Providing Meaningful, Stable And Secure Health Insurance For All Americans

Ms. CASTOR of Florida. Mr. Speaker, the House of Representatives is poised for a very historic milestone this evening. We are on the cusp of beginning debate on the Affordable Healthcare for America Act, and Democrats are going to deliver what American families and businesses have been asking for when it comes to their health: one, meaningful, stable, and secure health insurance; two, improved Medicare for our seniors; and, three, vital consumer protections.

For families with health insurance, health reform will provide coverage you can count on. All Americans will have affordable options, even if they change their jobs or if their employer does not offer health insurance. We are going to get into a few of the important consumer protections tonight with a few of my colleagues.

Under this revised bill, families will not have to worry about insurance companies canceling their coverage because someone in the family gets sick or is diagnosed with cancer or another illness. Health insurance companies will no longer be able to bar you from health insurance just because you have cancer that is in remission or you have had a heart ailment. We are going to ensure that our neighbors are not forced to go bankrupt when a serious illness strikes.

What is insurance for, after all? It must be meaningful for American families. You have to admit, American families have been doing everything right. They have been paying their copayments, they have been paying their premiums, even as the cost has risen astronomically. What our health reform bill says is, in return, these American families must have coverage that is meaningful, stable, and secure.

Now, we reached this historic milestone reflecting back upon other important milestones in American history. It was January, 1935, when President Roosevelt sent his economic security bill to Capitol Hill. At that time, the Congress took that economic security bill and renamed it the Social Security Act; and, after many months of heated debate, in April of 1935 the Congress adopted the Social Security Act. President Roosevelt signed that bill into law at a ceremony in the White House Cabinet Room.

After President Roosevelt, it was President Truman who sought to build upon Social Security and provide that important stability and security to American families by launching the health care initiative. Unfortunately, it stalled under President Truman; and we have been in that stalling pattern for decades after, with the exception of 1965, with the adoption of Medicare.

In 1965, the House took up consideration of the Medicare bill; and President Johnson signed that bill into law at a special ceremony in Independence, Missouri, in 1965. President Johnson at that time, over the objections of some aides, insisted that the ceremony happen in Independence, Missouri, and that President Truman, who launched the national health care debate, be in attendance.

At that signing, President Johnson said, ``No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy savings that they have so carefully put away over a lifetime so that they may enjoy dignity in their later years.''

Mr. Speaker, with our corresponding health reform act that follows upon Social Security and Medicare, no longer will illness crush and destroy American families. They are entitled to dignity as well.

Now, during those debates, Mr. Speaker, there was a lot of opposition, great opposition from the Republican Party. The Republicans' record on Social Security and Medicare in America is not outstanding. They opposed Medicare from the beginning.

In 1965, the GOP said that Medicare was ``brazen socialism,'' and they have kept up that mantra year after year. They have tried to undermine Medicare. The Republicans have voted against protecting and strengthening Medicare since it was adopted. They have sought to privatize Social Security and Medicare. They have consistently wanted to move seniors into private markets. And, just this spring, House Republicans offered a budget that would eventually lead to the end of Medicare programs as they are presently known. If we had listened to Republicans, American seniors during the economic downturn would have seen their lifetime savings nearly disappear.

So here we stand again on the cusp of an historic milestone, to follow upon the legacy of Social Security and Medicare, the foundational values of the Democratic Party, popular initiatives that provide great security and stability to all American families; and we are going to deliver again for America's families.

We have some outstanding Americans here in the Chamber tonight. I would like to yield time to my good friend from Ohio, Mr. Ryan.

BREAK IN TRANSCRIPT

Ms. CASTOR of Florida. I thank my good friend from California.

I can't blame you, after listening to some of the debate, for having some consternation because here we are, we are poised to take this historic step on behalf of the American people that really is akin to what this great body has done in 1935 for Social Security, again in 1965 for Medicare. The vast majority of Americans would never think of turning back the clock to a time before we had those very important securities, that stability for American families. But that doesn't mean that they came easy. They didn't. And a lot of the arguments that were used then against Social Security and against Medicare have been used over the past year.

