[Congressional Record (Bound Edition), Volume 163 (2017), Part 3]
[House]
[Pages 4077-4082]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         HEALTH CARE IN AMERICA

  The SPEAKER pro tempore (Mr. Biggs). Under the Speaker's announced 
policy of January 3, 2017, the gentleman from Maryland (Mr. Raskin) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. RASKIN. Mr. Speaker, I am delighted to have this time on behalf 
of the minority and the Progressive Caucus. We have a number of very 
distinguished Representatives who want to talk about what is going on 
with people's health care in America and the attacks leveled against it 
this week in Congress.
  Before we begin, I yield to my distinguished colleague from New York 
(Mr. Jeffries).


           honoring christopher ``notorious b.i.g.'' wallace

  Mr. JEFFRIES. Mr. Speaker, I thank the distinguished gentleman from 
Maryland for yielding.

     It was all a dream,
     I used to read Word Up! magazine.
     Salt-n-Pepa and Heavy D up in the limousine,
     Hangin' pictures on my wall,
     Every Saturday Rap Attack,
     Mr. Magic, Marley Marl.

  Those were the words of the late great Notorious B.I.G., Biggie 
Smalls, Frank White, the King of New York. He died 20 years ago today 
in a tragedy that occurred in Los Angeles, but his words live on 
forever.
  I have got the privilege of representing the district where Biggie 
Smalls was raised. We know he went from negative to positive and 
emerged as one of the world's most important hip-hop stars. His rags-
to-riches life story is the classic embodiment of the American Dream.
  Biggie Smalls is gone, but he will never be forgotten. Rest in peace, 
Notorious B.I.G.
  Where Brooklyn at?

                              {time}  1945

  Mr. RASKIN. Thank you very much to the distinguished gentleman from 
New York. We are going to go from the Notorious B.I.G.'s music to the 
notorious GOP healthcare proposal being considered in Congress this 
week.


                             General Leave

  Mr. RASKIN. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks and to 
include extraneous materials in the Record on the subject of this 
Special Order.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Maryland?
  There was no objection.
  Mr. RASKIN. Mr. Speaker, I am going to yield to my colleague from 
Minnesota, Mr. Ellison. It was 7 years ago in March 2010 that President 
Obama signed the Affordable Care Act into law extending access to 
affordable health insurance coverage to more than 20 million previously 
uninsured Americans.
  Insurance companies under the new law could no longer deny you 
insurance because you had a preexisting condition, and, surely, that 
makes sense. The fact that you have a preexisting medical condition 
should be the reason that you get health insurance, not the reason you 
get denied health insurance.
  Also, under the new ACA, young people up to age 26 could stay on 
their family plans, which helps families like mine because I have got a 
22-year-old, a 20-year-old, and a 25-year-old. And believe me, they 
would not have health insurance if not for the Affordable Care Act, and 
I think my situation is that of millions of people across the country.
  But today, the ACA is in mortal danger. The House GOP finally 
unveiled their plan for repealing and replacing the ACA with something 
else, which I call the unaffordable care act, that will cost millions 
of people their health insurance, increase everybody's premiums, reduce 
everybody's coverage, and bring incoherence and chaos into the system.
  Mr. Speaker, I am going to yield to Mr. Ellison in just a moment to 
talk about what is going on with this legislation. But I do want to say 
something about the process by which we arrived here, because back when 
the Affordable Care Act was being debated--and I wasn't in Congress 
then, so I approach this just as a historian--there were multiple 
complaints from the GOP Members about how fast things were going, how 
the legislation was being rammed through.
  For example, our now-Speaker Paul Ryan said about the ACA: ``Congress 
is moving fast to rush through a healthcare overhaul that lacks a key 
ingredient,'' he said, ``the full participation of you, the American 
people.''
  Greg Walden, the Energy and Commerce chairman from Oregon, said: On a 
bill of this significance, you would think we would at least allow 
people to come in who are affected by the extraordinary changes in this 
bill, and have a chance to let us know how it affects them.
  And the Ways and Means Committee chairman today, Kevin Brady, said: 
The Democratic Congress and White House simply aren't listening. The 
Democrats are ramming it through over the public's objections.
  Well, let's go back and look at how long it took the Democrats to get 
the Affordable Care Act passed and how much public participation and 
debate there really was.
  Here in Congress, there were 79 hearings--I repeat, 79 hearings--on 
the Affordable Care Act.
  There were 181 witnesses, both expert witnesses and members of the 
public, citizens coming to testify about the need for expanded health 
insurance coverage for the American people because of the high expenses 
of health insurance and the rip-offs of various insurance companies.
  There were multiple scores that were received from the Congressional 
Budget Office during that time, as there was constant attention to the 
budgetary and fiscal implications of the Affordable Care Act.
  Now, fast-forward to today. We took a year-and-a-half to get to the 
Affordable Care Act. How about them? Well, let's see.
  The Republicans introduced their bill on Monday. They passed their 
bill in the dead of night, at 4:30 in the morning, 3 days later. There 
have been no hearings on the bill. There have been no witnesses to 
testify on the bill. There have been no expert witnesses. There have 
been no witnesses from the public.
  There is no analysis from the nonpartisan Congressional Budget Office 
on how much the bill will cost American taxpayers, American citizens, 
on their plans or how many Americans will lose their health care at 
all.
  In other words, the party that complained about how fast the 
Affordable Care Act came into being, which was over the course of a 
year and a half with dozens of hearings, and dozens and dozens--more 
than 100 witnesses and lots of public debate where we went back to our 
districts and had townhall meetings, where there was orchestrated 
opposition against the plan, but we still stood there and we engaged in

