Repeal of the Affordable Health Care Act

Floor Speech

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Mr. GARAMENDI. Madam Speaker, it's a great privilege to be here on the floor with you. Congratulations to you and the other new Members of the Republican Party.

We have some extraordinarily important tasks ahead of us. This afternoon, I'm going to be joined by some of my colleagues. We've just heard a very useful discussion on the role of the Constitution and how it plays into it. And indeed, today we did spend about 3 hours reading through the Constitution, and I think it was to all of our benefit. We started off with the new Speaker actually reading the preamble. I think that's a good place for us to start, because we're going to discuss health care today and we're going to discuss an effort by the majority party, the Republicans, to repeal the Affordable Health Care Act that was passed last session. And this issue has become a constitutional issue, so reading the preamble to the Constitution and Article I, section 8 is useful.

``We the people of the United States, in order to form a more perfect Union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare''--promote the general welfare--``and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States.'' And then later, in article I, section 8, ``Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States.''

It's about the general welfare of the United States that we'll be discussing in this next hour, and that's the welfare of the people of the United States. It speaks to us, the citizens--all of us--whether we are a newborn baby or a senior in the last of life--how do we provide for that general welfare?

Last year, in a major step forward, the first time in more than nearly four decades, this Congress, together with the Senate and the President, passed the Affordable Health Care Act, a very, very important and extremely useful step in providing for the welfare--that is, the general welfare--of the American population. It's a law that makes life better from birth to retirement. Part of this law, a very, very important part of it, deals with what we call the Patient's Bill of Rights--the Patient's Bill of Rights, vis-a 2-vis, the insurance industry.

I think all of us can go back to our districts, to our homes, and even to our own lives and find numerous episodes where the insurance industry has said, No, you cannot have this procedure; or, No, you cannot have coverage because you have a preexisting condition.

Today, we are going to talk about the Patients' Bill of Rights and the Republican effort that is now underway in the Rules Committee in this building, as we speak, to write a rule that they will bring to the floor next week, without one hearing, to completely wipe out this extraordinarily important effort to provide for the general welfare of the American people. We are going to discuss that in great detail.

Now, for me, this is a very important part of my life. I spent 8 years of my life as the insurance commissioner in California, taking on the insurance companies, trying to force them to honor their commitments, to force the insurance companies to pay the claim of a patient who had undergone chemotherapy, to provide insurance that was contracted for and not to rescind that health care policy. I cannot even begin to count the number of cases that came before me as insurance commissioner where the insurance companies would rescind a policy because the person suddenly became ill and had a very expensive episode.

The Patients' Bill of Rights prohibits that. We are going to talk about that. I want to start here, and then I'm going to turn this over to my colleagues.

I am going to give an example of a very dear friend who lived here in Washington. He was a Peace Corps volunteer, married. He was working here in Washington, DC, as the director of the National Peace Corps Association, the returned volunteers. He had a child. That child had a severe disability--kidneys didn't work. He was insured. His wife was insured. The pregnancy was insured. The delivery was insured. But that child, on the day the child was born with that preexisting condition of kidney failure, was uninsurable under the parents' policy.

That kind of action is prohibited by the Patients' Bill of Rights. No more would that happen to men and women, families, pregnant women across this country who deliver babies that have some problem. Those babies will be insured whatever the condition might be.

Our colleagues on the Republican side will bring to this floor next Wednesday, without one hearing in any relevant policy committee, a repeal of the Patients' Bill of Rights. What of the babies that are born in the future that have some issue? How will they be provided for?

The rest of the story is this family has spent 20 years now struggling to provide the health care services that their child needed. They have been close to bankruptcy many, many times. They have struggled through it. The child is no longer a child--a young adult--and under the law today, he has health insurance.

Is that what the American public wants from the Republican Party--the
repeal of that Bill of Rights that guarantees coverage for that young man? I think not.

Let me now turn to our colleague from the great State of Virginia.

Bobby Scott, would you please share with us your own views and how this is going to affect the general welfare of the American people.

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Mr. GARAMENDI. Thank you very much.

You've raised about seven of the major issues that are involved in this repeal that the Republicans will bring to this floor next Wednesday without one hearing in any relevant policy committee, a repeal that will affect every single American--that will affect their well-being, their health, their ability to get health insurance, and their ability to stay healthy.

So we have an enormous issue before us and we want the American public to be aware of what's going on here. It is the repeal of the Patient's Bill of Rights.