But you just have to stand up. You have to stand up and speak out for the families, the seniors, the older Americans that you represent and understand what this reform will mean to those families, finally giving them health insurance that is meaningful.

One of my very good friends that has been so involved in this debate for many years, I've had the privilege of serving with him on the Energy and Commerce Committee and the Health Subcommittee, and he's simply an outstanding voice on behalf of the families in Connecticut. So I feel very privileged tonight, as we're poised to take this historic next step, to yield to my good friend, Mr. Murphy from Connecticut.

BREAK IN TRANSCRIPT

Ms. CASTOR of Florida. I think you have summed it up well, Mr. Ryan. We are simply going to stand up for American families against the powerful interests that oftentimes and unfortunately the way health care has developed in America, it is take the money from well people. And the profits of these health insurance companies has been astronomical.

Why is it so difficult when somebody needs to call upon that policy, they have been diagnosed with cancer, they high blood pressure, and it is a fight. It is not a fight when you have to send the premium or the co-payment in, but it is a fight when you need to call upon what you have been paying for month after month.

So our reform is going to give the consumer, these families that we have the privilege to represent, greater bargaining power when it comes to their health.

You have to hand it to President Obama. He has reached out. He reached out early on in a bipartisan way. I know each of us here on the floor tonight have done the same. Early on, I called a bipartisan meeting of the Members from the State of Florida to say, What are our Florida priorities? We came up with a number. We have a terrible doctor shortage. We want to improve Medicare. And I am glad some of those ideas are incorporated in our legislation.

We have been having bipartisan meetings. We have had committee meetings, hundreds of committee meetings over the past couple of years, and hundreds of amendments incorporated. Our families back home, this isn't something where we are only listening to one side of the aisle. I know all of us have been taking the ideas, no matter what your political persuasion, because this is a critical American issue and it demands a unique, American solution.

As we begin the debate, I know there will be a lot of partisan rhetoric, but I want folks at home to know that we are going to stand up for you and fight for your family to ensure that if you have a diagnosis in your family of a serious illness, we are not going to let that insurance company cancel you. And if you have to change your job and your cancer is in remission, our reform will ensure that you will have affordable options. These are our fundamental values.

BREAK IN TRANSCRIPT

Ms. CASTOR of Florida. Chairman Pallone, you have hit upon another important underpinning of this bill, and that is personal responsibility. We are, through many initiatives in this bill, calling upon the American people to take personal responsibility for their health.

You are right. It is very expensive, very expensive, and American families know it. They know that one of the reasons that the costs have risen astronomically, and they are in the open enrollment period now, and families I hear from, they can't believe the rate of increase. But they understand, especially in a State like Florida where we have the second highest percentage of uninsured out of the 50 States, that we are paying, the folks with insurance are paying for the uninsured that show up in our emergency rooms, the most expensive place to receive care, and those costs have to be paid for somehow. Most often, it will make its way onto the copayments, premiums, and policies of American families that have taken personal responsibility, and that is just not fair. We can do better, and through our Affordable Health Care for America Act, we try to shift this very expensive way we deliver health care and make a historic investment in wellness and prevention.

Communities all across the country are going to have new incentives to build their communities in a sustainable way. Our hospitals are going to partner with universities and communities and nonprofits all across the country to focus on the most effective way to reduce childhood obesity and encourage folks to refrain from smoking, the way we can really control costs over the long term.

I appreciate the leadership of Chairman Waxman and you, Chairman Pallone. You encouraged me to offer an amendment in the Energy and Commerce Committee to encourage small businesses to do more in wellness initiatives. Big companies encourage employees to exercise and eat right and quit smoking. But, oftentimes, it is the small businesses that are left in the lurch. Certainly in this economy, they do not have the wherewithal to initiate those types of wellness programs. But in our health reform bill, we provide grants to those small businesses that are willing to cut their health care costs through new wellness initiatives. I know that it will pay great dividends for families and those businesses.

BREAK IN TRANSCRIPT

Ms. CASTOR of Florida. I thank you for that. Small businesses clearly are going to be big winners under this initiative.

