[Congressional Record (Bound Edition), Volume 157 (2011), Part 1]
[House]
[Pages 479-486]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       THE REPEAL OF HEALTH CARE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 5, 2011, the gentleman from Vermont (Mr. Welch) is recognized 
for 60 minutes as the designee of the minority leader.
  Mr. WELCH. Mr. Speaker, we appreciate the time for this Special Order 
of 1 hour to discuss the repeal of health care. And this legislation 
which passed today is the triumph of the Republican victory in the 
elections. And the Republicans ran on a campaign platform of repealing 
ObamaCare, as it was called and vilified, and today accomplished that 
goal.
  ObamaCare became a vilification of health care, really a caricature 
of what was in the bill. It became a million different bad things to a 
million different people. But the moment the campaign is over and the 
partisan political points have been put on the board, each of us who 
has been elected, Republican or Democrat, has the responsibility to use 
our office to make pragmatic progress for the American people.
  And the purpose of our Special Order tonight is to explain in 
concrete detail what the American people lost and will lose if the 
repeal is ultimately successful. We have a number of my colleagues here 
to join us. And to start it off for us is one of the senior members of 
the Energy and Commerce Committee, a leader in health care reform and 
elements of the health care reform that have broad bipartisan support, 
Representative Eshoo from California. I yield her such time as she may 
consume.
  Ms. ESHOO. I thank my colleague for organizing this evening. And I 
rise to talk to whomever is tuned in this evening to tell some stories. 
I think stories are really what relate more than anything else to what 
is going on in the lives of our constituents and the American people.
  I want to take people back several years. It was 1996. I was a fairly 
new member of the Energy and Commerce Committee. And after having had 
meetings in my district with people in the disabled community, I 
learned something that I didn't know, and I shared it with many other 
Members of Congress. They were not aware of it. I don't think the 
general public was

[[Page 480]]

aware of it. And it was the following. And that is that buried in the 
fine print of insurance policies, in this case health insurance 
policies, was a cap on lifetime limits of benefits.
  Now, that doesn't sound too menacing to begin with. But just think if 
any one of us, God forbid, were in a horrible automobile accident. We 
have seen what has happened to our colleague in Tucson, and the bills 
that are attendant to that kind of high-end of health care.

                              {time}  1910

  Certainly people in the disabled community understood this very well. 
So the more I probed, the more I learned.
  Meanwhile, the actor, wonderful, optimistic and superb actor, 
Christopher Reeve, had endured a terrible, terrible accident as an 
equestrian. I think everyone remembers that; and they remember the 
courageous battle that he waged, not only for more research to be 
invested in our country, but the hope that stem cell research held. But 
he also understood this whole issue of limits in an insurance policy on 
total benefits that would be paid for by the insurance company.
  And so it was at that time, 1996, that I introduced legislation to 
lift the lifetime limit on the caps, on the ceiling in health insurance 
policies. That effort has been going on since 1996. In 2010, the 
Democrats saw fit to place that legislation into the health reform bill 
that has become law.
  So today, the law of the land right now, January 19, 2011, at 7:10 
p.m. eastern standard time, no one has a limit on their benefits in 
their life insurance policies. So if someone is in a terrible accident, 
that won't be held against them. If someone has a chronic illness, a 
chronic illness with cancer, with whatever one might name, that will 
not be held against them.
  I tell this story because we have heard some tall tales, some tall 
tales about what the health care legislation, now the law, contained. 
More than anything else, what the legislation is about is addressing 
what happens to people in their day-to-day lives, the stories that our 
constituents have told us.
  I want to tell you another story. This is from Elaine from the town 
of Los Altos, California, in my district. This is what she wrote to me: 
``This is the first time I have ever written to any government 
representative on any topic in my 50 years of existence.'' Elaine was 
diagnosed with breast cancer in 2006. It's a disease that we are all, 
all too familiar with. One in eight women will develop breast cancer in 
her lifetime.
  Elaine wrote: ``Normally, when I feel that a service provider is 