[[Page 4078]]

the dialogue, and we stood up for the Affordable Care Act. The people 
who said that that was too fast are now ramming through, at 
unprecedented, breakneck, lightning speed, a bill that will wreak 
devastation on the healthcare rights of the American people.
  That is what is taking place. If you have got a contaminated, 
clandestine, secret, closed process, it will produce a terrible, 
undemocratic, and unhealthy result. That is what we are going to 
describe to you tonight.
  I am delighted to yield to my colleague from Minnesota (Mr. Ellison.)
  Mr. ELLISON. Congressman, thank you for that introduction, and thank 
you for your service to the Congress and the great people of Maryland.
  I think it is really important tonight to focus on a few key things 
about what is happening in Congress. One is that 20 million people 
stand to lose their healthcare coverage. Many have never had it, and 
the Republican majority is set to snatch it from their hands. That is 
really sad.
  One of the people who come to mind is actually a young woman who 
works on my staff. Her name is Abby, and she is a young woman who has 
her whole life to look forward to, but as a young person, when she was 
born, she had a disease called toxoplasmosis. She doesn't mind me 
talking about it because what Abby would tell you if she were here is 
that it was tough growing up.
  She had a lot of medical attention growing up. She was a good 
student, and she really braved all of the medical care she needed with 
tremendous courage, and her family was there with her the whole time. 
But she had numerous surgeries growing up, and she also came close to 
death's door on more than one occasion.
  One thing that she says--and says to anybody who is willing to 
listen--is that the Affordable Care Act helped save her life. Why? 
Because Abby has a preexisting condition, a pretty serious illness. And 
she had insurance companies that have lifetime limits and annual limits 
on coverage and care.
  Without the Affordable Care Act and with the provisions that preceded 
the Affordable Care Act in the insurance industry, she simply was 
uninsurable, therefore, not in a position to get the care she needed. 
By some miracle, she made it to adulthood with the status quo before 
the Affordable Care Act, but the Affordable Care Act made the 
difference between her being with us and not.
  I was talking to a physician who operates an institution in my 
district called the Hennepin County Medical Center, HCMC, who said: 
Look, if you were to stack up all of the diseases in our country that 
end in fatality, you would have to put up there car accidents, you 
would have to put up there heart disease, you would have to put up 
there pulmonary illnesses and cancers, of course. But, he said, if you 
stacked those illnesses up on a list, the most fatal in a given year, 
he said, the third one would be uninsured, people dying because they 
don't have insurance.
  And our Republican majority is here to tell us they are okay with 
that. It is hard for me to believe, but it is true.
  Right in front of us, we know that this repeal will relieve wealthy 
individuals of paying taxes. If they are able to repeal the Affordable 
Care Act, people with a lot of money are going to have more of it, and 
people who needed health care will have less of it.
  People who need help dealing with the doughnut hole and need to be 
filled in with the moneys that come from the Affordable Care Act won't 
have that anymore. Now they will go back to the status quo of Medicare 
part D, which is where they get help up to a certain amount, then there 
is no help, then they have got to spend up to start getting help again. 
The Affordable Care Act filled in the doughnut hole, and seniors who 
can barely afford their prescription drugs now will have even more 
trouble.
  Seniors who need Daraprim, which was a medication that cost about 13 
bucks until this guy Shkreli bought the patent for it and jacked it up 
to about 700 bucks, people who need even things like insulin, people 
