you're a Democrat or a 
Republican or a tea party activist or an Independent, or whomever, you 
will benefit from it whether your Member voted for it or not.
  Thank you again, Congresswoman Fudge, for your leadership. And thanks 
to the Congressional Black Caucus for being such strong advocates for 
health care reform.
  Ms. FUDGE. Madam Chair, we would like to thank you.
  Mr. Speaker, I think that there is probably no one in this caucus who 
fought harder to get this bill passed. Our Chair, Representative Lee, 
is one of the hardest working Members of this entire body. She has 
vision and leadership. And most of all, she has courage.
  We want to thank you for being our leader. We thank you very much.
  Mr. Speaker, I would now like to yield to my friend who has joined us 
and has always been a consistent voice for the people of this country, 
the gentlewoman from Texas, Sheila Jackson Lee.
  Ms. JACKSON LEE of Texas. I thank my colleague from Ohio very much, 
and I am delighted to be able to join her, and as well my chairwoman of 
the Congressional Black Caucus and other Members who I know have a 
great interest in this area of reminding the American people of the 
great strides that we have made in the passing of this outstanding new 
attitude for health care in America. It is long overdue, and it was an 
enormous struggle.
  I can remember that weekend of March 2010 and the week that led up to 
it and the days that we stayed over on Saturday to gather our resources 
and to continue to work and to push, working and ensuring that the 
Senate would bring the bill over to the House so on that Sunday, we 
could cast a vote for what has to be a monumental change in American 
life and will go down as a monumental move in American history.
  Just a few minutes ago, I had the privilege of listening to our 
Secretary of Agriculture, Secretary Vilsack, and he reminded us of how 
diverse America is. Rural America, for example, with all of its needs 
and all of its specialness--of course, just on the floor of the House, 
we stood in silence to acknowledge the loss of lives in rural Arkansas 
in a terrible flooding. And then he expressed the inequity in terms of 
poverty in some of our rural communities and the need for investment in 
that community. And I would venture to say that alongside of that 
investment, this health care bill, which as our chairwoman just said, 
it is not respective of region or what party you're in or who 
represents your district; you will have access to health care. That 
means that many of the rural Americans, some of whom scratch their 
survival out of the earth, some of whom are still tenant farmers, some 
may have small family farms, and many of them have sacrificed to invest 
in those farms and have probably ignored the need for health care 
because of the cost. Now we have that opportunity to ensure that those 
Americans, hardworking Americans who put bread on our table, have the 
ability to provide for their family.
  The Secretary made mention of the fact of the First Lady's commitment 
to, in essence, stamping out obesity, particularly in our children. 
This health care bill provides for preventative measures, preventative 
care, and a focus on nutrition and an emphasis on helping children, 
something long overdue. And it compliments the First Lady's effort and 
the Secretary of Agriculture's acknowledging that we must have healthy 
foods, for example, in our school cafeterias to make healthy children. 
But at the same time, it is important to note that that child who may 
be obese as we speak should have access to some form of health care.
  Now, with the passage of this health care bill, that child will have 
that opportunity to have a better life, a healthier life, to have a 
nutrition plan--we don't like to call plans for children diets, but a 
good healthy nutrition plan that can be governed by their family 
practitioner now or their pediatrician, to which they will have access, 
either through the National Exchange or through health care that now 
this family farm or their family can purchase.
  Just a week or so ago, during Memorial Day week, I had the privilege 
of announcing a $1 million grant that was to allow an inner city 
hospital--the only African American hospital in the State of Texas, and 
one of very few in the Nation--to receive a grant to servicemembers and 
their families, active duty servicemembers and their families for PTSD, 
post-traumatic stress disorder. We know that is a prominent and 
prevalent condition that many of our soldiers are coming back from Iraq 
and Afghanistan and have been impacted by that.
  But what about mental health and the need for mental health care 
across America that people who have had mental health concerns have 
literally suffered because we never had parity in our health care 
insurance coverage? It has never been required federally until 
recently. The legislation, of course, shepherded by the late Senator 
Ted Kennedy, and our friend and colleague, his son, Patrick Kennedy. 
But for so many years, we did not have mental parity; insurance 
companies could ignore it. Just think if you would ignore the 
servicemen and their families who are impacted by post-traumatic stress 
disorder.
  Well, many Americans feel isolated with mental health concerns and 
not being able to access good care. This health care bill turns a 
corner on mental health care, and I want to say to the American public 
that physical illness has no position to be raised up over a mental 
health condition. There should be no stigma, and you should have access 
to as good a care for a physical ailment, a broken arm, an upset 
stomach, diabetes, kidney disease, terrible diseases, of course, but 
you should equally have access to mental health care. Well, this health 
care bill allows that to happen, and I think that that is a step 
forward for the American people.
  It's good to note that families who have raised children who are now 
entering the work world or looking for work and coming out of college, 
used to be an enormous burden of, how do I care for my child when they 
have aged out of my insurance? Well, now we have the opportunity for 
them to remain on the insurance until 26. But let me give an 
admonition--and I think this is going to be important for the Congress 
to do. In the legislation, there are several oversight provisions in 
the bill--in fact, our own Congressional Black Caucus, working with 
Congresswoman Edwards and some others, were very insistent on making 
sure that the raising of the cost did not inappropriately or unfairly 
burden middle class, upper middle class Americans, just by the nature 
of who it falls on.
  But the other aspect of it is, the rumor is that if insurance 
companies are required to keep children on until they're 26, that ugly 
word of ``increased cost'' is going to rise. What I would say is that 
we need to pay attention to the actuarial tables and the database that 
suggest how many times a 26-year-old or under utilizes health care and 
not let insurance companies just willy-nilly on their own regard, on 
their own basis make the determination, well, they're giving me 
something to do, I'm going to raise the cost, because that's what 
people are afraid of. We have to say to the American public, we're 
going to be your watchdog in the United States Congress and ensure that 
that doesn't happen.
  Let me also take note of the federally qualified health care clinic. 
I'm excited about that. I debated this some years before when we were 
talking about trying to put more funding into the legislation to 
increase the number of federally qualified health clinics even before 
this health care bill because for a long time, these clinics were not 
even known about. But the idea to be able to walk out your front door 
and walk down your block and go to a health care facility that is not 
an emergency room will make an enormous difference on the healthiness 
of Americans, preventative care.