price gouging or in any way treating me unfairly, I take my business 
elsewhere. This is what I did with my auto insurance, and this is how 
market forces are supposed to work.''
  But Elaine couldn't do that because so few insurers would even take 
her. Most of them would not go near her.
  The health insurance market, in my view, in so many of my 
constituents' view, has really failed our country.
  We believe in markets. We believe in strong markets. We believe in 
competitive markets, but we don't believe that a market should be part 
of crushing human beings in terms of the rules that they write.
  Elaine saw her rates increase by 94 percent over a 13-month period.
  Let me repeat this: Elaine saw her rates increase by 94 percent over 
a 13-month period.
  What Member of Congress can endure this?
  And I have to say that those that have fought the hardest against 
this bill, now the law, are taking their health care coverage from the 
government as a government employee.
  Now, I am proud to be part of my government. I will never run away 
from that. I am proud of what I do. I am proud of my profession. I 
always want to be uplifting to it. But I don't think that there is room 
for hypocrisy in this. These are great needs. Yes, Members of Congress 
have insurance coverage. And the way that we designed the bill was so 
that the American people could get what we have, to get what we have.
  Look and listen to what Elaine is saying. Elaine's gross income 
increased only 4 percent as her insurance rates increased by 94 percent 
over a 13-month period. I don't think that this is sustainable, not for 
any working person in this country, not for any community and certainly 
not for our Nation and our national economy.
  Health care represents a major sector of our national economy, and if 
we don't do something, as we did, about the rising, spiraling costs and 
the effect that it has on families and individuals, it will really tear 
them apart and bring them to their knees financially. So I am very 
proud of the vote that I cast on behalf of my constituents.
  Was the bill complicated? Absolutely. For those that say it was a 
long bill, they have voted for plenty of trade bills around here, and 
the trade bills are 4,000 pages. I wonder if they have read that.
  But this one, this one lands in the middle of a family so that they 
don't have the panic at night or the cap on the benefits if they are in 
a terrible accident, like Christopher Reeve, God rest his soul, or 
Elaine, in my district, that told her story to me.
  Elaine's health is not a commodity that can be bought or sold on the 
open market. She doesn't have the option to go without health insurance 
if prices get too high. For Elaine, this is an issue of life or death.
  So today I found it to be a rather sad day that any Member of 
Congress would stand on this floor and, with a sense of glee, say we 
are going to repeal the progress that America made.
  For the first time in the history of our country, the Congress passed 
comprehensive health reform for every single American. That, to me, is 
a great source of pride. I think it is to Elaine; and I think if 
Christopher Reeve were here, he would say ``bravo'' as well.
  So thank you to my colleague, Mr. Welch, to all of my colleagues that 
care so much about this that have worked so hard on it and will work to 
defend this. This is for the American people. I think that they deserve 
to be rewarded.
  They work hard; they play by the rules. No one should be crushed by 
unfair rules.
  Mr. WELCH. I thank the gentlewoman from California.
  The story that Congresswoman Eshoo told is making very real what the 
consequences are of taking away from families benefits that they have 
and now depend on.
  Just a quick story about Vermont, to make it, again, real. A woman by 
the name of Donna, from Plainfield, Vermont, a hard-working person, she 
and her husband both work. Their young son graduated from school, got 
an entry-level job that paid $8 or $9 an hour. And as the case with 
most entry-level jobs, it came without health care.
  That child was no longer eligible to stay on his parents' policy, and 
they were doing all they could to pay their bills. Health care is 
expensive. They couldn't afford to buy a separate policy for their son. 
And most of the time that works out, but sometimes it doesn't, and it 
didn't in this case.
  Their son had a car accident, $20,000 in medical bills. They are 
still paying those bills off.
  When we passed the health care bill that included the provision that 
sons and daughters who were starting out in life, taking that first 
job, usually without health care, but learning job skills, fiscal 
discipline, personal responsibility, the worst, the bill we passed 
allowed those kids to stay on our policies until age 26.

