[Congressional Record (Bound Edition), Volume 163 (2017), Part 4]
[House]
[Pages 5010-5012]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 IMPROVE THE AFFORDABLE HEALTH CARE ACT

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Maryland (Mr. Hoyer) for 5 minutes.
  Mr. HOYER. Mr. Speaker, last week was an historic week in many 
respects.
  My Republican colleagues have indicated, for 6 years, they wanted to 
repeal the Affordable Care Act. They introduced a bill which really did 
not accomplish that objective, but it did undermine, very severely, the 
protections and the opportunities that the Affordable Care Act provided 
our citizens. That bill did not come to a vote. Had it come to a vote, 
it would have lost very substantially.
  Mr. Speaker, the proclamations last week by Republican leaders are 
that the Affordable Care Act will now remain in place. As Paul Ryan, 
our Speaker, said on Friday: ``ObamaCare is the law of the land.''

                              {time}  1015

  The Affordable Care Act is, indeed, the law of the land. Mr. Speaker, 
I rise,

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however, in a deep concern that the Trump administration and its allies 
in Congress will take steps to undermine the law and weaken it, to the 
detriment of millions who will see their health care put at risk. In 
other words, in my view, they may well try to do indirectly what they 
could not do directly.
  Let it be absolutely clear: Republicans control the White House, the 
Senate, and the House of Representatives. As a result, they are the 
governing party and will be responsible for anything that happens to 
our healthcare system on their watch.
  Even without the passage of a repeal bill, the Trump administration's 
actions could fundamentally undermine the law and the stability of our 
healthcare system.
  First and foremost, the Trump administration must commit to 
continuing payments for cost-sharing subsidies. We met with insurance 
companies yesterday to see whether or not the environment that was 
being created by the administration was undermining confidence so that 
it would undermine the ability to price the product that Americans 
need: healthcare insurance.
  Cost-sharing payments, paid for and in the bill, are being put at 
risk by a suit that the Republicans in the House of Representatives 
have filed. They ought to withdraw that suit to give confidence to the 
system. We all know that confidence in markets is critically important. 
This is essential to preserving the affordability and accessibility of 
health care for millions of Americans and to ensuring stability in 
health insurance markets.
  The uncertainty around cost-sharing subsidies that has been 
perpetrated by the administration's silence on this issue, must come to 
an end. The administration has said the system will implode. It will 
only implode if they are forced to do so by the administration through 
executive action. Insurers are preparing to file rates as soon as next 
month in some States. Without a clear and public commitment from the 
administration, we could very well see premiums spike and insurers 
flee.
  Americans have made their opinion pretty clear. They said: Do not do 
that. Do not undermine the system.
  Second, already, President Trump has undermined that requirement 
through lax enforcement that the individual responsibility 
requirement--a Republican suggestion, a Heritage Foundation suggestion, 
a Romney-adopted policy in the State of Massachusetts--a premise of 
personal responsibility that is being undermined right now by the Trump 
administration. The individual responsibility requirement is vital to 
ensuring that those with preexisting conditions can be guaranteed 
coverage.
  To my friends across the aisle who talk often about defending our 
Constitution, I would remind them that the President has sworn an oath 
to faithfully execute the laws of this Nation; not picking and choosing 
which ones he likes.
  Third, the administration can--and I would suggest it should--
encourage States that have not yet accepted expanded Medicaid to do so. 
It works. According to a 2016 report by the Department of Health and 
Human Services, in the expanded-Medicaid States, premiums were 7 
percent lower on average.
  Mr. Speaker, just yesterday, the Republican-controlled Kansas State 
legislature--Republican Governor, Republican House, Republican Senate--
sent a bill to the Governor that would expand the State's Medicaid 
program. Presumably, they made a judgment that was in the best interest 
of their State and the best interest of their people.
  The Republican sponsor of the bill, State Senator Vicki Schmidt said: 
``I don't believe we can wait for D.C. They had an opportunity, and 
they didn't take it.''
  So her response was, and the legislature's response has been: adopt 
Medicaid expansion.
  We have heard a lot from Governors of both parties from States with 
expanded Medicaid, almost universally extolling the benefits that they 
