Department of Defense

Floor Speech

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Mr. DURBIN. Madam President, the issue of quality, affordable health insurance is personal to me. I know what it feels like to be a new dad with a beautiful little baby girl with a serious medical condition. It happened in my life when I was a student in law school at Georgetown here in Washington, DC.

God gave us this beautiful little girl, but I didn't have health insurance as a law student. We ended up in the charity ward of Children's National Hospital waiting for our name to be called to be introduced to the doctor--the new doctor--at the hospital who would do his best to help my daughter.

I thought about it as I sat in this ward with other people who could not afford to pay their medical bills and thought to myself, I failed as a father and husband. I didn't do the basics. I didn't have health insurance when my baby came along.

Well, there were some wonderful people who did some wonderful things for our daughter, and I will never forget it. But I also never will forget sitting in that chair wondering who would come through that door and be my daughter's doctor. I would be meeting him for the first time. I never felt so helpless as I did at that moment.

As lawmakers, I believe our job is to help make life a little bit better for the people we represent. This week, it means tackling the quality, affordable health insurance issue. It is no secret what happened in this Chamber over the last several weeks and months. We had the longest government shutdown in history--42, 43 days, depending on how you calculate it, but it was a record.

The issue was whether or not we would do something to provide health insurance to some 20 million Americans who stand to lose it because the premiums are too expensive.

We went back and forth, and every day I came to this floor and stated our position on the case. Senator Thune, Senator Barrasso stated their position. Senator Schumer, of course, was part of this dialogue that went on week after week.

The decision was finally made by a number of us to end the government shutdown by voting to open the government. There was an understanding that certain things would happen: Appropriations bills would pass as part of the continuing resolution, and many Agencies of government, which were in a questionable position, would be funded.

That was important.

But when it came to health insurance, we reached an agreement that this week, before the Christmas recess, we would have a debate and a vote on extending health insurance.

Why are we doing this? Because the Affordable Care Act passed under President Obama provides tax credits, help in premium payments, for millions of Americans who could otherwise not afford to have it. And the decision in the Big Beautiful Bill--the budget bill of President Trump--to end those tax credits meant that millions of Americans stood to lose the health insurance that they had before starting January 1 with new and higher premiums.

Senator Thune promised a vote, and I believed--he told me personally--he would keep his word, and I believe he will. I think we will have a vote this week, but a vote is not enough if we can't come to an agreement.

We need 13 Republicans to join us in a bipartisan effort to extend this tax credit so that millions of Americans don't lose their health insurance--13 of them. They need to step forward and, frankly, join us in a bipartisan effort. There is a lot more to be done. This is not all that we will do, but extending this health insurance premium assistance to these families can make a real difference.

Let me tell you a story. If you are looking for breakfast in downtown Chicago on a Sunday morning, let me recommend a restaurant. The name of the restaurant is Lou Mitchell's. Lou Mitchell's restaurant is in the shadow of Union Station, the Amtrak station downtown Chicago. It is two or three blocks from our Catholic parish, and we are there regularly on Sunday mornings, 8 o'clock. We have got two stools by the counter that my wife and I sit at and eat breakfast. We have come to know just about all of the waitresses and helpers in this restaurant.

It is legendary, by Chicago standards. They claim to be the starting point for the creation of U.S. Route 66. There are people, literally, coming from all over the world to make that journey down Route 66 and start with breakfast at Lou Mitchell's.

Donna Fenton is my personal friend, my wife's as well, and she is the maitre d' at the breakfast restaurant. She is 94 years old. She never misses a day of work. She is a wonderful person, a diehard Cubs fan who wears earrings with the Cubs logo on them. I have taken her to games over at Wrigley Field, and she, even at her age, is just as lively and involved as any person in the whole audience.

Yesterday, when my wife and I went to Lou Mitchell's for breakfast before church, I had conversation with another person who is on their staff, a waitress. She is a manager as well, and she has been working at this job for years. She is 63 years old.

Her husband just qualified for Medicare, and she felt relieved that that worry about his health insurance would be take care of. She then found out that the Medicare Advantage Program that she would be having him sign up for runs $200 a month. Her original premium that she is paying for health insurance for him and for her is $279 a month.

So right off the bat, she faced an increase over her base premium that she has been paying for some time, but she had the good fortune, at least now--up to now--to have a tax credit to help pay for those premiums. Then she got the notice from her insurance company that the cost of her insurance, even with her husband not covered by the same policy, is going to virtually double.

I can tell you, this is a hard-working lady. I have come to know what it means to be in your sixties and still working as a busy waitress in a busy restaurant. It isn't easy, physically demanding. She has had orthopedic surgeries and other problems occasioned by the fact that it is just an act of life. At a time when most of us would like to think we are going to close that chapter and take it easy, she is not able to.

She said to me: What is going to happen to me when I can't afford health insurance?

