Tsunami Warning, Education, and Research Act of 2015
Floor Speech
BREAK IN TRANSCRIPT
Mr. KAINE. Madam President, I rise to talk about the ongoing discussions about the repeal of the Affordable Care Act. I basically want to make the case that this repeal, without a replacement being known, would be malpractice for the health care of millions of Americans as well as malpractice for the American economy. Before I talk about why, I just want to tell two stories.
On Monday of this week, I visited Neighborhood Health, which is a community health center in Northern Virginia that serves 14,000 patients. It is not a walk-in clinic; they are sort of a medical home for 14,000 low-income Northern Virginians, mostly working people.
Community health centers in Virginia, West Virginia, and in every State are a critical part of the health care safety net. In Virginia, they serve about 300,000 patients and millions nationally.
They are medicine with a mission. They don't deny anybody primary health care services because of inability to pay, and residents have equal access regardless of where they live, their culture, their gender, their race, or resources.
Many centers, including the one I visited just 20 minutes from here, were centers that were able to build or expand because of the Affordable Care Act. Facilities have gotten better in communities across the country because of the Affordable Care Act. That visit made powerfully clear to me how much every ZIP Code in this country has been affected by the Affordable Care Act because of these centers and other services that are provided.
The second story is a story from my recently completed, 105-day, unsuccessful venture as part of a national ticket. I was at the Iowa State Fair. A grandfather was carrying a little boy who looked to be about 3\½\ years old. I said: Tell me this youngster's name. The grandfather said: This is Jude. Of course, I said: Hey, Jude, and I said: Tell me about Jude. The grandfather and now the father walked over and started to talk to me, and what they said is this: Jude is 3\½\ years old and he has already had five open heart operations at the Omaha Children's Hospital, which is just across the river from Western Iowa, in Nebraska. They looked at me and they said he couldn't have had these operations had it not been for the Affordable Care Act.
Had it not been for the Affordable Care Act, he now would have exceeded his lifetime limit of any policy he could ever get, and he also would have a preexisting condition because of his heart condition that would render him unable to get insurance for the rest of his life. They looked at me, and--the father especially is a pretty big guy--and they asked: Will you do all you can--will you do all you can to make sure that this act is not repealed? You can strengthen it, you can improve it, but will you do all you can to make sure it is not repealed? I looked at them and I said--because I believed this even before they asked me the question: I will do anything to my last breath to make sure that we improve this but that we don't get rid of it. That is why I stand on the floor today.
Since the Affordable Care Act was passed in March of 2010, 20 million Americans have health insurance and many of them for the first time in their life. That is, I think, the combined population of about 14 or 15 States, having health insurance for the first time in their lives.
Now, when you have health insurance, it is not only that you can get care for an illness or an accident, even when you are healthy, you can go to bed at night with the knowledge that if something happens to my wife tomorrow, if something happens to me tomorrow, if something happens to my child tomorrow, they will be able to receive care.
The percentage in the Nation of people who were uninsured when the Affordable Care Act was passed was 16 percent. One in six Americans was uninsured. Now it is down to 8.6 percent. That is the lowest level of uninsured we have had probably since we have measured it. In Virginia, the drop has been from 13 percent--we were a little better than the national average--and we have dropped down to 9.1 percent uninsured. We are a little higher than the national average now because my State does not accept Medicaid expansion, but the difference in 6 years is 327,000 more Virginians have health insurance in 2015 than had it in 2010. That is a powerful thing.
In addition to having health insurance, families are protected because they can't get turned away because of preexisting conditions, they can't get turned away because they have reached lifetime limits in terms of their medical care, as Jude would have reached by age 3\½\.
Children can stay on family policies until age 26. Women cannot be charged different health care premiums than men. Insurance companies are required to rebate excess premium payments back to consumers if they overcharge.
It is not just about the millions who have health insurance who have never had it before, there are also millions and millions more to receive protections they have never had before. These are important provisions.