who need all kinds of medications now are going to be staring at that 
doughnut hole all over again.
  I mean, we can get up here and talk about the toll, the human 
tragedy, the pain and suffering that people are looking at, but none of 
it seems to penetrate the minds of our colleagues. They seem to be deaf 
to the pleas of people like Abby and so many other people like that.
  I was here when my colleagues on the other side brought forth I think 
as many as 60 attempts to repeal the Affordable Care Act. We would come 
forth and we would say: People are getting lifesaving treatments that 
they never could afford before; people are getting treatments that are 
literally keeping their families intact, keeping their lives intact; 
people are getting coverage they never had; people have something more 
than the emergency room to turn to. Our colleagues would just say: 
Well, we are just going to get rid of it anyway.
  In fact, I remember, Mr. Speaker, when the Republicans shut down the 
government for 16 days because we refused to cooperate with their 
effort to repeal the Affordable Care Act. Ted Cruz occupied time and 
demanded that we repeal it. We said we would not turn people like Abby 
and others back to the tender mercies of the insurance industry. They 
said: Well, we will shut down the entire government unless you do it. 
We said no, and, well, here we are.
  It is true that we never thought we were going to lose this election. 
We never thought we would be this deep in the minority, but we now have 
gotten in a position where the Democrats don't hold the Presidency. We 
have a President who ran on the promise of repealing the Affordable 
Care Act, and we have two Houses of Congress that are committed to 
doing it.
  The last line of defense really is the American people, Mr. Speaker. 
The last line of defense is the American people standing on the most 
fundamental of rights, the First Amendment, which guarantees them the 
right to redress grievances, guarantees them the right to petition 
their government, guarantees them the right to freedom of assembly, 
guarantees them the right to freedom of faith, guarantees them the 
right to receive information from a free press.
  We are relying on that amendment, Mr. Speaker, to stop these 
Republican efforts to snatch healthcare access out of the way, out of 
the hands of Americans. We are relying on Americans to stand up and 
say: We will not tolerate this--going to community meetings, going out 
on the street, using their rights as Americans to express their right 
to have health care. This is what the moment calls for.
  Governors, even some Republican Governors, are saying: Wait a minute. 
This Medicaid expansion, you know, we used it. It is not so bad. It is 
helping us.
  Their pleas are being ignored as well. We are at a critical moment: 
Will the American people continue to make the same advances that people 
all over the developed world have made with regard to health care?
  You know, Europeans look at us and think there is something wrong 
with us. Even our northern neighbors look at us and say: Wait a minute. 
Health care is not a right down there?
  No. You get it if you can pay; and if you can't pay and answer 
somebody's bottom line, you are just out.
  We pay the most for health care in the whole wide world, Mr. Speaker. 
We pay the most--the most--and yet we don't have the best outcomes. We 
don't have the best indicators of health. Yet our colleagues on the 
other side of the aisle want to return us to a day when the number one 
reason that people would declare bankruptcy was medical debt. That is 
the world we are looking at, and it is really, really something.
  Now, many people have said--you know, Democrats say to me all the 
time, and I am sure they say it to Mr. Raskin of Maryland: Hey, look, 
you know, there are things we would change in the Affordable Care Act.
  We are not saying that it fell down from tablets in the sky. Of 
course, there are reasonable amendments that might be made. But I am 
here to say to you, Mr. Speaker, that the Republican

