Affordable Care Act
Floor Speech
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Mr. CASTRO of Texas. Today, we are here to talk about the Affordable Care Act, and especially the big week that we have had in this country in making sure that millions of Americans will now enjoy access to quality, affordable health care.
Last week, we had a chance to talk about this and had other Members from all over the country who represent wonderful districts come forward and talk about how the Affordable Care Act has been very beneficial to their constituents. Part of the discussion last week and in the previous months, really since October, has been about whether Americans would accept the Affordable Care Act and how many people would enroll and how many States would expand Medicaid.
The numbers are very clear that, despite all of the advertisements and the millions of dollars that has been spent on television promoting misinformation about the Affordable Care Act, demonizing this as socialism and other bad things, that despite all of that, the American people have clearly rejected that narrative, that they believe the Affordable Care Act and what it is doing for this country are good things and that in the wealthiest nation on Earth, as we are, that people should be able to afford health care, that they should not be denied because of preexisting conditions, that students should be able to stay on their parents' plans after college, and that Medicaid for low-income Americans should be made more readily available.
Let's look at some of those numbers. We know, for example, that 7.1 million people ended up signing up for the Affordable Care Act in the exchanges. Now, that is on top of the 3 million students who can now stay on their parents' plans because of this act. That is on top of all of the States that expanded Medicaid to make sure that folks who don't make a lot of money, the vast majority of these people working hard day in and day out, that they are going to be covered, too.
There are still about 19 States, including my home State of Texas, that have chosen not to expand Medicaid. That has been such an incredible blow to the people of my State. For example, we have the highest percentage of people in the Nation that have no health care coverage.
On Monday, I was back home in San Antonio and there was a large enrollment fair, as there was in many cities throughout the country on Monday. It was probably about 6, 7, and this fair was going to close at 8. So I went over to see how it was going and to say hello to folks. There was a long line of people waiting. Families were there, two and three and four and five family members. People brought their young kids to enroll them in insurance.
One of the narratives during this debate has been this idea that has been pushed that this is just benefiting people who may be lazy or not working. One of the things that struck me when I was making my way through that line was that there were so many people there that had the insignia of the company that they work for or their uniform on. They told me that they had just come straight from work and how grateful they were that this was going to go on until 8 so that they had time to come after work.
It was really a stark reminder that--despite all of the stories or this idea of the makers and the takers in this country, or 47 percent of people versus 53 percent--the vast majority of people who are benefiting from this law, benefiting from things like Medicaid, are, in fact, not just takers, but are hardworking Americans who are powering our economy. All they want is a fair chance at the American Dream.
We talk a lot about freedoms in this body. The United States Congress is, of course, one of the main bodies in government that is entrusted with protecting American freedoms. So we talk about our First Amendment rights, whether it is freedom of expression, freedom of speech, freedom of religion, or Second Amendment rights, other amendments, the right against self-incrimination, all of these things, all of the Bill of Rights enshrined in the Constitution. But I pose the question to those who continue to want to repeal the Affordable Care Act: What good are any of those rights that we are entitled to as Americans, that previous generations of Americans and this generation of Americans have fought so hard to preserve, what good is freedom of expression, freedom of religion, freedom of speech if you are stuck in a hospital bed sick, broke because you can't pay your hospital bills, worried about your family and your future?
Remember, that is not an uncommon situation for Americans over the years.
The biggest reason for personal bankruptcies before the Affordable Care Act was the fact that people were racking up these huge health care bills that they couldn't pay, and this happened for a few reasons. Sometimes people just couldn't afford the insurance for their primary care physicians--the doctors they would go see--or emergency room doctors, not doctors in some clinic or private practice. Sometimes, even if they could afford insurance, they were hitting lifetime caps--somebody with cancer, somebody with MS--somebody like my grandmother and my mother with diabetes, who suffer from complications. My grandmother, before she passed away from congenital heart failure because of diabetes, had her leg amputated.
There are so many people who can't enjoy the freedoms that we are supposed to be able to enjoy because they can't afford health care coverage, so they have ended up not going to the doctor for many years. They have put off going to the doctor for a long time because, if they went without insurance to the doctor, then they wouldn't be able to make their mortgage payments or to pay their rent or pay their car bills, cars that they need in order to get to work. These are the common experiences of millions of Americans, not just of low-income Americans--certainly, low-income Americans--but also of Americans in the middle class, who power our Nation and power our economy.
I want us to consider the success of the Affordable Care Act. Of course, there was the Web site that had a tough rollout, and a lot of people doubted whether the program would be successful. This has shown also that the Affordable Care Act is about more than just a Web site that had a glitch. Again, the fundamental reason that this law has passed is that America is the wealthiest nation on Earth, and for generations, other countries with a lot less money have been able to provide and make available health care to their citizens a lot better than the United States of America has.