                              {time}  1920

  It makes an enormous amount of sense in the peace of mind it 
provided. That assurance to Donna relieved her, her husband, and their 
son of all this anxiety about whether they'd have the health care they 
needed in the event of an accident. The action today by this Congress 
led by the new majority takes away from Donna, her husband, and their 
son their access to affordable health care. It didn't need to be done. 
And the question I think all of us have to ask is why?
  There are elements of the health care bill that are imperfect. Let's 
improve

[[Page 481]]

them. There are elements that are very controversial. The individual 
mandate is controversial, and we have to acknowledge it. I supported 
it, and I'll tell you why. I believe that if everybody is going to have 
access to health care, and the vast majority of this country believe 
that's the case, then all of us should share in the responsibility of 
paying for it, on the ability to pay. That's why I supported the 
individual mandate, because folks who don't have insurance don't go 
forever without having the need for health care services. And most 
States are like Vermont. If somebody gets hit by a truck, the rescue 
squad shows up, and they take that person to the hospital. The hospital 
may inquire about insurance, but they don't condition providing full 
and extensive care on whether that person has insurance or doesn't. And 
that cost gets shifted on to the taxpayer. That cost gets shifted on to 
those who do have insurance in the form of higher premiums. So this is 
real what happened. The consequences to families are real.
  I would like to yield to the Member from New York, also a leader on 
health care, Congresswoman Clarke. Thank you for joining us tonight.
  Ms. CLARKE of New York. Thank you, Peter Welch.
  Mr. Speaker, I just find it so interesting that here we are in the 
new 112th Congress and in the wealthiest Nation on the planet where 
nearly 50 million Americans still lack health care insurance, 13.5 
percent of which are New Yorkers. Last year alone, New York City's 
hospitals spent $1.2 billion in charity cost. You see, in a city like 
New York, we're going to make sure that at the moment that people are 
most vulnerable, in an emergency, they're able to receive health care. 
But it has cost us $1.2 billion in charity costs.
  Tragically, people who are either uninsured or underinsured often 
have to go without the vital health care services they need simply 
because they can't afford it. Every American has a human right to 
adequate physical and mental health care, and I believe that government 
has a responsibility to assist its citizens in securing quality health 
care. That's why I've been such a fervent supporter of the Patient 
Protection and Affordable Care Act which passed the 111th Congress, 
because it does just that. It ensures that Americans have access to 
quality health care, and it makes sure that we begin an enlightened 
process of preventive care, which is the least expensive way of our 
being able to meet our health care needs.
  Repealing this bill would mean that insurance companies will, once 
again, be able to drop coverage for people when they are ill, exactly 
when they need that coverage the most. It will mean that kids with 
preexisting conditions will be denied coverage once again. It will mean 
that insurance companies would again be able to impose devastating 
annual and lifetime caps. And it would mean that young people will no 
longer be able to stay on their parents' plan until the age of 26. It 
would mean that pregnant women would be denied coverage simply because 
they are pregnant, since pregnancy is considered a preexisting 
condition and therefore a basis for denial of coverage. And finally, 
our seniors, who face an increase in their prescription drug costs 
because they would be thrown back into the Medicare part D doughnut 
hole which the health care reform law would close by 2020.
  With all that has been discussed about the virtues of health care 
reform, all that has already been implemented as a part of the health 
care packages of constituents in my district, people are recognizing 
how earthshaking and groundbreaking this legislation has been.
  I would like to share with you a letter that I received from one of 
my constituents in the 11th Congressional District. His name is 
Jonathan. He says, Congresswoman Clarke, I am a two-time cancer 
survivor. I'm constantly worrying about being denied coverage because 
of my preexisting condition. I'm not comfortable that corporations 
under the old rules would have considered me unprofitable. I think it's 
a disgrace that this problem has existed in our country. I for one will 
move to Canada or elsewhere if health care reform is repealed and if I 
ever have a reoccurrence of my cancer. Meanwhile I think it's every 
American's responsibility not to allow other people with preexisting 
conditions to be denied coverage.
  You see, Jonathan is not just thinking about himself. He recognizes 
that like himself there are millions of Americans across this country 
who may not have options of mobility to leave the country to seek 
health care but who need this legislation to go into full effect. And 
that's what we are here discussing today, the essence of what this 
legislation means for Americans across this Nation.
  One thing about health care insurance, you often don't know what you 
need until you need it. And because there are individuals in our civil 
society, and many have referred to them as the invincibles, young 
people who are young, vital, physically fit, one tends to look after 
their health care after the fact. Well, we want to do a paradigm shift 
in this Nation where it brings down the cost of health care insurance. 
That means that every year we go through an annual physical. We know 
how our body is operating, and we are clear on that. And if by chance 
we develop a need or we're in a catastrophic accident of some sort, we 
have the coverage that will not allow us to go into bankruptcy. That's 
all that any family can truly ask for. And that's what we congratulate 
the last Congress on accomplishing.
  What was displayed here today really was not forward leaning or 
forward thinking. It's our hope that the Senate won't even take this up 
because right now we're hearing from seniors who are saying, already we 
are looking forward to the support we can get for the prescription 
drugs that we need to address our chronic disease.
  So as Jonathan noted in his letter to me, this repeal would once 
again allow big insurance companies who are only focused on 
profitability to deny coverage to him and so many others with 
preexisting conditions. I don't think we're going to allow Jonathan to 
be punished and denied coverage simply because he's a cancer survivor, 
and that's what repealing this health care law would do.
  So I want to thank my colleagues for promoting this Special Order 
today and making sure that our voices are heard and the voices of our 
constituents are heard, who are really in favor of this legislation, 
this law of the land, actually, going into full maturity. Because as 
this law matures, more and more Americans will be covered, their 
families will be more secure, and we will be all the more healthier for 
it as a civil society.
  I want to thank the gentleman from Vermont, Peter Welch, for 
anchoring this Special Order this evening.
  Mr. WELCH. I want to thank the member from New York. You talked very 
eloquently about preexisting conditions. And who of us doesn't have 
one? There was an article in The Washington Post today that said about 
65 percent of Americans have preexisting conditions. So if the 
insurance companies are able to deny people coverage on that basis, 
it's a tremendous business model for them. They insure folks who are 
healthy, that's great for the shareholders, but it doesn't do much for 
most of us, the majority of Americans who have a preexisting condition. 
So thank you for focusing on that real provision in the bill.
  I'm going to yield in a moment to the Member from Maryland. We have a 
number of Members here, so maybe we can be interactive.

                              {time}  1930

  But one of the things that I was going to ask you was on this 
question of preventive care. When we were considering this bill, I 
called Tom Huebner, who is the administrator of a local hospital, 
Rutland Regional Medical Center; and he had a lot of reservations about 
the health care bill, whether on balance it was good or bad. He decided 
on balance that it was good.
  But one of the things that he said very specifically was that the 
free preventive care for seniors is absolutely