[[Page 4079]]

caucus has never said: We will talk about how we are going to make 
reasonable amendments to make it better. They have only said to repeal, 
repeal, repeal.
  They have also said replace, but everyone knows you cannot repeal and 
replace the Affordable Care Act because, if you repeal it, you are 
repealing all of the taxes that go along with paying for it. And if you 
repeal the taxes, you are going to tell me that a Republican caucus is 
going to levy a tax? They think tax is a four-letter word if somebody 
with a lot of money has to pay it.

                              {time}  2000

  Now, they are okay with fees and pushing down regressive taxes. They 
do that every day and all the time. If somebody with real means has to 
pony up, even though they are already wealthy, you could never see a 
Republican do that. It is just not something they are going to do.
  The ACA has provided coverage to more than 20 million people. That is 
20 million more people who have better patient care, access to doctors 
and medicines, and are no longer turned away because of preexisting 
conditions.
  The Republican proposal puts the brakes on the progress we have made. 
People will lose access to insurance coverage. The Republicans gut the 
preventative health fund, which literally funds programs to invest in 
keeping people healthy.
  Who do Republicans help?
  Insurance and pharmaceutical corporations. They get huge tax breaks 
at the expense of the help and the future of the American people.
  The Republican bill doesn't stop there. It is an outright attack on 
Medicaid. Seniors out there should know that the Republicans are 
attacking Medicaid. They are attacking Medicaid.
  Medicaid is one of our most effective antipoverty programs and 
provides lifesaving care to millions of elderly, children, pregnant 
women, and people with disabilities. Republicans want to dismantle the 
program as we know it and kick people off and leave States to pay for 
the bill.
  This bill takes away health care from women and shifts costs to the 
older, sicker people. It compromises the Medicare trust fund. It 
destroys Medicaid and gives tax breaks to corporations and 
millionaires. It is wrong, and the American people need to oppose it. 
And I oppose what they are trying to do.
  Mr. RASKIN. Mr. Speaker, I hope the gentleman from Minnesota (Mr. 
Ellison) will stick around. I want to salute him and congratulate him 
on his new position, not only as a leading Member of the United States 
House of Representatives, but now as vice chairman of the Democratic 
National Committee.
  All of your colleagues are beaming with pride about your 
accomplishments and about your national political leadership, and we 
are delighted that the rest of the country is going to get to share in 
your leadership now in your new aggressive role out organizing 
opposition to what is taking place in Washington today.
  I want to take a little break from railing about this unaffordable 
care act that is going to drive everybody's rates up and throw millions 
of people off their health insurance.
  I want to say a couple of good things that President Trump said as a 
candidate because he attacked ObamaCare, but he said he wanted a system 
that covered everybody. He's been quoted many times speaking in favor 
of a single-payer plan that would cover every citizen. Now, that talk 
has completely dried up. It has vanished and disappeared.
  I urge President Trump to go back to his original instinct, which is 
that, if you are going to repeal and replace ObamaCare--the Affordable 
Care Act, as he keeps saying--let's replace it with the kind of system 
they have in Canada, they have in Europe, and just cover everybody. 
That would be the direction to go in. But to go backwards to throw 
millions of people off their health care is precisely what the American 
people don't want.
  Now, here is another proposal that President Trump mentioned in 
passing when he stood in this Chamber the other night. He said: Let's 
repeal the special interest lobbyist provision that was snuck into 
Medicare part D, saying that the government could not negotiate for 
lower drug prices with the pharmaceutical companies.
  Again, that was a very popular talking point for Donald Trump when he 
was running for President. He campaigned like William Jennings Bryan, 
but he is governing like William McKinley; that is, a cabinet filed 
with CEOs and billionaires. He did mention that. That was one tiny 
crumb, a remnant of the populist campaign he ran.
  I urge my Republican colleagues to throw this terrible bill that they 
are going to waste everybody's time on, that cannot pass, which their 
Freedom Caucus is totally opposed to; and, instead, focus, at least, on 
something we can agree on, which is that the 25 or $30 billion that 
that special interest provision is costing us should be saved. We 
should allow the government to negotiate for lower drug prices in the 
Medicare program the way we are allowed to negotiate for lower drug 
prices in the Medicaid program and in the VA program.
  So we can work together in a bipartisan basis. However, we are not 
going to allow anybody to throw millions of Americans off of their 
health insurance plan while driving up everybody else's rates and 
bringing the whole healthcare system to the brink of ruin.
  When I got elected to Congress, I went down to the basement of the 
Longworth House Office Building after I was sworn in to sign up for my 
health care because we get health care as part of our jobs as Members 
of Congress. We pay for it through the local ACA healthcare exchange in 
the District of Columbia, but we are guaranteed the right to get that 
because of the Affordable Care Act.
  When I went down that morning, I was signing up and I was looking 
through the memo about what we would be doing during my first week in 
Congress here. Sure enough, I saw that the GOP leadership had put on 
there a procedural proposal to set the stage for the dismantling of the 
Affordable Care Act.
  I looked up to see a line of my new colleagues waiting to come and 
sign up for their health care. Some of them I recognized as my 
Democratic colleagues, and some of them I recognized as my new 
distinguished Republican colleagues. And I said to myself: Wait a 
second. Please tell me that we are not going to have new Members of 
Congress come in here and sign up for their own health care that they 
get as part of their job as Representatives in the United States House 
of Representatives and then go upstairs to this floor to vote to strip 
millions of people of their health care.
  Surely that is not what democratic representation means in the 21st 
century; that we get to have health care through our jobs, but we are 
going to take away the health care that other people have. But, my 
friends, I am sorry to say that is the reality that we are in this 
week.
  Congressman Ellison is right, we are not taking the position that the 
Affordable Care Act is perfect. Far from it. I wasn't in Congress then. 
I don't know if the gentleman from Minnesota (Mr. Ellison) was. I 
wasn't in Congress then. But had I been in Congress, I would have been 
fighting for a single-payer plan.
  I am on legislation this session to support a single-payer plan. In 
other words, the Affordable Care Act, for me, doesn't go far enough in 
guaranteeing that everybody has health care and in dramatically 
reducing the role of the insurance companies so we can spend more money 
on health care and less money on red tape and bureaucracy.
  So the Affordable Care Act, which I support with all of my heart 
right now against all the attacks to dismantle it, was a compromise. It 
was a very carefully crafted compromise. Remember, we had more than 100 
witnesses come and testify about it. They had zero on their crash-and-
burn legislation this week. We had dozens and dozens of hearings where 
we had witnesses come and testify about it. They have had zero on their 
crash-and-cash legislation--crash the system and give cash