Consider this: with the Affordable Care Act, up to 129 million Americans who have preexisting health conditions, including up to 17 million children, no longer have to worry about being denied coverage or being charged higher premiums due to their health statuses. Again, you might have a woman who is 55 years old or 60 years old. She loses her job that gave her insurance, so now she tries to find another job, and tries to buy insurance, and she is rejected. She tries to go on to the individual market, and finds that she can't afford the prices on the individual market.
What is that person to do? A lot of them are suffering from chronic diseases.
In south Texas, for example, we have an incredibly high rate of diabetes. In other parts of the country, in other communities, it is other diseases, but whatever it is, these ailments are common, and they are forcing people oftentimes into bankruptcy, into not being able to pay their bills or in not being able to get health care coverage. So lifting the lifetime caps has made a mountain of difference for people. It has helped ease their minds, and it has also made things more fair.
Yesterday, the President was pretty very forceful in his comments. I think they did the press conference in the Rose Garden, but I was on an airplane, so I couldn't watch the press conference, but I got to see some of the clips. He made a comment that really struck me, which is that the Affordable Care Act is here to stay. This law is not going anywhere despite all of the opponents and despite the millions of dollars that have been spent on television for misinformation and demonizing this law.
The reason it is not going anywhere is not just because of the political reality. I mean, the politics, really, are tough on both sides. The country had been evenly divided for a long time. The reason that it is not going anywhere is because of the human reality, because we want fewer people going bankrupt because they are hitting lifetime caps and their insurance companies won't pay for their bills anymore. It is because you want more people who are not using the emergency rooms as their only way to get medical care and putting off ailments and diseases because, if they go to the doctor, they know that a month later or 3 weeks later they are going to run up these huge bills, and they know they can't pay them.
By the way, many folks have pointed this out, but certainly, when we had a dialogue last week, I pointed out again that there is a measure here also of personal responsibility, of people getting insurance in the same way that many States require you to get auto insurance. Why do States require you to get auto insurance? It is because, if you rear-end somebody, somebody has got to fix his car. In many public hospitals throughout the Nation, certainly in Texas--in San Antonio, for example--what happens routinely, oftentimes not from San Antonio but from surrounding counties, is that these folks come in, and you can't deny anybody emergency room coverage. You have to treat them. Then you send them a bill, and they can't pay the bill. They don't have insurance, and they can't pay the bill. Guess who pays the bill? That bill has to be paid somehow. The taxpayers end up paying that bill. Somebody has to eat that cost, and it is not the hospital. They pay a fraction of it, but those costs are spread, and all Americans have to pay them State by State, county by county. So this is a way that people can not only benefit from the Act but can also take a measure of personal responsibility for their own health care coverage.
That is why in the 1980s and in the 1990s, which was before this issue became so political and before President Obama was inaugurated in 2009, that originally the kind of legislation that we now know as ObamaCare, or the Affordable Care Act, was actually legislation that was promoted by the very conservative Heritage Foundation. It was considered to be a conservative idea in the same way that somebody getting car insurance--taking personal responsibility in case you hit somebody on the road--is thought to be a conservative idea. You are going to own up to your responsibilities. It has been very interesting over the last 4 years and even over the last few months to see the evolution of the arguments about health care coverage and about the Affordable Care Act and about how politics sometimes and often has trumped public policy.
In a minute, I would like to yield to my good friend from California, Mark Takano, but before I do that, I want to share with you just a few stories of people from my area, from Texas, who said that I could share their stories with them and how grateful they are that they are now able to afford health care.
The first one is a woman named Magdalena. She is a substitute teacher and had a hard time transitioning to San Antonio since moving from Del Rio. Del Rio is a city right along the Texas-Mexico border. It is about 2 1/2 hours from San Antonio. She has dedicated herself to taking care of her family, and she often puts her family in front of herself. Like many mothers, she was worried about her health as she moved into her senior years. She was skeptical about trying to fill out an application, but she eventually came to an Enroll SA event. Many cities had Enroll SA or Enroll Austin or Enroll Dallas. After sitting down with a counselor, she was able to get a plan for 5 cents a month. This is a woman who had previously been unable to get health care coverage. She returned to the registration table and wept tears of joy, with her eyes filled with hope, and the volunteers wept along with her. Her face just lit up because now her life was truly changing.
Like many others, Magdalena is a hardworking American, somebody who has taken care of her family, who is going to work day in and day out, who is not asking for very much--just a chance to enjoy the freedoms that we talk about here in Congress a lot.