Let me move on to one of our other colleagues from Tennessee. Mr. Steven Cohen, if you will join us, please.

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Mr. GARAMENDI. Well, I would assume that they will try to go into their interpretation of the Constitution and avoid the very difficult argument of forcing or eliminating the Patient's Bill of Rights and allowing the insurance companies to engage in gross discrimination based upon sex. Clearly, women are discriminated against by the health insurance companies unless the Patient's Bill of Rights is there to protect them. Similarly, the two examples that you gave, pre-existing conditions, I cannot imagine that they
would even attempt to successfully or even would be unsuccessful to argue that somehow these protections for the individual are not worth having.

I think they will go into some obscure interpretation of the Constitution. We'll see. There's going to be a debate on the floor. Unfortunately, there will be no hearings to precede that, and there will not be a discussion of the details.

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Mr. GARAMENDI. As you know--I saw you in Rules Committee earlier today--it is my impression that the Rules Committee is going to prohibit any amendments on the floor. We'll see. I mean, that has yet to be decided by the Rules Committee. We don't know, but surely the one amendment I would propose is: don't do it, maintain the Patient's Bill of Rights, maintain these protections that we all need.

There's not a person in this Nation that is not subject to the possibility of an incident that would become a reason for rescission. That's my experience. Eight years hammering the insurance industry, you have got to honor your contract. Yet because of the laws, they were able to wiggle out of an expensive incident.

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Mr. GARAMENDI. I don't know if you were a Member of Congress at the time, but we all under this law would have the same policy that every American would have. We wouldn't have any different policy than the American public would have, and the question about rescission, and you're a prime candidate should you lose office, which you shouldn't, to be uninsurable if the Patient's Bill of Rights were repealed.

Under the Patient's Bill of Rights, if you were to leave Congress, you could get an insurance policy because the pre-existing condition that you have, polio, and an operation resulting from the polio would go into play as a pre-existing condition, and you would not be able to get an insurance policy.

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Mr. GARAMENDI. Mr. Cohen, thank you so very much. Your closing sentence needs to be repeated. That the very first piece of legislation taken up by the new Republican majority in the 112th Congress is to repeal the Patients Bill of Rights. It's unfathomable.

Let me now call on Frank Pallone, our colleague from the great State of--yes, it is--New Jersey.

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Mr. GARAMENDI. I do have some experience on that. I wanted to deal with that. It's called the medical loss ratio, and the insurance companies have cut a fat check for themselves over the years by taking a big premium and then paying a very small amount of it out for the medical coverages.

In this legislation, the Patients' Bill of Rights, and in the Affordable Health Care Act, they can't do that. They've got to pay, for the individual policies, 80 percent and, for the group policies, 85 percent for medical services.

So what was the very first thing they did after this bill was signed into law? We passed it last year, and the President signed it. The very first thing they did was to run down to the Health and Human Services Department and say, Oh, but our advertising ought to be included as a medical expense, and, Oh, these expenses for these kinds of employees, mostly statisticians and the like, that's a medical expense. Fortunately, the administration said, No, we think not.

So what we're trying to do with this legislation is make sure that when we pay a dollar, at least we get 80 cents back in medical services. Our friends on the other side would repeal that and allow the insurance companies to take that money--or at least a larger portion of that money--put it in their pockets, give it to their CEOs, whatever, but not use it for medical services. Medical loss ratio is really important.

And the other thing you mentioned needs to be understood also, and that is the ability of the governments to review, not to say ``no,'' but to shine that big, bright spotlight onto the insurance company premium increases. Is it justified? Yes? No? What are your costs and so forth? What ratios are you using in medical losses and the like? So that spotlight of information is required under the law. Many, many things in the law.

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Mr. GARAMENDI. Well, Mr. Cohen, it just happens that we prepared this little blue chart here. Actually, it probably ought to be in the red. The repeal of the Affordable Health Care Act obviously deals with the Patients' Bill of Rights, but it also deals with the deficit.

This week, the Congressional Budget Office, nonpartisan, not Democrat, not Republican, they answer to neither party. They answer to the general public. They said that the repeal of the Affordable Health Care Act will increase the deficit by $230 billion, $230 billion in the next 9 years, and in the out years, the next 10 years, well over 1 trillion, $200 billion increase in the deficit.

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Mr. GARAMENDI. Thank you so very, very much. Before I turn to our colleague from Virginia, you reminded me of two very quick stories. One, on Monday I was at the inaugural for the Governor of California. Jerry Brown is back again. And a lobbyist that I knew when I was insurance commissioner representing health insurance companies came up to me and he put his finger in my chest and he said, don't let them repeal the law.