Just a couple of months ago, I had a roundtable of small businesses from the Tampa Bay area, and there is one great business that has a lot of those retail shops in the airports. They do very well. She told me the story about trying to negotiate with health insurance companies. The problem, unfortunately, has grown over time where there is not much choice. There are so few options. As these small businesses attempt to go out and compete with their small numbers of employees, it is practically like sending a person out alone. It is just astronomical. I don't understand it because the profits of these health insurance companies are so high, but they don't offer affordable options to small businesses.

She told me this terrible story where, because they have a largely female and young workforce, it was very important to them that they have maternity care covered. And so they negotiated and had an agent, and maternity care was covered. The only problem was the health insurance company refused to pay for the baby's delivery of one of her employees.

These kinds of tricks have got to end. It's time that we stand up for families across America, make insurance meaningful, provide some stability, some security, just like Social Security did in 1935 and Medicare in 1965. These are the types of commitments we are trying to make with the American people.

We have great support as we launch the debate. I mean, let's go over a few of these great endorsements from just this week. Coming from the State of Florida, the AARP endorsement will ring out loud and clear because the AARP advocates for older Americans and our seniors. And the American Medical Association, also, doctors across America believe in our health reform initiative.

Mr. PALLONE. If I could ask the gentlewoman to yield on that.

Ms. CASTOR of Florida. I will yield to my friend.

Mr. PALLONE. The major reason why the AMA, which is the major doctors association of this country, I believe supports the bill is two reasons: first of all, right now under Medicare the reimbursement rate for physicians as well as hospitals is rather low; it doesn't pay for the actual cost of their delivery services under Medicare. So we have a major increase in here for provider payments, in other words, both hospitals and physicians.

Part of the problem under Medicare is, I know in New Jersey it's not hard yet, but it's starting to get more difficult to find a doctor who will actually take Medicare. If you're on Medicaid, it's almost impossible because the reimbursement rate under Medicaid is about 30 percent of actual cost in New Jersey, and we increase that rate as well.

With regard to hospitals, by eliminating the uncompensated care, because now everybody is covered, they are getting more money for Medicare, more for Medicaid, and we have eliminated the people that don't have any insurance, which basically, you know, they have to sort of eat that, it goes into their balance sheet. So we're going to make it a lot easier for hospitals to stay open. I've had two close in my district in the last 10 years because they were too dependent on Medicare and Medicaid, and they had too many people who didn't have health insurance.

I yield back.

Ms. CASTOR of Florida. And that's highly important because our hospitals oftentimes are taking care of folks who do not have health insurance. So there is a great amount of uncompensated care, and it feeds that vicious cycle in America where someone has to pay that cost. And it is put on to the backs of families with insurance oftentimes having to pick up the tab for some people who have not taken personal responsibility for their health.

As we launch into the debate, it is very heartening that we have groups like the American Medical Association and AARP on our side, along with the American Cancer Society, the American Academy of Pediatrics, the American Academy of Ophthalmology, the Campaign for Tobacco-Free Kids. I mean, these lists go on and on. These are Americans and interest groups from all across the country that have been involved for years in trying to get to this point to provide meaningful health care to American families, to ensure that that insurance, when you pay those premiums and copays, is really something you can count on. It's coverage that you can count on.

And then correspondingly, as we've gotten smarter and realize we need to do more in prevention and wellness, we're going to invest in a great new health care workforce. It means a lot to my home district in Tampa because we have a large research university, the University of South Florida, with a College of Medicine, College of Nursing, College of Public Health, Physical Therapy directly across the street from the busiest VA hospital in the country.

The new loan repayment scholarships that will be provided to young people, or anyone that wants to find a job in the health care workforce, this is a landmark investment in that new workforce. When you look at the unemployment numbers across America right now, the one sector where jobs are being created and there are opportunities is in health care. It might be in IT, in the electronic medical records, but we are going to need a modern health care workforce. Fortunately, that's what our initiative provides.

I yield to my friend.

BREAK IN TRANSCRIPT

Source