[[Page 4080]]

to the insurance companies and the wealthiest people in the country. So 
we had an open process, and it was a compromise.
  I remember very clearly as a State senator in Maryland watching 
President Obama on TV saying, if we are starting from scratch, he would 
be in favor of a single-payer plan. He said that would be the logical 
way to go. It is what they have in Europe. It is what they have in 
Canada and Mexico.
  He said we are path dependent. We are on a particular path. We 
understand the role that the big insurance companies play, and they 
have got a lot of political power, and we have got everybody on the GOP 
side screaming and shouting for the insurance companies. So he said 
let's figure out a plan where we keep the insurance companies involved.
  Guess what? That plan was hatched at The Heritage Foundation, a 
conservative think tank in Washington, much beloved and revered by the 
GOP Members of this body. It was the exact same plan that Governor Mitt 
Romney, their standard bearer running for President a couple of 
elections ago, put into place in Massachusetts.
  The Affordable Care Act was the compromise. Now everybody is on their 
case because they are hiding under their desks, they are running away 
from their constituents, and they are canceling their townhalls. Nobody 
could get a plan out of them.
  Suddenly they pull a plan out of their sleeve in the middle of the 
night. They rush it through this body. They voted on it at, I think, 
4:30 in the morning after a 27-hour hearing. Everything is meant to be 
under the cloak of darkness, and people are making fun of them about 
how silly it is.
  I sympathize with them because there is nothing they can do because 
the Affordable Care Act was the compromise. Now, they wanted to name it 
ObamaCare, of course, because they couldn't stand the idea that 
President Obama would get the political credit for bringing tens of 
millions of Americans health insurance. So they had to name it on him 
and then make up all of these stories about how terrible it was.
  Guess what? They wake up today. Nobody is calling it ObamaCare 
anymore. President Obama is doing his own thing. They are calling it 
the Affordable Care Act, and people are defending it all over the 
country in 50 States in every congressional district.
  You have got indivisible groups that have grown up all over the 
place, and my dear colleagues on the Republican side of the aisle are 
afraid to face their own constituents. They are canceling their 
townhalls, they are hiding under their beds and behind their office 
sofas, which, in many cases, are the exact same pieces of furniture 
because they sleep in their offices here. They don't want to face the 
people and the fact that we do not want to turn the clock back and go 
backwards and wreck this system. It is a lot easier to destroy things 
than to build things.
  So we urge the GOP: If you want to meet to make real substantial 
improvements, expansion of the Affordable Care Act to include more 
people, to reduce the cost of the bureaucracy, let's do it. But your 
plan is a terrible plan. Your plan is one that is going to throw 
millions of people off of their health insurance. Your plan is one that 
is built around a huge tax break and transfer of wealth upwards in the 
country--one of the biggest transfers of wealth in the country ever to 
go in the northward direction.
  It is an amazing thing that that is how they have designed their 
plan.
  So it is a huge tax break to the insurance companies and to the 
wealthiest people, and millions of others are thrown off of their 
insurance plans. Everybody else's premiums are going to be soaring, and 
the whole system is likely to come crashing down.
  If a foreign government like Russia, for example, were trying to do 
this to us, we would consider it an act of aggression, an act of war 
against the American people in our health care. But this is, instead, 
coming from what used to be one of our great political parties, the 
party of that President who talked about government of the people, by 
the people, and for the people.
  We have, instead, a wrecking ball targeted right at you, the American 
people, coming after your health insurance, your health care, your 
ability to participate as a citizen in our healthcare system. That is a 
remarkable thing to be taking place in 2017.
  Mr. Speaker, I yield to the thoughtful gentleman from Minnesota (Mr. 
Ellison).
  Mr. ELLISON. Mr. Speaker, I thank the gentleman from Maryland (Mr. 
Raskin) for being so clear on the issues in front of the American 
people. It is so important that we have these Special Order hours so 
that we can really help the American people understand what is at 
stake; and what is at stake literally is the health and security of our 
Nation.
  When we talk about security, usually people think about law 
enforcement and military. There is also the security that families can 
expect, the security of your health. In this situation, the Nation's 
security of health and family security is absolutely on the chopping 
block.
  Let me give you an example of what I mean. In the district I 
represent in Minnesota--which I am so proud to represent the people of 
the Fifth Congressional District of Minnesota--we used to have an 
uninsured rate which we thought was low. It was 10.9 percent. If you 
remember, in the pre-Affordable Care Act days, 10.9 percent was pretty 
low. Well, now it is 6.6 percent. That means literally thousands of 
Minnesotans can now go and get regular doctor care rather than just 
show up at the ER.
  Part of the way that we used the Affordable Care Act in Minnesota in 
the Fifth Congressional District is that the folks at HCMC set up 
something called Hennepin Health. What Hennepin Health does is it says: 
We are going to take some of these Medicaid dollars and we are going to 
help people who are chronic users of the ER system. We are going to 
work with other agencies and other providers in the community to help 
house them stably and then do regular medical surveillance with them.
  Do you know what has happened with this program?
  The costs at the ER have dropped through the floor. The money has 
been saved because of the Affordable Care Act. Not only is it about the 
money--because if you talk to our Republican friends, all they want to 
talk about is money--something even more important has happened.