[[Page 10590]]

  Right now I am, in my community, assessing different locations in my 
congressional district that a federally qualified health clinic would 
be suitable; the population, the partnership, 501(C)(3)s, and 
petitioners who would want that to be in their neighborhood. I'm 
excited about it. And I'm excited about the Martin Luther King Center. 
That is a health clinic that I helped fund so many years ago when their 
doors were about to close. They are not only open today, but they have 
sprung two more Federally qualified clinics in order to be able to 
serve the public. This is a good investment.
  As was indicated earlier, our small businesses will finally be able 
to spell the word relief, r-e-l-i-e-f. They will be able to say, I will 
be able to not only pay for the owners, but my employees will be able 
to get insurance, and that is a great mechanism. And we should not let 
anyone, in essence, dump on our parade. We should not let anyone 
miscalculate or mischaracterize, if you will, how much of an impact the 
small business tax exemption will be for those small businesses to 
allow them to be able to provide health insurance for their employees.

                              {time}  2030

  Small businesses are the backbone of America. They are probably the 
largest employers of the American economy. They want to provide 
insurance for those mothers and fathers who work for them every day, 
who are committed and dedicated--sometimes they are mothers and fathers 
with family businesses--and now they will be able to do so, and I 
believe that is very important.
  The doughnut hole was the most horrific vote that was taken here in 
the United States Congress some years ago, which was for Medicare part 
D. We lasted on the floor of the House until 6 o'clock because our 
friends on the other side of the aisle could not get a vote until they 
squeezed it out of some of our colleagues. It was horrific. For those 
who don't understand it, it means that you pay for your prescription 
drugs, which are going through the roof, until you, as a senior, fall 
in the hole because you've gotten a catastrophic illness, and they will 
wind up paying for you. What an atrocity. We're going to close that 
hole in the next 2 years.
  As well, right now, seniors should be receiving $250 checks in their 
hands. We recognize the undermining of your health care because of 
Medicare part D. First of all, it was unrealistically expensive, and 
certainly, it was a plan that we Democrats have indicated was a wrong-
headed decision. Obviously, we have been proven right. Part of our 
deficit, which was spoken so loudly about by the other side of the 
aisle, was caused by Medicare part D, and the large majority of our 
party, our caucus, voted against it. Really, it was a wrong-headed 
direction to take.
  Here is another negative that the naysayers would say: well, you can 
hardly get into doctors' offices today. How are you going to get into 
their offices now? They're standing in line. I'm afraid that I'm not 
going to be able to see a doctor.
  They were scaring seniors with that kind of information. Well, I 
think that when people are inclined to serve, there is a great deal of 
love and affection for the medical profession. Yet one of the reasons 
we don't have the numbers is that we have not been able to give people 
opportunities. It is very expensive training, so we will be engaged in 
providing resources to train nurses, nurse practitioners, and 
physicians. We will actually have resources to give young people who 
want to go into that profession.
  I spoke at the High School for Health Professions in my district. 
They have a diverse student body, but many of them are not going into 
the health profession. Yet many are, and more would if they had the 
resources to do so. So we are excited about that.
  As I focus on closing on some of these points, let me quickly bring 
something in that you might not think is related to the health care 
bill, but it is. The BP oil spill is plaguing the gulf coast. More 
importantly, there is human devastation, if you will. There is the 