provided, and urging Congress not to roll it back.
  The Trump administration must recognize the importance of Medicaid 
expansion and support ongoing efforts in States like Kansas, Virginia, 
and Maine to do what is right for their people and their State.
  Fourth, the Department of Health and Human Services, under Secretary 
Price, has a responsibility, a duty, an obligation to focus at least as 
much on outreach and enrollment, as did his predecessor, Secretary 
Burwell, to let people know what options they have, what opportunities 
they have, what protections they have, what securities they can 
achieve.
  Earlier this year, the Trump administration, instead, intentionally 
sabotaged enrollment efforts in the final week, pulling media ads to 
let people know what they could sign up for, and ending other outreach 
programs.
  This move resulted in half a million fewer people obtaining 
affordable coverage through the marketplaces--the first decline in the 
history of the law. Those people will be hurt because some of them are 
going to get sick. Some of them may have a catastrophic accident, and 
they will need insurance, and they will not have it because they did 
not get the information that they needed.
  Now that the Affordable Care Act will continue to be the ``law of the 
land,'' to use words first spoken by former Speaker Boehner in 2012, 
the issue in 2012 was the Affordable Care Act--President Obama's 
probably crowning achievement. Republicans called it ObamaCare, 
derisively. We call it the Affordable Care Act, supported by President 
Obama.
  After the 2012 election, Speaker Boehner said, well, we resolved that 
issue. The American people have voted to confirm a President whose 
principal law that was. But the Republicans kept trying to undermine 
it. They kept trying to say they wanted to repeal it. And now they have 
all of the power. They haven't done that.
  Don't break it. If you couldn't do directly something, don't do it 
indirectly. Don't undermine the security of the American people 
indirectly; not through law.
  So when open enrollment comes later this year, Mr. Speaker, it would 
be a dereliction of duty--let me repeat that: it would be a dereliction 
of duty--not to inform Americans to know how they can benefit under the 
law, what options they have for finding coverage at more affordable 
rates or through expanded Medicaid. Let there not be a dereliction of 
duty.
  The larger point here, Mr. Speaker, is, as I have said, that 
Republicans cannot now simply throw up their hands and say: We failed 
to offer a viable alternative, and we will now, by action and inaction, 
by negligence and malfeasance, conspire to undermine the options that 
are available to the American people.
  More than two-thirds of Americans have said that is not a responsible 
policy. The Affordable Care Act has brought protections and benefits to 
millions. Twenty million more people are insured in America. But now my 
Republican friends, who have no workable alternative, are in power; and 
it is now their duty to ensure that they faithfully execute existing 
laws to benefit the American people. If they fail to do so, or 
intentionally sabotage the current healthcare system, they will surely 
be held accountable by the American people.
  Democrats don't want to see that happen. We reject the premise of 
some kind of death spiral. By the way, the Congressional Budget 
Office--an independent bipartisan group, but its director appointed by 
Republicans--said it was not only not on a death spiral, but it was 
stable.
  The yardstick by which we all ought to be judged is not whether the 
law succeeds just enough, but whether we can work together--work 
together, work together--to make the law work as best it can, to 
benefit as many Americans as it can.
  President Trump, speaking at that rostrum, looked directly into the 
TV camera of 100 million-plus Americans and said: I want every American 
to have health insurance that will be cheaper and higher quality than 
we have today.

[[Page 5012]]

  Mr. President, if you send such a bill to this House, I will vote for 
it. I haven't seen a bill like that, but if I see it, and if you send 
it down here, and that is your commitment, I will vote for it.
  Mr. Speaker, I hope my friends across the aisle will take a lesson 
from last week that, to paraphrase the President, health insurance is 
indeed complicated, and that it will truly take both parties working 
together towards consensus to meet the healthcare challenges we face.
  Our constituents and our country is counting on us not to fight, not 
to throw bricks at one another, but to act in their best interest. And 
what I urge the Trump administration to do, Mr. Speaker: Do no harm 
until you have a bill that accomplishes what you said to the American 
people you want to accomplish. Mr. President, do no harm. Ensure that 
the American people continue to have access to affordable, quality 
health care.

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