There has been discussion that I have been reading and following that what some want to do is just repeal the Affordable Care Act, with a vague promise that something will happen down the line. Of course, those who want to repeal the Affordable Care Act who voted against it in March of 2010 have had 6 or now nearly 7 years to come up with what they think would be better, and there has been no consensus about what they think would be better. So the notion of we are going to repeal it and don't worry, we will come up with a better alternative, rings pretty hollow to a family like Jude's parents and grandparents who have a three-and-a-half-year-old-boy who needs open heart surgery. The notion that don't worry, we will find a replacement, we will find a fix--I think we could forgive somebody like Jude's family for not having a lot of confidence in that.
If, in fact, we are serious about finding a fix, why don't we go to work finding a fix before we pass legislation to repeal the law.
I have said I think it is health malpractice and economic malpractice. Let me start with the economic malpractice. The worst thing Congress can do for the economy is to inject uncertainty into it.
I have been a mayor and I have been a Governor and I am a certainty fanatic. What I have learned about the economy is that our strong and resilient business sector--if you give them certainty, they can plan. They may not like a policy, they might not like a budget number, but if you tell them this is the way it is going to be, the ingenuity of our private sector is significant. They are going to be able to plan, they are going to be able to make the best of it, they are going to be able to figure it out, but if you provide uncertainty and don't tell people what you are going to do, that is very devastating.
I am on the Budget Committee. I came into the Budget Committee in the Senate, and I told me colleagues on both sides of the aisle: I am a certainty fanatic. We should be doing a budget. We shouldn't be doing a continuing resolution right now. We should be doing appropriations bills because when we tell both our own planners in our own departments and also the private economy: This is what it is going to be for the next year, they can figure it out, they can adjust, and they can do well. When we instead deliver a message that we don't know what we are going to do--oh, there will be a fix, but it will be a few years from now, we can't tell you what it is going to be now, and really we can't even promise we will do it since we haven't done it in 6 years--you inject uncertainty into the economy, and that is the worst thing we can do.
I have made the argument that the recovery we have been on economically--which is not a robust recovery, but it is a steady recovery--the principal reason it has been steady but not robust is because of uncertainty, and the principal generator of uncertainty in the United States is this body, Congress. Congress's inability to do budget in regular order, Congress's inability to tackle priorities, Congress's inability to work on big picture fiscal issues generates uncertainty.
So now we are talking about a repeal of the Affordable Care Act, the single largest sector in the American economy. One-sixth of the GDP of this country is health care. If you tell the entire American economy we are going to go into the largest sector in the economy, we are going to repeal it, and don't worry, we will get to something down the road as a replacement, you will inject uncertainty into an economy in a degree that has never been done by this body that I think will have catastrophic economic consequences even beyond health care.
It is also malpractice in the health lives of Americans. The Urban Institute has come out with a study today, an update of a study they did a year ago. There was a proposal a year ago to repeal the Affordable Care Act that President Obama vetoed. They did a study about what would repeal mean. This is what repeal means to the American public as we get ready to celebrate the holidays, a time when we are mindful of the needs of others:
The number of uninsured people in the United States, if the ACA is repealed, would rise from its current 28.9 million to 58.7 million, an increase of 29.8 million uninsured in this country. The share of nonelderly people without insurance would increase from 11 percent to 21 percent.
Of the 29.8 million newly uninsured as a result of the repeal, 22.5 will become uninsured as a result of eliminating premium tax credits, Medicaid expansion, and the individual mandate, and the additional 7.3 million would become uninsured because of the near collapse of the nongroup insurance market, and 82 percent of the new 29 million who will become uninsured are working families, 82 percent; 38 percent would be ages 18 to 34; 56 percent would be non-Hispanic Whites; 80 percent of adults becoming uninsured are adults who do not have college degrees. There will be 12.9 million fewer people with Medicaid or CHIP coverage in 2019 if the Affordable Care Act is repealed, and nearly 9.5 million people who have received tax credits to help them purchase private nongroup health coverage in 2019 will no longer receive that assistance. This is catastrophic to tens of millions of Americans.