devastation of not working in the shrimping, fishing and oyster 
industries. There are some energy industry workers who are now not 
working as well. All of those individuals were probably living off 
their salaries or off the revenue that they brought in day to day and 
month to month. I would imagine that some of those individuals did not 
have health insurance. They might have even been paying a fee for 
service because they made choices of putting money into businesses as 
opposed to into health care. Well, now we have an opportunity for these 
individuals, if they are at risk, to either go into a high-risk pool or 
to prospectively be able to go into a health exchange to be able to get 
the most cost-effective health insurance that they might be able to 
get.
  With that in mind, I would like to indict, if you will, those States 
for refusing to get into the health exchange program, like my State, 
which has the highest number of uninsured, as evidenced by Dr. Oz, who 
came to Houston, but also as evidenced by the data that says that Texas 
needs opportunities for people to be insured. So I would hope that we 
would have the kind of energy and excitement around this idea of the 
health exchange so that States would have to engage in it because the 
people would rise up and would say that they wanted it.
  Of course, under this bill, hospitals which have been facing 
increasing costs with no compensation now will have the opportunity to 
be paid for uncompensated care. We hope those numbers will go down now 
because, obviously, if they go down, it will mean more people will have 
gotten their own insurance; but just in case, these hospitals will have 
that.
  I want to close on these last two points which I think are unique to 
the Congressional Black Caucus. One is to express great applause to the 
CBC Health Care Task Force with Dr. Donna Christensen and to the Tri-
Caucus health effort, because out of that effort came the very 
important language on disparities or on the continuing work on 
disparities that we see amongst our minority population, such as with 
regard to diabetes, kidney failure, heart failure, and such as with 
regard to devastating breast cancer. These are elements that are 
clearly as a result of disparities that were not addressed, and I think 
we will see more opportunities for clinicals where minorities will be 
used so we will be able to find causes and will begin to find cures for 
some of these devastating diseases in the minority community.
  Lastly, our work is yet unfinished. I worked very hard on the issue 
of physician-owned hospitals. Many of us thought that the passage of 
the bill was worthy of our looking down the road and of our making sure 
that we would cure that problem. It is a serious problem because these 
hospitals were stigmatized as hospitals that were all for-profit and 
not for service. I know for a fact that the hospitals that are in the 
State of Texas which hire or which have at least 40,000-plus employees 
are serving their constituents with OB/GYN and with full service care. 
One of the hospitals in my district was the only hospital that had a 
wing dedicated to H1N1 when it was rampant here in the United States.
  I am looking forward to the leaders of these hospitals having the 
opportunity to come back to Washington to sit down with our leadership 
and to talk about making sure that these hospitals are not 
discriminated against as it relates to Medicare reimbursement. Some 
language allows that to happen in the bill, but it is a very peculiar 
formula that may not match all of the needs of the constituents who 
need to be taken care of by these hospitals.
  So I thank the distinguished gentlelady from Ohio for her constant 
leadership. She has a great medical community in Cleveland, a community 
that certainly was engaged in this process of putting together this 
very, very strong health care reform bill, historic in its own efforts; 
and I thank her for her leadership.
  My final words are: it is never easy to make hard decisions. We said 
that as we debated and as we compared this to the 1964 Civil Rights Act 
and to the 1965 Voting Rights Act. There were