[[Page 482]]

essential. It was essential for their good health, and it was essential 
for bending the cost curve because folks do not come in if they don't 
have the way to pay for it. That was him talking to me telling me about 
the Rutland population. Whatever your remarks are, Member from 
Maryland, I am wondering if that is consistent with the experiences you 
have had in your district.
  Ms. EDWARDS. Well, I thank the gentleman. I think that is right. You 
look at so many things that can be prevented if only people were able 
to get their preventive care.
  Today what we did in this House, what the majority did in this House, 
is so sad, taking away the ability of senior citizens to go in for an 
annual checkup and make that early discovery and diagnosis of diabetes 
or hypertension or any of the markers for those chronic illnesses that 
if treated early can actually save all of us a lot of money, all of 
those seniors a lot of grief, and really be good for the system.
  And so when I think about what we did today, I think of the millions 
of Americans all across this country who every day are discovering a 
new benefit that is now available to them because of the new health 
care law.
  I think it is important for us to remind the American public that the 
Affordable Care Act isn't a bill, it isn't an idea, it is not a 
proposal. It is the law. Today the law is that if you are up to age 26 
that you can stay on your parents' health insurance plan. The law of 
the land today is that if you are a senior and you are paying out-of-
pocket costs to the thousands of dollars for your prescription drugs, 
those drugs that fall in that prescription drug doughnut hole, you will 
receive a 50 percent discount on those drugs.
  The law of the land is that you can't be excluded for preexisting 
conditions. Now, the gentleman from Vermont talked about preexisting 
conditions, as did the gentlewoman from California. It is so simple. It 
is true, almost not a one of us is without a preexisting condition. 
Well, the law of the land, despite the sadness of what happened in this 
House today, is if you have a preexisting condition and you are under 
age 18, that you will actually be able to receive health care insurance 
for that. And as we go through implementation, that you will be able 
to, whatever your age and preexisting condition, you will not be 
excluded from receiving your health care.
  The law of the land today is that small businesses receive a tax 
credit for providing health care to their employees--35 percent last 
year when the law was started, 50 percent this year. That's the law of 
the land.
  And so I am glad to be here with our colleagues. I don't want to 
overplay the sadness that happened in this House today because there 
was a lot of business about taking care of campaign promises and 
meeting artificial goals. But the fact is that last year we passed the 
health care law. It is being implemented right now, and that's the law 
of the land. And thank goodness for the millions of people all across 
this country who have the security in knowing that not only do they 
have access to quality, affordable health care, but that that applies 
all across this country.
  Mr. WEINER. Will the gentlelady yield on that point?
  Ms. EDWARDS. I will.
  Mr. WEINER. If I can just point out something, a lot of people look 
at this through the lens of their personal experience. Perhaps people 
watching this say, You know what, I have health insurance, I like my 
health insurance and I don't have a preexisting condition. Why should I 
really care about those who do?
  Well, I think you understand this, but I think many of our Republican 
colleagues don't. We wind up paying as citizens one way or the other. 
You know, we had awhile ago this H1N1 flu outbreak. Now, if someone has 
a choice and health insurance coverage that allows them to get a 
regular checkup and get doctor's screenings and get medications and 
given an idea what they should do to treat that, is it better or worse 
if they don't have insurance and they get on the bus in the morning and 
they wind up in a hospital emergency room and take you and your kids 
with them?
  The fact is it is not whether we are going to pay for health care; it 
is how we do it most efficiently. My Republican colleagues don't seem 
to understand this very basic idea that they talk about we should have 
choice. Nobody chooses to be born with cystic fibrosis. No one chooses 
to have a child that is born with asthma.
  I don't care how much you believe in the free market, when God 
strikes you with those afflictions and you need care, the only question 
then becomes how do we provide the care that is most efficient. Right 
now if people don't have insurance and they fall down or they get hit 
by a bus, God forbid, and they don't have the ability to pay, it is not 
as if there is some magical force out there that absorbs those costs.
  We wind up paying it. Everyone who has a health insurance policy 
winds up paying it. We in New York, and Congresswoman Clarke made the 
point about New York, we pay $8 billion in additional taxes. So it is 
just a matter of how we do it, and it comes down to a very simple idea: 
it is less expensive to give people a subsidy so they can buy insurance 
than it is to pay for them in emergency rooms. It is cheaper that way.
  So it is just a matter of how we choose to do it, and I think when 
you point out the fairness and the decency as Americans that we have 
when we provide the care, it is also doing a favor for everyone who has 
insurance, and every taxpayer in this country.
  So even if you don't buy into the idea that we should be altruistic, 
and we fundamentally believe, and I believe this is a fundamental 
difference between the parties, we don't believe you can get too far 
ahead as a country when you have so many, 30-some-odd million people 
without health insurance. We don't believe you fundamentally can. There 
are more people taking time off from work. Every single product we buy 
has more cost because of our health care failures. That is the 
difference between Republicans and Democrats. We believe those things 
out of a sense of compassion.
  But even if you just look at the economic bottom line, you should 
want to provide people with preventive care. It makes the most sense. 
It saves us money. It saves every American who has insurance money, and 
I want to thank you for pointing those things out.
  Ms. EDWARDS. I thank the gentleman. I am going to finish up because 
we have other Members who want to speak on this really important issue.
  I want to say in closing, today I began with a story of a young woman 
who is very close to me. Her name is Annie. She is such a delight. 
Well, in the spring she was diagnosed with leukemia. She will be 28 
years old in February. When she was diagnosed, she had health 
insurance; but what she realized and her family realized right away was 
very quickly, as she was approaching trying to get a bone marrow 
transplant and all of the attendant costs that are associated with 
that, that without the change that we made in the health care law, 
maybe her parents would have to give up their retirement fund; maybe 
they would have to sacrifice their home because they wanted to save 
their daughters's life because she would have bumped up against those 
lifetime limits.
  And so what we did in the 111th Congress in passing a health care law 
is we said to young people like 28-year-old Annie that we are committed 
to making sure that she has the ability to take care of her health and 
to save her life. That is what this is about. It is about real people. 
It is about their lives, and it is about our obligation that we have to 
one another.
  I thank the gentleman for organizing this Special Order this evening.
  Mr. WELCH. I thank the gentlewoman from Maryland.
  In order that we can allow all Members to speak, I am going to yield 
to my colleague from Texas; but if there are any inquiries by Members 
who are present and want to engage in a dialogue, I encourage you to do 
that.
  Ms. JACKSON LEE of Texas. I thank the gentleman from Vermont, and I 
am