I will tell a third story that is a story about me. I have to have the healthiest family in the United States, my wife and I and our three children. The only hospitalizations we have ever had, until my wife recently broke a bone, was for three child births. Our kids are 27, 24, and 21. We are the healthiest family in the United States. I was required once to go out right after the Affordable Care Act passed to buy health insurance on the open market. I didn't have an employer who could cover it. Two insurers turned me down because they said: We can't write a policy for your whole family because of a preexisting condition. One insurer turned me down because of something about me, and one insurer turned me down because of something about one of my children. Again, we are the healthiest family there is.
We were able to say: Wait a minute. The Affordable Care Act just passed. You are not legally allowed to do that now. You have to write a policy for the whole family.
The insurance agent who dealt with us on the phone said: Let me talk to my supervisor, and then called back and said: You know, what. You are right. We have to write you a policy.
This is a law that not only provides health insurance to 20 million people who never had it before but for even healthy families like mine provides benefits to protect against some of the worst and most predacious behaviors of insurance companies. If the act is repealed, this all goes away.
Americans agree, repeal is not the answer. A Kaiser Foundation poll that was done in the last 2 weeks showed that only 26 percent of Americans support a repeal of the Affordable Care Act. Of the other 75 percent, some think it should stay the same, some think it should be tweaked backward a little bit, some think it should be advanced, but only one in four Americans believe we should repeal this law.
Overwhelmingly, what the American public is telling us is, we should improve the law. That is what we should be about in this body.
When I was the Governor of Virginia, I noticed at the end of every legislative session there would be 1,100 bills on my desk for me to review, sign, veto, or amend. Of the 1,100 bills, pretty much every year 200 or 300 would be new, but 800 would be improvements to existing law. The job of a legislature is more about taking existing laws and reforming and improving it than repealing or doing something brand new.
That is what puzzles me. Why aren't we doing that? Clearly, there is no rush. There is no rush because the discussions are, we would repeal the Affordable Care Act with a promise we will find a replacement in 2 or 3 years. So if the notion is we are going to work for 2 or 3 years to find a replacement, there is no rush, and if there is no rush, why aren't we sitting down right now? Instead of repealing the law, why aren't we sitting down right now? Let's sit down around the table, let's talk about what we don't like, let's talk about what we do like, let's talk about what it means to have 20 million people in this country with health insurance, many for the first time in their lives, and what they might think. Let's get the perspectives of hospitals.
Let's get the perspectives of insurers, of doctors, and other medical professionals. That is what we should be doing. What is the rush? I fear the rush is for one reason: a desire to do something before this President leaves office that can be a little bit of a poke in his eye, but it is a poke in his eye politically in a way that takes families like Jude's family or the families I saw at the neighborhood health center in Alexandria and puts deep fear and uncertainty in their lives and also puts uncertainty into one-sixth of the American economy.
I know we will be having this discussion in earnest, I suspect a little bit over the next couple of days but more when the year begins, just as we are going to be having discussions about Medicare and Medicaid, with 1.3 million Medicare enrollees in Virginia as of 2015.
The CHIP and Medicaid Programs in Virginia have an additional 970,000 enrollees. I read dramatic discussions about these programs as well, these basic safety net programs.
I will conclude and say there is no reason we shouldn't be able to sit down around the table and talk about improvements. What I might call a reform somebody else could call a replacement. I don't care about the label, but what I do care about is repealing a law that provides millions of people the confidence that they have health care for the first time in their lives, doing it and having the discussion during the holiday season, doing it in a way that will hurt working people, will hurt working people who don't have high school degrees, doing it in a way that will hurt people who are already sick, who are already dealing with illnesses in their families.
I am a student of this body. I am not a historian. I am a student of this body, but my prediction would be this: If this body goes down the path of repealing this important law that provides important protections to millions with no idea about what the replacement is, I think it will be a day we will look back on and those who care about this body will look back on, probably in the not-too-distant future, and will say this will be one of the low moments in the history of the United States Senate. There is no need for it because there are people of good will in this body who are willing to sit down and find solutions and find improvements and find reforms, but nobody seems willing to have that discussion. Let's have that discussion rather than the repeal discussion, and we will serve our constituents better.
Madam President, I yield the floor.
BREAK IN TRANSCRIPT
Source