                              {time}  2015

  When you talk to the people who would go to the ER all the time, they 
are saying: I have somewhere to live. I have somebody who helps me stay 
on my medication. I am beginning to rebuild relationships with my 
family again. Schizophrenia can be very devastating to your mental 
health; and I was all out of control when I was off my meds, and I used 
to end up in the ER within an inch of my life. But now, because of the 
Affordable Care Act, I can get the care that I need, I can be stably 
housed, I can be productive in my community, I can be a participating 
family member again.
  It has improved their lives.
  I don't understand what the Republicans don't understand. It is a 
good thing to have people to have an option other than the ER.
  I heard one of my colleagues on the other side of the aisle say, 
well, in America, if you show up at a hospital, there is a Federal law 
that says they have got to take you.
  It is true that if you show up at an ER, somebody is going to have to 
let you in there. They may move you from one hospital to another, but, 
eventually, the law does say you will end up with somebody seeing you.
  Guess what the medical professionals say about it? It doesn't work. 
It is the most expensive care. It is usually left to people who have 
allowed an illness to fester and to go on and to advance, which makes 
it more difficult to treat, more expensive to treat. It is the wrong 
way to run a healthcare system.
  Yet, people have a straight face and say things like, well, you know, 
you can go to the doctor if you need to. It is called the ER.

[[Page 4081]]