[[Page 483]]

just very pleased to have heard my good friends from New York, Ms. 
Clarke and Mr. Weiner, and my good friend from Maryland. I hope this is 
a comforting Special Order because even as we speak, I think it is 
enormously important because people look at this because they saw a 
debate and they saw a vote, and now we are here on the floor of the 
House. I want them to know this bill is the law of the land. What we 
are trying to explain to them is the potential devastation of that bill 
being repealed.
  The good news is that this was a payback to those who voted for my 
good friends on the other side of the aisle, Republicans, and we 
understand that. But lives are involved. To the distinguished gentleman 
from Vermont, lives are actually involved. I just have a few points 
that I want to characterize this debate as and to give people comfort 
that we are still fighting for this law. This law is in place.

                              {time}  1940

  Right now, the elimination of lifetime caps: you can still use this 
bill.
  The idea that seniors, some 40 million of them, beginning in January 
2011 will begin receiving savings on preventative care services: you 
can still use this. This is very important, the 50 percent discount. If 
anybody had an earful from the seniors, it was the doughnut hole. At 
every senior citizen center you go to, they're talking about the 
choices I have to make between food and rent and prescription drugs. I 
want them to know the law is still in place.
  I know there was a debate on the floor of the House. I know there was 
a vote, but it should be well known that Democrats put up an able 
fight. More importantly, we know that our President will be working to 
preserve the law that exists. That's very important.
  In having listened to a gentleman by the name of Ed, first name Ed, 
who has a chronic disease--hemophilia--he told a very important story 
of how he and his brother grew up with that and how he lives well today 
because of the fact that we have passed the elimination of lifetime 
caps. So he can be treated. He can work. He has insurance.
  That is why when people ask, How does this impact me? Those of you 
who have insurance, we are not taking it away from you; but I assure 
you you have lifetime caps.
  What about the young woman and her son who came to my town hall 
meeting who said, in tears, Congresswoman Sheila--whatever they call 
me--we had insurance. We went to a doctor for a physical for my son who 
had to get a physical to get into school--every child has to get a 
physical at the beginning of the school year--and the doctor turned me 
away and said, Your insurance only covers emergency room.
  We won't have that kind of half-baked insurance anymore.
  So I quickly want to do this, Mr. Welch. There was a big discussion 
about the constitutionality of this bill, and I got into another big 
discussion with one of our wonderful pundits who wanted to argue about 
whether someone would die without this health insurance.
  This is a Medicare patient, or someone who is using Medicare. It 
indicates that she spent the week of New Year's of 2008 in an emergency 
room, and then was confined to her home for weeks because she developed 
pneumonia. She says she had never been so sick in her life. The good 
news was, in 2008, she had a government-run health care provision, a 
Medicare program, that allowed her to discover her sickness and to be 
treated.
  Her very words: For a time, I was so sick I was afraid I was going to 
die. Then I was so sick I was afraid I wouldn't, and I was miserable.
  The real question is: even though she is a senior, this government-
run program allowed her to get care, and she didn't die. Sometimes 
walking pneumonia, as everyone knows, is not anything to play around 
with.
  Why are my friends on the other side of the aisle complaining about a 
government-run program? This program has not been ruled 
unconstitutional, and it has been in place since 1965. So when they 
make the argument and it frightens our seniors who are listening and 
they're saying, This vote, do we not have it? You have Medicare. We are 
enhancing Medicare. We are making it solvent. 2037. This is what this 
bill will do for you.
  Then let me just conclude with this. This is probably not readable, 
but this is my State celebrating the bill. This is the Texas Department 
of Insurance that has just put out a report celebrating all of the 
provisions of this bill that will help the millions of uninsured. You 
all know that Texas has the highest number of uninsured in the Nation. 
We are obviously a growing State with the highest number. This is not a 
Democratic Texas Department of Insurance. I only say that to say other 
States are doing the same. Moneys are now flowing to States to ease the 
burden of health care.
  So I don't know what my friends on the other side of the aisle are 
doing when States are receiving money now, when people have no more 
lifetime caps, when young people can be on their parents' insurance 
because of the issue of being 26 years old.
  Then there is this legal argument--and this is the conclusion. I 
carry this book around. The commerce clause has covered our health 
bills or a number of Federal provisions that we have used, and we have 
not seen them overturned, and we haven't seen Medicare overturned.
  Yet there is another element that, I think, raises a question for my 
colleagues, and I hope that those who are now in the courts on this 
bill--and it is the courts that make the determination of the 
constitutionality, not this Congress, not people who are responding to 
a campaign or to promises they made. I think they'd have to look at the 
question of the 14th Amendment and the equal protection of the law.
  Does that mean that those who can only pay a certain amount and get 
low-caliber insurance should be taken advantage of, or does it mean 
that small businesses that would like to provide insurance for their 
employees don't have a right to some form of equal protection of the 
law?
  We thought about that. That's what this bill does. It helps to 
equalize access to quality health care, and the Fifth Amendment clearly 
states that no one can deprive you of life or liberty or property.
  So there are a lot of provisions that, I think, are meritorious in 
any argument to suggest that this is an unconstitutional act that we 
did. We equalized the playing field as opposed to depriving people of 
the equal playing field.
  I thank the gentleman for having this. There are a whole bunch of 
items that we can comment on. Every State is benefiting. Every district 
is benefiting. I don't know how my friends could vote against actual 
direct benefits when the people in their States are jumping for joy.
  This bill is in place, and it is the law of the land. Let it be very 
clear: it is the law of the land.
  Mr. WELCH. I thank the gentlelady.
  The example you gave is of Texas, which is where the authorities who 
have responsibility for health care are pushing ahead to take advantage 
of the provisions that will allow them to do their jobs better even as 
we are having this debate about repealing and unwinding, but not 
replacing.
  I mean, the point is that, if you want to improve something, you 
know, that's our job. Let's do it. There are provisions that all of us 
who supported this bill know could be improved; but we are hearing now 
real-world stories about things that are working really well, and we 
want to keep them.
  Mr. Speaker, may I inquire as to the time available?
  The SPEAKER pro tempore. The gentleman has 19 minutes remaining.
  Mr. WELCH. I am going to yield to the gentleman from Connecticut, who 
has played a major role, especially in making fair the financing of 
this health care and not doubly taxing folks who are getting employer-
sponsored health care benefits, and also for his tremendous work for 
seniors.
  The gentleman from Connecticut (Mr. Courtney).
  Mr. COURTNEY. Thank you, Mr. Welch.