Now, I'm not going to give his name. He'd lose his job immediately.

And I said, I'll do everything I can, but why? You represent them. Why?

And he said, I have two children. Both are type 1 diabetics. They're approaching 23 years of age. They will be out of luck. They will never be able to get an insurance policy if this bill is repealed. The Patient's Bill of Rights gives that lobbyist for the health insurance industry an opportunity to see his children get health insurance.

Now, I have six children of my own. Patty and I do. All six of them have gone through that age of 23. It is the scariest time for a parent. You graduate, you get a diploma, and you also get an exit from the insurance that you've had perhaps for your entire life. This law provides another 3 years after you graduate, that period of time where it's almost impossible nowadays to find a job that provides insurance to give that insurance.

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Mr. GARAMENDI. If I might interrupt you for just a moment, Mr. Scott. You are into an issue, an area that is profoundly important to the seniors of America.

The discussion last year as this bill was passing was that somehow this piece of legislation would harm seniors by taking away Medicare benefits. It was not true last year. It is not true this year. However, if our Republican colleagues are successful in repealing it, they, the seniors, will be seriously harmed.

I want to make this point very, very clear and ask my colleagues to join us perhaps from their own personal experience in their districts. You started going through this list here. This legislation actually extends the solvency of Medicare by reining in the costs and by giving seniors specific pre-illness care so that they will be able to get preventative care free, free annual checkups. They can't get it today, but under this legislation seniors can get free annual checkups, which reduces the cost, because you get to the illness quicker.

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Mr. GARAMENDI. You mentioned the doughnut hole, the prescription drug doughnut hole. Every senior that was in the prescription drug doughnut hole last year, 2010, received a $250 check to help them pay for their drugs. In going forward, the doughnut hole will be lessened and lessened, and eventually, 9 years from now, will disappear. There will be no doughnut hole.

You talked about the quality of care. Extremely important, quality of care. Thank you for bringing that up. More primary doctors, more geriatric care from nurses and doctors, an extraordinary important part of the legislation, not just only for seniors. You also mentioned the community-based and of course the preventative care. All of these things are there, and all of them will disappear if the Republicans are successful with their legislation next Wednesday that will be brought to this floor without one hearing to discuss any of these issues in a relevant policy committee.

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Mr. GARAMENDI. Well, I think you are asking me a rhetorical question, because you know the answer and I think most Americans know the answer, that all the industrialized nations--we are not talking about China, but we are talking about Korea, Japan, the European countries, the European Union. All of those countries provide universal health insurance coverage. Universal.

Everyone, including tourists who happen to show up--and this I know from one of my daughters who fell off a stair at the Leaning Tower of Pisa. She fell, went into an emergency room, they took an MRI, bandaged her up, and said, ``Get out of here.'' And she said, ``Well, I haven't paid.'' ``Well, you are covered.'' That was in Italy.

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Mr. GARAMENDI. The other countries of the world don't look at it that way. They look at it as a right for their citizens to have access to health care, and they provide the health insurance. There are different ways of doing it. Germany, France, Britain, Canada all do it differently, but they all do it.

Incidentally, the health statistics in all of those countries are considerably better than America, and America is placed at the bottom of the industrialized countries in terms of our health care, how healthy we are, how long we live, how sick we get. We are at the bottom. In fact, we are often with developing countries in the statistics. We spend almost twice as much as any of those other countries.

So the Affordable Health Care Act goes after many, many things beyond the Patients Bill of Rights and the senior issues. Thank you so very much for raising that issue.

We have about maybe 10 more minutes. Mr. Pallone.

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Mr. GARAMENDI. We are going to wrap this one up. I see the gentleman from Kentucky is here and he will probably carry on with health insurance. Maybe a couple of us will be asked to join him.

We have really today focused on a broad range of issues: The patients' bill of rights; the way in which the repeal would harm individuals who have preexisting conditions; young children from infancy; the 23- to 26-year-old coverage.

We also discussed a little bit about how this affects business and, of course, we went into some detail about senior citizens. All of these are critically important issues. We will be discussing these in the days ahead. I do hope the American public will really pay attention, because this next week, particularly as we move towards Wednesday, is going to be absolutely critical to the American people. It's a question about will all of us in America be able to get health care coverage that is affordable and provides us with the opportunity to have the health care that we need.

Mr. Speaker, I yield back the balance of my time.

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