With that, I would like to yield to my colleague from California, Congresswoman Loretta Sanchez.
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Mr. CASTRO of Texas. Thank you, Congresswoman. Thank you for your passion over the many years on health care and many other issues, and you raised several wonderful points, but there are a few in particular that I wanted to mention.
We debate our national debt and deficit here a lot. Since the Affordable Care Act was passed, as we know, health care has been the biggest driver of our debt. The Affordable Care Act has actually slowed the cost of health care, the slowest growth that we have seen in decades.
So this is something that has actually been good and will be good for our fiscal health in this country. Thank you for alluding to that.
Also, you mentioned that in many of the communities we represent--not only in California or in Texas, but many places--ailments like diabetes are things that affect so many people in our neighborhoods and our cities, but it is not just diabetes.
In other places, it could be cancer or sickle cell anemia or multiple sclerosis. All of those patients will now find a lot more relief because the United States Congress passed this bill.
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Mr. CASTRO of Texas. Thank you, Congresswoman Jackson Lee. Thank you for all of your work on this and many other issues. You are one of the most tireless folks, Republican or Democrat, who is involved in all the floor debates and amendments and proposing legislation. So thank you.
Just a few things that you mentioned. You were talking about the bill that we just discussed, and it was essentially saying that for sizeable businesses, not small businesses, because the small businesses are exempted from the requirements of the Affordable Care Act. That is worth repeating again. Small businesses are exempted from the requirements of the Affordable Care Act, so this was about larger businesses.
Instead of requiring that they offer health care coverage to their employees at 30 hours, the Republicans wanted to move it up to 40. One of the myths has been that all of these employers are reducing hours and cutting employees hours and this is hurting the workers. Well, the Congressional Budget Office, which both sides use as a neutral resource to figure out what's what, said that there is no evidence of that. There is no trend that says that part-time work versus full-time work is increasing because of the Affordable Care Act.
I also pointed out earlier in the discussion that part of the challenge in this economy is that American business has bounced back, but ordinary Americans still have not fully bounced back.
So, when we see that the stock market every other week, if not every other day, is hitting alltime highs and at the same time there are millions of Americans still struggling to find work, I think it is fair to ask why an employer shouldn't offer health care coverage to somebody that is working 32 or 35 hours a week.
Under the Republican plan, somebody that was working 39 hours a week, as Steny Hoyer mentioned earlier, you wouldn't be offered health care coverage necessarily. And we believe that that is wrong. We believe that the freedoms that we would otherwise enjoy as Americans, those freedoms are harder to enjoy if you are sick and unhealthy and broke because of medical bills.
So the Affordable Care Act is not perfect and, quite frankly, nothing this Congress does, from health care to education to any other issue, is ever going to be perfect. If anybody is expecting perfection from this place, they are always going to be disappointed. But this is a bill that is absolutely a step in the right direction and one that we are going to continue to improve with the help of the American people, with the voices of the American people.
But I will tell you what. As I mentioned earlier, this law is not going to be repealed. We are not going to go backward. We are not going to go to the way things were because the way they were was not good, and this is much better.
Thank you, Congresswoman.
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Mr. CASTRO of Texas. You make a wonderful point. California and several other States have had the benefit of a State legislature and a Governor who have been helpful in making sure that the Affordable Care Act, health care coverage, is available to their residents.
In places like the State where I live, in Texas, you have a Governor, State legislators, both Senators who are actively working and campaigning against the Affordable Care Act. So, many of us, not just elected officials but others who are trying to make sure that people have health care coverage, have faced a very strong headwind when trying to get the word out about the Affordable Care Act.
I told a story earlier about a woman who showed up at an enrollment fair in San Antonio and she ended up being able to provide insurance for herself and her family, but she went there and she was skeptical at first. Well, part of the reason she was skeptical is because there has been so much misinformation about this law and so much demonization about the law that I am not surprised that a lot of Americans would say, hey, you know, that thing doesn't sound like a good thing. It sounds like a bad thing.
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Mr. CASTRO of Texas. That is right. You bring up a good point.
There was a group that was specifically set up to go on to college campuses, funneled millions of dollars to go on to college campuses to convince college students not to enroll in the Affordable Care Act. That is just amazing to me.
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Mr. CASTRO of Texas. California also, I believe, expanded Medicaid, and that is something that Texas didn't do. In fact, I remember several months back, when the State legislative session in Texas was still going on, and usually it goes to about the end of May or early June. We went down there and we were doing a press conference, and at the same time, the Governor and the Senators, Lieutenant Governor, all Republicans were doing their press conference.