[[Page 484]]

  In actually following the Congresswoman's comments about Texas' 
participation in various parts of the program, I wanted to focus for a 
minute on one of the really strong pro-employer provisions of this 
bill.
  We heard a lot of talk on the floor today about job-killing health 
care laws. I mean, the fact of the matter is, since President Obama 
signed the measure into law in March, over 1 million private sector 
jobs have been created in this country. I would contrast that to the 
day he was sworn into office, January of 2009, when the U.S. economy 
had lost 800,000 jobs in 1 month alone. So, clearly, you know, on just 
a simple data basis, this claim really doesn't pass the test of the 
facts.
  One of the pro-employer measures which Texas is now participating in, 
along with the other 49 States, is a provision called the Early Retiree 
Reinsurance Program. In 1986, over 60 percent of America's employers 
had a retiree health insurance plan so that people hitting age 55 or 60 
could retire, and their benefits would be extended. In 2009, that 
number had fallen to below 30 percent.
  What this bill did is it created a reinsurance fund, which is like a 
government backstop for private employment-based health insurance 
plans, similar to the same type of reinsurance plans that we have for 
terrorism insurance, flood insurance, and the nuclear energy industry. 
These are types of property and casualty coverage which would never be 
written in this country if the government did not act as a backstop. We 
set up a similar fund and basically opened the doors to employers 
across America who had, again, employees who were over age 55.
  What have we seen?
  Over 4,700 employers have enrolled in this program. Over half of the 
Fortune 500 companies in America have signed up for this program. I 
mean, you can just go down the list: GE, General Dynamics, Coca Cola, 
Pepsi, AT&T, Comcast, Ford, GM, Walgreens. The list goes on and on.