  This is absolutely not the right thing. And so here we are again, 
right at this hour where, really, things look kind of grave, and we 
need the American people to stand up and object. I tell you, we need 
people to say that they insist upon a humane society where a person 
suffering from schizophrenia, who is so afflicted by their illness that 
the only thing they can do is make it through the day and then, if they 
get sick, maybe somebody will take them to the ER.
  We should have a society where that person can get the care they 
need, can get housing that they need, can be cared for, and can be a 
participating member in our society with just a little bit more help.
  I think that is what makes us Democrats. That is the difference 
between us and them. We care about people. We believe people are 
inherently valuable and all have dignity, and we don't believe that you 
are only as worthy as what is in your pocket or your bank account. We 
reject that idea out of hand and believe that people must be--if you 
are too poor to work, too sick to work, too old to work, we believe our 
society should care for you; and I don't make any apologies to anybody 
for believing that.
  I believe the government should do everything it can to make sure 
there are enough good-paying jobs for everybody. Lord knows we have got 
enough work to do around here, potholes here and there, school kids 
need help. We have got plenty of work to do. That is not the problem.
  We have also got plenty of wealth. We have got plenty of wealth in 
our society. And I believe that if you live in this greatest of all 
countries in the world--and I believe that, I am so proud to be an 
American--and you are allowed to make a profit, which I believe in 
that, I am a former businessperson myself--I don't think it is asking 
you too much to put a little bit in the pot so some people who can't 
afford it can go to the doctor.
  I don't think it is asking you too much to put a little bit in a pot 
so a kid can go to school, or so that a senior can get medication, or 
so that we can have clean water. I don't think it is too much.
  But some people think it is too much to say that, even though I have 
been blessed by being an American and being able to pursue my economic 
dream, I don't want to give them anything. This is all for me.
  I just don't--we are just not on the same page with that. We think 
that it is all right to make sure that we fund the basic necessities 
that people need to have a thriving, humane society, and that includes 
health care.
  So tonight, I just want to say to people that it reminds me of a 
question that a lady asked Benjamin Franklin when Benjamin Franklin 
walked out of the Constitutional Congress in Philadelphia, way back so 
many years ago. The lady said to Benjamin Franklin: What do we have, 
Mr. Franklin? He said: A democracy if we can keep it.
  Part of being a democratic society in this country right now means 
that we should have health care for people because this society can 
afford it. Part of what it means to have a civilized democracy in this 
moment means that people can rise up and lift their voices up to defend 
their right to have decent health care for all in this society; and we 
urge people to do that because it is the right thing to do, and this is 
the right time to do it.
  So I want to just yield back to my friend from Maryland. I will be 
taking my leave at this point, but I want to thank the gentleman for 
holding down this very important Special Order because the Affordable 
Care Act is worth fighting for.
  As you said, Mr. Raskin, the Affordable Care Act is not perfect. What 
piece of legislation ever was?
  We have amended the 1964 Civil Rights Act. We have amended the 1965 
Voting Rights Act. We amend laws all the time because, as society 
changes and times change, the needs come up. But to just repeal and 
then not come anywhere close to replacing, it is wrong, and we must 
oppose it.
  Mr. RASKIN. I thank the gentleman so much and, again, I salute him 
for his incredible work for the people of Minnesota and the people of 
America.
  Mr. Speaker, how much time do I have left?
  The SPEAKER pro tempore (Mr. Faso). The gentleman from Maryland has 
20 minutes remaining.
  Mr. RASKIN. Mr. Speaker, I just want to tie up some loose ends by 
exploring a few of the points that Mr. Ellison raised. But one of the 
very messy features of this legislation that is barreling through 
Congress this week is that the GOP leadership understood how popular 
the ban on denial of coverage for preexisting conditions is. That is 
going to be a mainstay of American life.
  People should not be denied health care because they have a 
preexisting condition. That is the reason they should get health care, 
because they have a preexisting condition and they need it.
  So they don't want to get rid of that. They understand that that is 
politically toxic. But they don't want to have the mandate for 
individuals to have to purchase insurance under the Affordable Care 
Act. That has been the major problem they have with the ACA. That is 
their major anathema. They can't stand that.
  But guess what? You can't have one without the other. And if they 
believe in economics and they are being honest, they will have to 
concede that. Why?
  Well, if I am a healthy young person, as I used to be, I will say to 
myself: Wow, an insurance company has got to cover me, even if I have 
got a preexisting condition, and I am perfectly healthy now, and I 
don't have to buy the insurance. So I am just going to go on my merry 
way, la-di-da, until maybe 1 day I have got a problem, I am in an 
accident, or I get some kind of diagnosis. At that point, I go to an 
insurance company, and they are going to cover me.
  So they have kept the preexisting condition provision of ObamaCare, 
which is wildly popular in the country now. They are terrified to touch 
it now, although they were opposed to it before. But their proposal 
gets rid of the individual mandate, and it doesn't work. It will 
bankrupt the entire system. It is not going to work.
  Now, another thing is that they are ignoring the extraordinary 
success of the Affordable Care Act. With whatever flaws it has got, it 
has been extraordinarily successful. It has dramatically reduced the 
number of uninsured people. It has insured more than 20 million people 
who did not have insurance before, and, therefore, it has dramatically 
reduced the number of people showing up at the hospital in the 
emergency room with no insurance, and the hospitals have been obligated 
to see them.
  And who pays for that? Guess who pays for it? You do, I do, the 
American public does when people show up without insurance. But the 
Affordable Care Act reduced, in a very significant way, the number of 
people showing up like that.
  Now, in my home State of Maryland, we have seen extraordinary 
reductions in the numbers of people showing up in the emergency room 
without insurance because of the ACA. We have cut the uninsured rate by 
more than one-third in Maryland. We had a rate of 10.6 percent. Now it 
is down to 7 percent since the ACA was implemented.
  All of the people who run the hospitals and our healthcare system are 
terrified that, if the GOP bull in the china shop wrecks the Affordable 
Care Act, what is going to happen is we are going to have hundreds of 
thousands of more visits every year in emergency rooms by people who 
are not covered by insurance, which means that the taxpayers get stuck 
with the bill again.
  Now, let me tell you about my congressional district, the beautiful 
Eighth Congressional District, of which I am very proud. Everybody 
loves their district, but I do have the most beautiful, the most 
extraordinary district in the country. In Montgomery County, Maryland, 
in Frederick County, Maryland, and in Carroll County, it is gorgeous. 
Please come out and visit us in Bethesda, in Rockville, throughout 
Carroll County, throughout Frederick County. Come to Middletown, go to