[[Page 10591]]

many in their home districts who threatened them for taking that vote. 
Where would America be today if we had not taken the strides to break 
down the shackles of discrimination to allow all Americans to vote? I 
hope and I pray and I believe that we will have the same opportunity to 
look back on history in 2010 and will be able to say how we have 
changed the lives of Americans and how we have saved the lives of 
Americans.
  With that, I yield back to the gentlelady, and I thank her again for 
her leadership.
  Ms. FUDGE. I thank you.
  Mr. Speaker, I just want to again thank my friend and colleague, 
Representative Sheila Jackson Lee, for her insight and for her 
knowledge, obviously, of the bill as well as for her ability to connect 
with the American people.
  I thank you for joining me this evening. It is always my pleasure.
  Mr. Speaker, again tonight, we are going to focus on the benefits of 
the health care reform that Americans are experiencing today. When it 
comes to health care reform, what is now called the Patient Protection 
and Affordable Care Act, I truly believe history will show those of us 
who supported it did the right thing, and we are already seeing 
evidence that our courageous act is positively impacting Americans.
  I am extremely proud that Congress took the task of closing the 
doughnut hole for seniors. The doughnut hole has, in many instances, 
become the black hole because, for some seniors, the uncovered 
prescription costs never end. Fortunately, that is about to change. 
Beginning in 2011, seniors in the doughnut hole will receive a 50 
percent discount on prescription drugs. By 2020, the doughnut hole will 
be completely closed. I know that many seniors cannot afford to wait. 
To ease the burden, Medicare recipients will automatically receive 
onetime $250 checks to help them with prescription costs. Some of those 
checks have already been received. I know that this is a modest step, 
but it is the beginning of our commitment to improve Medicare for our 
seniors, and I am very happy to see that it has started helping some of 
the 97,000 seniors in my congressional district who receive Medicare. 
Making prescription drugs more affordable for seniors is only one of 
the many benefits for seniors included in the recently enacted health 
reform law.
  Other benefits for seniors include free preventative care services. 
So, if you need screenings or if you want your physical examinations, 
all of those things become free, and all of those things become free 
under Medicare beginning in 2011. Extended funding for Medicare is 
going to be there through 2029. There is going to be increased access 
to doctors, and we will have expanded home- and community-based 
services to keep seniors in their homes instead of in nursing homes.
  I am also pleased that Americans without insurance and those who have 
been denied insurance due to preexisting conditions can now sign up for 
immediate access to health coverage. This will be done through a 
temporary high-risk pool until the exchanges are up and running in 
2014. This will be a great relief for Americans.
  Small businesses are receiving tax credits to assist in providing 
employees with health coverage. As a result of the health care reform, 
the Federal Government now offers tax credits of up to 35 percent of 
the employer premium contributions for those small businesses that 
choose to offer coverage. Beginning in 2014, those tax credits will 
increase to up to 50 percent of employer premium contributions.
  Beginning in September of this year, of 2010, just in time for the 
start of the fall semester for college, young adults will be able to 
remain on their parents' insurance plans until age 26. The best part is 
any young adult without employer-provided insurance will be able to 
remain on their parents' insurance plans up to age 26. The young adults 
need not be enrolled in college. He or she does not even have to live 
in the same State as his or her parents. Parents only need to contact 
their health insurance companies to enroll their children.
  Also, our young adults, including former foster youth, will be able 
to pursue their educations and start their careers without the fear of 
unexpected medical bills hanging over their heads. Finally, these young 
people will have access to medical care without fear that they will 
have bills they cannot afford.
  Further, Mr. Speaker, in September, we will also respond to the needs 
of younger children. Beginning on September 23, the unfair and 
discriminatory practice of denying children health care due to 
preexisting conditions will end. No more will insurance companies 
determine that children who face medical hardship don't deserve 
affordable health care. No more will private industry decide which 
children deserve care and which do not.
  I held multiple town halls on health care prior to the passage of the 
bill, and I was moved by the many stories I heard. One in particular 
came from a father who was barely able to afford health care for his 
son who suffers from sickle cell anemia. The insurance company found 
sickle cell to be a preexisting condition, and as such, the only 
insurance he could find was astronomical in price. He could not afford 
it. I am proud that this Congress remedied the situation for this 
father, who only wanted to give his son a shot at a healthy future.
  On September 23, insurance companies will be banned from capping the 
amount of money they will spend on a patient's care. One of my 
constituents, whom I will call Mary, is especially excited about this 
particular provision. Mary has been paying for health care insurance, 
as well as for catastrophic health care insurance, for many years. She 
does this in case she hits the lifetime limit. She saw her own brother, 
who has brain cancer and no health insurance, inundated with medical 
bills well in excess of $60,000. She lived in fear that that might 
happen to her, so she wanted to be sure that she was prepared. Just out 
of fear that an unpreventable or unexpected illness will force her into 
financial hardship, she prefers to be safe rather than sorry. Mary has 
maintained a policy with a $25,000 deductible--yes, I did say a $25,000 
deductible--just to be sure she doesn't fall into medical bankruptcy. 
For her, the countdown for September 23 can't come soon enough.
  Beginning on October 1, there will be increases in funding for 
community health centers to allow for nearly doubling the number of 
patients served over the next 5 years. For those in Ohio, you can find 
a community health center near you just by calling 211. There will be 
scholarships for medical students. There will be new scholarships for 
loan repayment programs that will be available for doctors, for nurses 
and for other health care providers who work in underserved areas. To 
those listening in the 11th District at home, to find a scholarship, 
visit National Health Service Corps' Web site at nhsc.hrsa.gov. Again, 
that is nhsc.hrsa.gov.