                              {time}  1950

  Again, all 50 States have enrolled for their State employee health 
plans, including States that are suing the Federal Government to try 
and blow this law to smithereens.
  The fact of the matter is is that they're voting with their feet in 
terms of whether or not this is a good law or not. If this was not a 
good program, they wouldn't enroll in it. But they understand that 
stabilizing early retiree health benefits is a way of making sure that 
people who are 55 years old and are teaching or police officers or 
working in corporate America are going to retire, and that will create 
elasticity in the labor market so that young Americans can actually 
fill those positions. I mean, this is even truer in terms of physical 
labor occupations. And again, Taft-Hartley plans, laborers, iron 
workers have all signed up for this reinsurance program, again, as a 
way of stabilizing 55- to 65-year-old Americans' health benefits and 
creating more opportunities for younger Americans so that people will 
follow that natural path of retiring.
  When you take that measure and combine it with the small business tax 
credit--$40 billion of tax relief for small employers--this is a pro-
jobs, pro-employer law. And again, quick example, I was at a roundtable 
on health care in my district. There was a family doctor that was there 
who was talking about the new Medicare changes and how excited she was 
about getting tools to better serve her clients. And she said, I'm 
getting killed on my own employee health plan, it's like $14,000 a year 
for four or five employees. And I said, well, did you check out the 
small business tax credit? She said the small business what? So she 
went on that tax calculator--it's smallbusinessmajority
.org--and called me back a couple of days later. She's going to save 
$4,000 on her health insurance premium because of that tax credit.
  By passing this law today, the Republican majority raised the taxes 
of small businesses all across America at exactly the same time that 
today they are figuring out their tax returns for 2010. I was a small 
employer before I came to Congress a short time ago. That's what you do 
in January and February, you start pulling your papers together to do 
your taxes. And they just voted today to blow up that tax credit to 
help the real job creators in America's economy.
  Ms. JACKSON LEE of Texas. Just a quick point.
  Number one is the benefit you just mentioned in a State like Texas, 
this retiree program. And we have a very quixotic or very complicated 
retirement program for teachers. And I will just say in closing, State 
legislators are beginning to go back to their capitals to try and 
understand how they're going to face these enormous deficits. I can't 
understand why we are burdening now States, by this vote, with extra 
responsibilities when they are all in crisis. The bill we have saves 
jobs, creates jobs, and provides benefits for people who need it and 
States who are in trouble.
  Mr. COURTNEY. And quickly to conclude, I'm glad you mentioned 
teachers because as we now begin a great debate in our country about 
trying to reform America's schools, the one thing I think everybody 
agrees is getting young teachers who understand technology, who are 
enthusiastic, that young students can identify with a little better 
than some of the older teachers that are in the classrooms. We want 
them in the classrooms. But older teachers who are afraid that they're 
going to lose their benefits if they retire are going to continue to 
work for their benefits. And this fund, this reinsurance fund is a way 
of trying to loosen the labor market and get new blood in occupations 
all across our economy.
  Thank you, Mr. Welch, for your great presentation.
  Mr. WELCH. I thank the gentleman from Connecticut. And as I listen, 
it's a good news/bad news story. The good news is businesses, large 
businesses and small, that have fiduciary responsibility to their 
shareholders and to their employees have sharp pencils and figure out 
what makes the most sense for them, and they're signing up for this. So 
that's an indication that they've kicked the tires and come to the 
conclusion that this is good for business.
  The bad news is, we apparently have done a pretty lousy job 
explaining this to the American people, and it has gotten obscured with 
the epithet of ``ObamaCare.'' But when you peel away the specifics of 
this--and then you provided evidence that businesses that have to make 
a hard-nose decision, this ain't about doing a ``good thing'' or they 
want to do the right thing for their company, but they've decided this 
is the prudent fiscal thing. So I thank you.
  I yield to the gentleman from Virginia, senior member of the 
Appropriations Committee and one of the Members who is always a voice 
of conviction and conscience in this institution, Mr. Moran.
  Mr. MORAN. I thank my very good friend from Vermont for yielding to 
me, and I thank my colleagues for participating in this discussion.
  There are so many things that are hard to understand with regard to 
what occurred today. One is that the new Republican majority tells us 
that jobs is their first priority. This will generate about 4 million 
jobs around the country we're told--and we can identify where they 
occur. And so we won't create those jobs, particularly in the health 
care professions.
  We are told that another high priority of course is to reduce the 
budget deficit. The nonpartisan Congressional Budget Office tells us 
that this will save more than $1 trillion through an emphasis on 
preventive care, by getting people out of the most expensive emergency 
care and into doctors' offices, and much more efficient delivery of 
care. But nevertheless, we won't save that money, and we won't create 
those jobs.
  One of the fascinating things is that I'm told by many of my friends 
on the Republican side that they actually agree to eliminating the 
insurance companies' ability to deny people due to preexisting 
conditions, it's just that they're opposed to the individual mandate 
because it's unconstitutional. The fact is you can't have one without 
the other.

[[Page 485]]

  Imagine how our car insurance system would work. You have to have car 
insurance, but there's no mandate. So just wait until you get into a 
crash, then go to the hospital, go to your insurance company, they're 
going to have to pay it up. I guess they think that's the way the 
health insurance system would work--wait until you get sick, wait until 
you have an accident, go to your insurance company, get your insurance 
coverage, they'll pay for it. Obviously they won't pay for it because 
every insurance company would go out of business. And so if you had 
preexisting conditions without an individual mandate, then it's the 
Federal Government that would have to provide health care to everyone 
when they got sick or when they had an accident because certainly no 
private insurance company would ever think of putting themselves in 
that position. So you can't have one without the other. It doesn't make 
sense.
  But to my very good friend from Vermont who gave us the opportunity 
to share a few comments tonight after this historic vote, the thing 
that troubles me the most that I can't get my mind around is that 
before we took that vote to repeal health care reform every single 
Republican Member of this Congress voted to say I want my Federal 
employees health benefits plan, I want my insurance coverage, and then 
they went ahead and every single one of them voted against providing 
the same sort of coverage to their constituents. That's what the 
recommittal was. I don't know how many of them read it--they're always 
complaining, well, we didn't have a chance to read it. Well, it was as 
simple as could be: If you're going to vote against providing health 
insurance for your constituents, then don't take it for yourself 
because it's basically the same plan. But every single one of them, old 
and new Members alike, voted to give themselves that very plan that 
they then turned around and voted against making available to their 
constituents. So this may have been one of the most hypocritical days 
in the history of the United States Congress.
  I don't know how they explain it. I don't know how I would explain it 
if I had to go back home: Sorry about that, I took care of myself in 
one vote--the very first vote of this brand new Congress--and then I 
voted to do just the opposite for you in the very next vote. Boy, we're 
off to a very interesting start.
  I thank my friend for giving us the opportunity to share that with 
the American people.
  Mr. WELCH. Well, I thank the gentleman from Virginia.
  I yield now to the gentleman from New York (Mr. Tonko), who has been 
listening to his constituents in the Albany region and hearing from 
them about prescription drug pricing and how it's too high. He has been 
bringing practical solutions to Congress to try to help make health 
care more affordable, the gentleman from New York.
  Mr. TONKO. Thank you, Representative Welch, for bringing to us the 
kind of focus that we need to have here on this floor. It is a pleasure 
to join with our colleagues from Virginia and Connecticut and Texas and 
Vermont, my neighbor to the immediate east. So thank you for your 
outstanding work in this capacity.

