[Congressional Record (Bound Edition), Volume 160 (2014), Part 10]
[House]
[Page 13617]
[From the U.S. Government Publishing Office, www.gpo.gov]




            MEDICARE, MEDICAID, AND THE AFFORDABLE CARE ACT

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
North Carolina (Mr. Butterfield) for 5 minutes.
  Mr. BUTTERFIELD. Mr. Speaker, with the stroke of a pen 49 years ago 
today, several weeks after I finished high school, then-President 
Lyndon Johnson signed into law two of the largest and most important 
health-related programs the country had ever seen, Medicare and 
Medicaid. Those programs were created nearly half a century ago because 
our Nation's leaders saw, time and time again, the hopelessness of 
people who had no way to provide the most basic level of health care 
for themselves and their families.
  It was President Harry Truman who initially conceived of a health 
care safety net for struggling Americans. Nearly 70 years ago, Truman 
said: ``Millions of our citizens do not now enjoy good health. Millions 
do not have security against the economic effects of sickness . . . and 
the time has arrived for action to help them get that protection.''
  Since the creation of Medicare and Medicaid, no achievement has been 
as significant and consequential as the Affordable Care Act. In 
addition to providing affordable health insurance, to some for the 
first time ever, the ACA has also provided for significant expansion of 
states' Medicaid programs so that individuals with incomes less than 
138 percent of the poverty level could finally have access to basic 
care.
  A Supreme Court case would make Medicaid expansion voluntary. Now, 
nearly half a century after Medicaid was created to help the least 
among us, 24 States in this country, 24 States believe it best to 
disenfranchise millions and deny them access to Federal dollars they 
rightfully deserve by not expanding their programs.
  States that have refused to expand point to the increased costs as a 
main reason for their decision. But, Mr. Speaker, the Federal 
Government has committed to pay 100 percent--that is, 100 percent of 
the cost of expansion--for the first 3 years and then 90 percent beyond 
the first 3. Nationally, the States would see only a 1.6 percent 
increase in their share of Medicaid spending, a 1.6 percent increase to 
provide health care for millions of deserving individuals.
  The benefits of expansion far outweigh the costs. In my home State of 
North Carolina alone, expanding Medicaid will save the State more than 
$65 million over the next 8 years and would benefit its economy by 
adding nearly $1.5 billion to the State's revenue. It would not only 
help to save jobs, but help to create them, too. That is just in North 
Carolina. And this same scenario is playing out in nearly half of all 
the States in our country.
  The cost of not expanding is simply too great. Pungo Hospital, 
located just outside of my congressional district in Belhaven, has 
closed its doors, closed its doors because North Carolina refuses to 
expand Medicaid.
  The decision by Governor Pat McCrory and the Republican-led State 
legislature has cost a woman her life. Portia Gibbs was 48 years old. 
She had a heart attack and died on her way to the nearest open 
hospital, which was an hour away.
  Providing care to the sick and injured is a moral imperative that 
Harry Truman saw nearly 70 years ago when he first spoke about it. 
Congress and President Lyndon Johnson believed caring for the least 
among us was a moral necessity when Medicare and Medicaid were passed 
and signed into law.
  At the signing ceremony 49 years ago, former President Harry Truman 
said of the people that would benefit from Medicare and Medicaid: 
``These people are our prideful responsibility, and they are entitled, 
among other benefits, to the best medical protection available. We 
don't want them to have any idea of hopeless despair.'' That was 
President Harry Truman.
  In response to Truman, President Lyndon Johnson said improving the 
health of all Americans ``calls upon us never to be indifferent to 
despair. It commands us never to turn away from helplessness. It 
directs us never to ignore or to spurn those who suffer untended in a 
land that is bursting with abundance.''
  Those elected officials standing in the way of Medicaid expansion 
should simply reflect on President Johnson's words. In a country that 
has come so far--so far--Americans who struggle financially deserve 
better than that. They deserve better than to have their elected 
officials tell them that their worth in this world is tied to their 
ability to afford health insurance.

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