And I thought back to my own experience here in Washington.

I said: Well, I hope you don't get sick. It is the best I can say for you.

She said: Who wants to raise my premiums more than double? Who is behind all this?

I said: Unfortunately, there is a political difference here. I won't go into details. It will sound too partisan. But there are some Members of the Senate, who, frankly, know you are going to have to pay twice as much and really don't want to see changes made--let it go forward.

I think that is unfair to her. I could give you her name, but I am not going to because I didn't ask her permission, but I believe every word she told me.

Hard-working woman, 63 years old, whose health insurance is going to more than double each month. She doesn't make a fortune as a waitress. She makes a basic wage in tips. And now she is asking me as her U.S. Senator: Why did you do this to me?

Well, my answer is: We have a chance this week to change it.

And that is what I told her.

If we can get a bipartisan group to agree to just extend these credits, we are going to be able to bring your premiums down to be more affordable. It won't be the same. It will still be high. But it won't double or triple, which is likely to happen otherwise.

I think about her as I stand on the floor of the Senate and think of the tears in her eyes as she talked to me about what her life is going to be like if we fail. We can't fail. We have an obligation to her as Democrats and Republicans.

Are there things we can do to deal with the Affordable Care Act? Yes. I still think it is fundamentally sound, but there are elements in it that need to be changed.

We look forward to not only extending these tax credits but also a meaningful, bipartisan gathering in the appropriate committees to talk about changes in the Affordable Care Act.

Now, there are some people who want to see changes that are politically volatile. To go into the issue of abortion now instead of just expending these premium benefits--I know because I have lived through the Affordable Care Act--it is a nonstarter. It is a poison pill. It is the end of the conversation. We are too divided on the issue.

Prior to the ACA, we must remember that insurance companies could deny coverage to patients with a preexisting condition. This waitress I am talking about has a long list of preexisting conditions now. I won't go through them here, but under the old school, before the Affordable Care Act, she would have had exclusions in all of her health insurance policies for all of these medical conditions.

Under the Affordable Care Act, she must be offered health insurance, regardless of preexisting conditions.

If someone had, for example, a history of diabetes, heart disease, or even a past pregnancy, insurance companies used to be able to exclude those services from your plan or charge you an amount that you couldn't afford.

Thanks to the Affordable Care Act, insurance companies are no longer allowed to discriminate against patients with preexisting conditions. We required in that law that health insurance plans cover comprehensive benefits, hospitalizations, prescription drugs, and even mental health and addiction treatment, and we allowed children to stay on their parents' health insurance until the kids reached--no longer kids, young men and women reached the age of 26.

What was the result? It worked. For 15 years, it worked.

We achieved the lowest number of uninsured Americans in our country's history. Millions more Americans suddenly had the peace of mind of having quality healthcare.

But faced with high costs, from expensive medications to specialty treatment, too many hard-working families are struggling to keep up with the high price of healthcare.

I have heard my colleagues on the Republican side, who didn't support the bill when it was created, come in and say: But healthcare is still too expensive.

That is a fact. But imagine, if there were no help in paying the premiums, what families would be doing with these increased costs.

Do you want to know one of reasons that the health insurance is so expensive? I have asked Blue Cross Blue Shield in Chicago, and they tell me it is pretty simple.

Did you ever see an ad for a pharmaceutical product on television? I will bet you did, and I bet you saw more than one. They play it all the time. There are only two countries in the whole world that run these ads for drugs: the United States of America and New Zealand. In every other country, it is prohibited.

What difference does it make? People get into their minds that these drugs just might be the cure for my problem, and they go to the doctor's office, and they sit down for the 10 or 15 minutes they have with that doctor and say: I have been hearing all these ads about Xarelto.

The doctor says: Xarelto? I am surprised you can pronounce it.

The person says: I can spell it. I have seen so many ads. I think I need it, Doctor.

And in too many cases, the doctor, rather than get into a debate or say there is a cheaper generic for this drug or the other, ends up writing a prescription for an expensive drug. It is one of the major reasons that health insurance premiums have gone up so high in the United States of America.

Now, I have a bill that eliminates directed consumer advertising, as approved and requested by the American Medical Association. I won't be able to add it to this bill--I want to--but I am prepared to join in the debate about making the system better and more affordable that will follow after this vote.

So what I am saying is this: The Affordable Care Act is so important. It is one of the most important votes I have ever cast. I still stand by it, but it needs to be improved, and we need to do that. We won't do it this week, but, this week, let's give peace of mind to my friend who is a waitress at Lou Mitchell's, and others that have written to me from all over the State of Illinois, that they can afford health insurance, that their premiums will get a helping hand.

It takes 13 Republicans to join the Democrats for that to happen. It has to be bipartisan.

As a result of the enhanced premium tax credits, the number of Americans covered in the ACA marketplace plans has increased from 11 million in the year 2020 to 24 million this year, including my waitress friend at Lou Mitchell's.