                              {time}  2045

  Next year, in 2011, a public option for long-term care insurance will 
become available. Further, in 2011, insurance companies will be 
required to spend 80 to 85 percent of all premiums received on patient 
care or provide a rebate to customers. Insurance companies can no 
longer just take inordinate sums of money and put them in their pocket 
and have nothing to show for the care that they have given to the 
people who have paid these premiums. Now they must spend at least 80 to 
85 percent on care. In 2011, Medicare patients will receive free 
preventive care.
  As President Obama rightly noted, passing health care reform is just 
the first step. Implementing it in an effective, accountable way is now 
the challenge and our goal. I am honored and privileged to have voted 
for health care. We need to remind ourselves reform was necessary and 
why we fought so hard to insure all Americans.
  I want to share the story of a constituent who was diagnosed with 
cancer when he was almost 15 years of age. This young man--we will call 
him Steve--should have been worrying about getting his driver's license 
or what he was going to wear to the

[[Page 10592]]

homecoming dance or excelling in school. Instead, he was concerned for 
his very basic survival. Steve and his family were told he only had a 
15 percent chance of living because he had a softball-sized tumor which 
had grown in his ribcage and into his spine. Luckily for Steve, he 
lived in the Cleveland area. He was being treated at Rainbow Babies and 
Children's Hospital in Cleveland, which is one of the leading pediatric 
hospitals in the world. Rainbow Babies is a world-class facility and 
cares for patients around the world.
  The doctors, nurses, and support staff at Rainbow worked miracles on 
this young man. He had intense chemotherapy and spine surgery, which 
shrank and ultimately removed the tumor. His bones, which had been 
eaten away by the aggressive cancer, were replaced with titanium rods. 
And he started on an 8-week path to learn how to walk again, a 
remarkable feat which, at 15 years of age, is something that few would 
have the emotional and mental maturity to handle, let alone the 
physical capacity.
  Despite the expert care, continuing radiation, and chemotherapy, it 
was not enough to prevent the relapse that occurs to a majority of 
patients diagnosed with this cancer. Within 4 months, Steve had to 
repeat the process of removing yet another tumor. The tumor was removed 
by Rainbow Babies. Thankfully, this particular type of cancer did not 
return.
  Steve would go on with his studies and graduate high school and stay 
close to home and go to John Carroll University in University Heights. 
His life was starting to get back on track, especially for an 18-year-
old. He was still worrying about school but adjusting to college life 
and figuring out what it means to be a young adult. But just as Steve 
had started his new life, he received devastating news. He was 
diagnosed with a new and different type of cancer called acute myeloid 
leukemia, or AML. AML is a blood cancer that required him to have a 
bone marrow transplant. An anonymous donor and doctors at Rainbow saw 
him through a successful operation. And thanks to them and the 
resilience of his family, Steve is now a robust young adult, physically 
and mentally ready for the challenges that come to college students.
  The story of Steve's resilience and his doctors' skill and 
persistence is a heroic one that can serve as inspiration to all of us. 
But what makes this story most notable was that much of it was done 
without the basic protections that should be guaranteed to minors by 
health insurance.
  Steve had exceeded his lifetime insurance limit during his third bout 
of cancer and, as a full-time student, he was ineligible for his 
parents' insurance. Steve sums up his own feelings about health care 
reform with this quote. He says, If you voted for the health reform 
bill, thank you, because for other kids, teens, and young adults like 
me, you solved two problems this year: one to prevent insurance 
companies from having lifetime maximums, and allowing young adults and 
teens to remain on their parents' coverage until age 26, even if they 
are not enrolled in postsecondary education.
  A story like this, Mr. Speaker, will never need to be repeated again 
in this Chamber, and that's because of health care reform. I am, again, 
proud to have been one of the persons who voted in this House to save 
the lives of so many.
  With that, Mr. Speaker, I yield back.

                          ____________________