[[Page 4082]]

Thurmont, check it all out. It is beautiful. Come and visit us.
  Look what has happened in the Eighth Congressional District. Well, as 
I said, we have reduced the uninsured rate by a third. We have 444,600 
people in the district who have health insurance that covers preventive 
services today, like cancer screenings and flu shots, without any 
copays, without any coinsurance or deductibles, and they now stand to 
lose this access if the majority succeeds in eliminating the ACA 
provisions requiring health insurers to cover preventive services 
without cost-sharing.
  We have got more than a half a million people in my district with 
employer-sponsored health insurance who are at risk of losing important 
consumer protections like the prohibition on annual and lifetime 
limits, protection against unfair policy rescissions, and coverage of 
preexisting health conditions if the ACA is entirely or partially 
repealed.
  We have 21,400 people in the district who have purchased high-quality 
marketplace coverage, who now stand to lose their coverage if the 
marketplaces are dismantled.
  We have 16,000 people in the district who got financial assistance to 
purchase marketplace coverage in 2016, who are now at risk of coverage 
becoming unaffordable, if they have their way and they eliminate the 
premium tax credits, and so and so forth.
  Everything is dismantling the protections you have, making your 
premiums go up, throwing millions of people out of health insurance, 
and transferring lots of wealth upwards through the tax breaks that 
they want to give to wealthy people and insurance companies.
  By the way, as I understand it, there is a provision that they want 
to repeal which capped the tax deductibility of insurance company 
executive salaries beyond a half a million dollars. They want to repeal 
that, so that would continue to be tax deductible. You could pay them 
millions of dollars, and they get the tax break because, of course, 
that is going to be their first priority, making the wealthiest 
executives in the health insurance companies whole.
  Who cares what happens to everybody else, whether they lose their 
insurance, their premiums go sky-high? They know exactly where their 
bread is buttered. And that is just the icing on the cake.
  Mr. Speaker, I don't think that their legislation can pass because 
the American people are too smart for it and will not stand for it. I 
don't think it will pass.
  The President is already distancing himself from it. We all started 
calling it TrumpCare. The word went out that he didn't want it called 
TrumpCare. We think he knows that it is not going to pass, or, if it 
does pass, it is going to be a debacle of historic significance and 
moment.
  None of them want it to be named after them. We have offered 
RyanCare, we have offered TrumpCare. None of them want to be associated 
with it.
  I don't think it is going through. I understand that the Freedom 
Caucus, which thinks that there should just be a total free market, is 
going to vote against their plan, which they say is worse than 
ObamaCare, which they hated from the beginning. Although they are 
ideologically opposed to it, they know that ObamaCare is working, and 
they know that lots of people are being covered on it. And now they are 
going to be throwing millions of people off of ObamaCare, but they 
don't get what they want, which is a total free market.
  Of course, a free market in health care doesn't work because health 
care is not a social domain where the market operates.

                              {time}  2030

  If you get sick or if you get injured, then you are just taken to the 
hospital. You don't have a lot of time to shop around for the best 
hospital or the best doctor. You just need to go in, which is why the 
civilized countries of the world that can afford it have gotten to the 
point of a single-payer plan. But they want to take us from the 
Affordable Care Act backwards. They want it to be a dog-eat-dog medical 
care system.
  The American people are not going to accept that. They don't have a 
majority in Congress to do it, and it is the job of the minority in 
Congress which represents a majority of the people. Remember that the 
Democratic candidate for President received 1.9 million votes more than 
the Republican candidate for President. So it is the job of the 
minority which represents the majority of the American people, and it 
is the job of the people of the United States to say that we reject 
this sloppy, terrible plan that they are trying to rush through 
Congress. If they want to have discussions about actually improving 
things, we are very happy to do it. Otherwise, this cannot be accepted, 
and the American people need to pay very close attention to what is 
taking place in Congress this week.
  I yield back the remainder of my time, Mr. Speaker.

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