In Florida, the number of residents with healthcare coverage has doubled since passage of the Affordable Care Act. In Alabama, tens of thousands of children and older Americans have obtained health insurance for the very first time because of the Affordable Care Act.

Why do we want to reverse this? Why do we want to put the waitress that I mentioned to you in a situation where she can't afford her premiums anymore? That is going to happen in just a few days if we don't act in a responsible, bipartisan way.

This summer, Congressional Republicans eliminated $1 trillion in spending for Medicaid. It is a different but related issue. This will take healthcare away from 11 million Americans and threaten rural and intercity hospitals. But in also refusing to extend premium tax credits, 22 million Americans may see their health premiums double, on average--double what the health insurance payments were just today and a few weeks ago. These could get raised by more than $3,000 next year.

In Jackson County, in Southern Illinois, an area of small towns and rural areas, residents there, on average, will see their monthly premiums go from $122 a month to $458. That is a difference of $330 a month, a 274-percent increase.

In Crawford County, in Downstate Illinois, monthly premiums could rise from $170 a month to $517, a 204-percent increase. That is why our vote this week is so important.

We can stop these premiums from increasing in my State, in Alabama, in every State where people are affected by it. In Western Illinois, residents, on average, will see a 120-percent increase if we don't do something this week.

What is our excuse? We are too busy? Look around you. Does this place look too busy? Not to me. We used to have legislation on the floor regularly--and amendments and debate--and we would actually pass laws that had to be considered by the House and Senate. And it would happen. It doesn't happen anymore. We come to the floor and make a speech. We may, once a month, have something to vote on the floor.

This Senate is described as one of the great legislative bodies-- deliberative legislative bodies--in the world. You couldn't prove it by the history of our schedule over the last several months.

This week, the Senate Democrats are going to put forward a proposal to extend health insurance premium tax credits for 3 years. I have heard some people say: Well, that is too long.

Well, come back with an amendment for 2 years or 1 year or something. Show there is a beating heart there that actually cares to solve a problem--a problem that affects a waitress in a restaurant in downtown Chicago.

We have tried many times to have this debate. It never gets off the ground. But now we have come to a moment where, on January 1, the world is going to change for millions of Americans if we do nothing.

I want to work with the Republicans on this bill. I want to make the Affordable Care Act better. But we have got to take care of the immediate crisis before January 1.

If Republicans, 13 Republicans--13 brave Republicans--will step up and say, ``We want to extend the tax credits,'' there is going to be an opportunity for us to sit down and say: All right, what do we need to consider to do to make the Affordable Care Act better?

There is an editorial in the Wall Street Journal this morning. I don't usually buy that newspaper, but I am glad I did. There is a long list of things they raised questions on when it came to fraud in the Affordable Care Act. It is legitimate to raise those questions. We should ask that of every single program.

They suggested in their editorial that the tax credits are somehow an inducement toward fraudulent enrollment. The Wall Street Journal came out with an editorial, as I said, highlighting the findings from the General Accounting Office, the congressional watchdog.

My response: Sign me up to sit down, put that editorial on the table, and, on a bipartisan basis, address the very things they have raised. But let's not allow these findings about malfeasance by brokers of insurance--and those are the ones they are blaming, not the patients-- to be the reason that 24 million Americans face unaffordable premiums, and not the reason my friend the waitress at the restaurant is going to face premiums she and her husband cannot afford.

To be sure, what the GAO found is unacceptable. But there are proposals on the table that Democrats would support to crack down on malicious brokers who fraudulently enroll customers. No excuse--that has got to stop. I will be part of it, on a bipartisan basis, if we get that opportunity, and I hope we do.

But to argue that tax credits to help my waitress friend pay her premiums are the reason for fraud and, therefore, should be eliminated is the wrong conclusion. It is an outsized, collective punishment to her. And what did she do wrong?

We don't punish seniors when their identity is stolen. We punish the grifters who did it, and the same things are true when it comes to fraud. Let's hold those accountable for it--strictly accountable. Raising premiums so that patients have skin in the game would still not deter malicious brokers from their illegal behavior--we can address this, and we should--and it would ignore the fact that the Medicare Advantage plans also have zero premium policies. I don't hear any bipartisan howling about that.

I am willing to work with Republicans to take on fraud, but let's be honest about the scope of the problem and not use it as an excuse to abandon the tax credits that more than 20 million Americans rely on.

I want to go back to that restaurant--maybe not next Sunday, maybe after Christmas--and tell that friend of mine that we heard her and we did something about it, and we are going to give her a helping hand, at a time when she has nowhere else to turn. She is working hard every single day and has done that all of her life. All she has asked us to do is to give her a fighting chance to have health insurance for her family. Isn't it really incumbent upon us to meet that responsibility?

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