[Congressional Record (Bound Edition), Volume 161 (2015), Part 3]
[Senate]
[Pages 3404-3405]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          AFFORDABLE CARE ACT

  Mr. DURBIN. Mr. President, last week I had an opportunity to cross 
the street into the Supreme Court, and I witnessed the first oral 
argument I have ever seen. It was a historic moment for me and for our 
Nation because it was a moment for the Court to argue about the 
Affordable Care Act and the intention of Congress when it was creating 
this Affordable Care Act.
  Having been here at the time it was debated and having voted for it, 
it was interesting to hear arguments made on the floor of the Supreme 
Court that suggested something we had never intended. The exchanges 
that were created under the Affordable Care Act are exchanges created 
by each State or Federal exchanges. There was never a distinction made 
in the debate nor any intention that the subsidy given to those who 
bought insurance in these exchanges would be different if the exchanges 
were State-created or federally created, and that is basically the 
argument before the Supreme Court.
  One can only imagine what the final decision of the Supreme Court 
will be, but we know it is critically important to millions of 
Americans. In the past year alone, 10 million uninsured Americans 
finally have insurance because of the Affordable Care Act. In the 
private market, millions more now have access to expanded coverage for 
preventive health services, such as a mammogram or a flu shot, without 
any cost sharing. Because of the Affordable Care Act, a person no 
longer needs to stay in a job simply to carry health insurance or be

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denied coverage because of a preexisting condition--a situation which 
virtually every family faces. And because of this law, prescription 
drugs for seniors cost less.
  Last week, when the Supreme Court heard arguments in King v. Burwell, 
the plaintiffs made an argument that those who were governed by Federal 
exchanges were supposed to be treated differently under this act. That 
was never the intention of those of us who were part of the creation 
and voting for this legislation.
  A ruling in favor of King would change this provision as we intended 
it. It would mean 8 million Americans would no longer be able to afford 
health insurance.
  According to the Urban Institute, premiums for people able to 
purchase insurance would increase by 35 percent. I can't imagine that 
even Senators who voted against this bill are cheering at the prospect 
that 8 million Americans would lose insurance and many others would 
face higher premiums.
  Well, the Republicans have argued they have an alternative to the 
Affordable Care Act in the Senate. They put out a draft proposal last 
month. The chairman of the Ways and Means Committee in the House said 
he was going to release his own plan.
  The Affordable Care Act puts families in charge of their care instead 
of insurance companies. It expands health care coverage and lowers 
health care costs, makes Medicare stronger, and lowers the deficit.
  What part of that do my Republican colleagues disagree with?
  Before the enactment of the Affordable Care Act, 50 million Americans 
lacked health insurance while health care costs for working families 
and small businesses were increasing by double digits. The Affordable 
Care Act changed all of that. Ten million people now have private 
health insurance, millions more are covered by Medicaid, and for the 
first time ever insurance companies have to live up to their promise of 
being there when you actually need them.
  The Senate Republican proposal falls short. It would allow insurance 
companies once again to charge higher premiums to women, to decide that 
people with preexisting conditions will not get any coverage at all, 
and to decide that certain individuals will only get so much help for 
paying their bills. If Republicans have their way, insurance companies 
will get to decide again whether you can renew your health insurance 
policy as you become older. Worse yet, under the Republican proposal, 
12 million people would lose their health insurance and taxes on 
working families would go up. That is not right.
  The Supreme Court would put in jeopardy health insurance coverage for 
Ariana Jimenez. She lives in Chicago and works part time as a nursing 
assistant at a community health center. Ariana pays $52 a month for her 
health insurance premium. When asked what would happen to her coverage 
if the Supreme Court took away the tax credit, she simply said: ``I 
wouldn't be able to afford it.''
  In Illinois over 800,000 people now have health insurance. Over 
290,000 people purchased their plan through the Illinois marketplace, 
which is a Federal marketplace. An additional 530,000 people have 
enrolled in Medicaid, and 125,000 young adults in Illinois can still 
stay on their parents' health insurance plan.
  Since September 2010, children under the age of 18 enrolled in the 
employer-based or marketplace plan have been eligible to receive 
vaccinations for diseases such as measles without any cost sharing.
  A few years ago Domingo Carino found out he had a health condition 
that required medication he couldn't afford. Thanks to the Affordable 
Care Act and to some help from staff at the Asian Human Services Family 
Health Center in Chicago, Domingo found good health insurance that only 
costs him $11 a month. Domingo's plan not only allows him to afford the 
medication he desperately needs, but he is also able to keep his 
current primary care physician. According to Domingo, he can now live 
without worrying about how to afford his medication.
  For Domingo and millions like him the tax credits provided by the 
Affordable Care Act are a lifesaver. If those who oppose the Affordable 
Care Act prevail in the Supreme Court, that tax subsidy, or tax credit, 
will not be available to Domingo.
  Over 54 million people also benefit from Medicaid. Before the 
Affordable Care Act, two out of three people on Medicaid were pregnant 
women and children. That is 36 million vulnerable Americans. Medicaid 
also provides for people with disabilities.
  Before the Affordable Care Act, almost 3 million people were covered 
by Medicaid in Illinois. More than half a million births were covered 
by Medicaid in Illinois, too. Since the Affordable Care Act was signed 
into law, another 290,000 people in Illinois are covered by Medicaid. 
That means these people finally get better from a condition they could 
not afford to treat. That is a success story.
  The new Republican plan uses something else out of an old playbook. 
Republicans want to cap Medicaid spending for each beneficiary. This 
budget gimmick would hurt the most vulnerable people in America--low-
income seniors, people with disabilities, children, and pregnant 
mothers. States would be forced to make harsh choices on what they 
would cover and what they would not cover.
  Is that what America wants?
  According to a recent Gallup poll, the uninsured rate dropped 3.5 
points from 2013 to 2014. In Illinois the uninsured rate dropped 4.5 
percent in the same period of time.
  The Affordable Care Act includes changes meant to help slow the 
growth in health care costs, and they are working. We need to stick 
with the Affordable Care Act.

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