                              {time}  2000

  There's nothing more powerful than the faces that put a real life 
meaning into the work that we've done here.
  Let me talk about a constituent, actually a family of constituents 
from Albany, New York. Ellena Young is a very young mom and has a 1-
year-old son, Liev, and she's a three-time cancer survivor. There's a 
history of cancer in her family. And in the latter half of 2009, her 
husband, Bill, testified at our health care forum because his wife was 
having complications with her pregnancy and required bed rest.
  Well, as you can imagine with preexisting conditions, she was in and 
out of insurance coverage and very often was struggling to find ways 
that they could get the family covered. Her preexisting condition 
complicated that severely.
  The way she found health care coverage was as a Ph.D. student hooking 
herself and her family to the university plan.
  They were thrilled about the news of the pregnancy. She was in 
remission. They had all of this hope going for them.
  She then developed complications with her pregnancy--situations with 
malnutrition, severe iron deficiency, and, yes, even blood clots--all 
of which were life threatening.
  Well, you talk about the pharmaceutical needs. She was given 
prescriptions for 10 different medications, all of which were very 
important. Representative Welch, she had to choose five of the 10. She 
tried to pick the five most important, and even then it was an out-of-
pocket expenditure of a thousand dollars a month so that she could stay 
well and stay alive during this pregnancy. And what made it very 
difficult, as she was working through all of this, was that because of 
the complications of this pregnancy, her doctors told her that she 
would need to undergo a C-section.
  So now the family is faced with a decision: Do I quit at school where 
I was earning an income and keep my coverage, or what is my other 
choice? Because in order to have the surgery, which was going to save 
her pregnancy and her life, she had to take time off from school, so 
fell out of the ranks of the insured.
  Now, let me just quote from Ellena. As she and her husband debated 
applying for more student loans or a new credit card, she had this to 
say: I needed a procedure to save both my life and the life of my baby, 
and I was choosing between interest rates.
  Is that not a powerful statement?
  And this is what this reform is all about and why it is so 
aggravating to see the repeal voted on here in this Chamber today, 
because the hope that was brought by our bill applied to a case like 
that of the Young family is a very, very powerful statement.
  The Affordable Care Act bans both annual and lifetime expenditure 
caps. And that health coverage that is limited annually or lifetime is 
very disrupting and can deny, when you most need health care, it can 
deny the coverage.
  And so with all of this outcome, here's a real-life example where 
this family, with their 1-year-old child, had to struggle to find the 
insurance coverage.
  But why are we putting people through this sort of difficulty?
  And this is not unusual. It's a powerful story. But there are 
countless episodes, anecdotes that are brought to everyone's attention 
on this floor. And we're here to be leaders that provide hope and 
opportunity for the people that we represent. And then to repeal 
progress just as it begins to reach the very households that we have 
addressed across this land is a very sad statement. And we have to 
continue to work to make certain that the beneficiaries, the millions 
of people who prospered from this sort of activity, are not let down.
  I think this is a very important time in our Nation's history for us 
to use our resources wisely, to respond to the constituents with 
compassion, and to understand that these real-life stories are exactly 
that--real and profound and deep and meaningful. And they ought to help 
us decipher what the best policies are.
  And I really thank Ellena and Bill and Liev for the opportunity to 
share their story. It's a painful story, and they're very generous to 
allow us to share it here on this floor.
  And I thank you again for bringing us together.
  The preexisting conditions, the annual and lifetime caps, the filling 
the doughnut hole for our Nation's seniors so that they can, you know, 
move forward and live comfortably and maybe even save their lives with 
the appropriate medication and affordability and accessibility, these 
are all of the dynamics for which we have fought. And it's a shame that 
they're being taken away or attempted to be taken away at a time when 
they're just beginning to have their presence felt.
  I thank you for bringing us together tonight.
  Mr. WELCH. I thank the gentleman, and I thank my colleagues for 
joining us for this hour tonight.

[[Page 486]]



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