Our junior Senator, Senator Cruz, compared folks who need Medicaid and accept Medicaid to drug addicts, compared them to drug addicts. And the State's leadership implied that--not implied, said--allowing Medicaid to low-income Texans was like getting people hooked on sugar or drugs.
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Mr. CASTRO of Texas. I appreciate those words. Unfortunately, in Texas there are a lot of people suffering needlessly, hardworking people. These are not lazy people. These are people that are going to work day in and day out, but they are suffering because their State leadership--even though Texas was going to get up to $90 billion for Medicaid expansion. The Federal Government was providing the funds through 2017 and then providing 90 percent of the funds after that. Despite the fact that it made economic sense, still, the State's leadership refused to do it.
I think it is worth mentioning a few other things. A lot of us, we saw there were long lines on Monday, March 31 of people waiting to enroll in the Affordable Care Act. It is worth noting that anybody that started that process on March 31 but was not able to complete it has until April 15 to actually finish it off. So the 7.1 million number of the number of folks that have enrolled will very likely, I would think, go up by at least a few hundred thousand people.
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Mr. CASTRO of Texas. Thank you very much, Congressman.
There is another benefit of the Affordable Care Act that I haven't talked about yet that is also very important to know. We know that 7.1 million people have signed up. Three million or more college students or young adults are able to stay on their parents' plans because of the Affordable Care Act. Millions more have benefited from Medicaid expansion. Millions of Americans also benefit because there is no longer lifetime caps. You know, you are not going to have somebody who is suffering from cancer in a hospital bed have a doctor or an administrative billing person from the hospital come talk to you about the fact that you are about to hit your lifetime cap. So now, not only are you lying there sick in the hospital bed, but you are also thinking about how you are going to pay your mortgage and keep your kids in college. That is not going to happen anymore.
So when you hear people talk about repeal--and first of all, repeal with no plan to replace it. I mean, the only thing coming from the other side is, just get rid of this whole thing. There is no plan to replace it.
So I think what we owe the American people is, when we talk about repealing a law, especially something as important and big as this, I think it is a very fair and necessary question to ask: What are you going to replace it with? Are we going to go back to the old system, where that cancer patient lying in a hospital bed now is going to hit a lifetime cap with the insurance company so they are going to be told that they either have to leave the hospital or they are going to get stuck with $250,000 of bills, and they have to sell their house because they can't afford it anymore? When you hear the word ``repeal,'' you should understand that that is what is at stake, that is what we would go back to, the old system.
Until folks come up with an alternative--and in 4 years, there has been no alternative, and really, there is no reason to think that over the next 4 years there is going to be one. Unless you can come up with an alternative, then we are talking about going back to that time.
But the thing that I wanted to mention and something that is often overlooked here is that part of the Affordable Care Act, another benefit of it is that mental health care coverage is vastly expanded because of the Affordable Care Act. That is extremely important. Millions of families in this country, individuals and families, have either suffered themselves or have family members who suffer from serious depression, anxiety, bipolar disorder, other mental health afflictions that--quite frankly, in America and many other countries of the world, for the longest time, we never took mental health issues as seriously as we have taken physical health issues.
So for a long time, people would tell you, oh, you are depressed. Well, you just need to snap out of it. Or they treated things like bipolar disorder very lightly. They thought somebody just had a bad attitude.
In Texas, in 2011, I and others worked on getting young people with serious emotional disturbances covered by insurance companies in Texas. And, you know, the Democrats are in a deep minority in Texas. The whole time I was there, for five terms, we were in a deep minority. So you would have a Republican-controlled legislature. And my bill went nowhere. It didn't go anywhere. It died. So serious emotional disturbances weren't covered. But under the Affordable Care Act, things like that will be.
The reason that was important was because families were coming to me--in my district office, there is one family in particular that came to me and said, We are scared of our son. Our son is a teenager, and he has gotten violent before. So we call the cops. The cops take him to the hospital. There is nowhere to keep him for any kind of long-term treatment because, by the way, the State provides inadequate resources for mental health care coverage. They can't really put him in jail unless he has really assaulted somebody. So there is just this cycle, where we are having this issue with our son, and we are scared to be in the same house with him. But we can't really do anything. And the law offers us no relief.
Well, one of the benefits of the Affordable Care Act is that serious emotional disturbances and many other mental health issues will now be taken more seriously, and they will be more covered by health care companies than they have ever been in the history of the United States. And that hasn't been a big focus because a lot of this has been about politics. And a lot of the milestones and, quite frankly, the celebrations about the more than 7 million people signing up, that has been the big focus of this whole thing. But we shouldn't overlook some of the things that haven't gotten as much attention.
For me, as somebody that worked on mental health legislation in Texas, and I know many other people, Republicans and Democrats, have worked on things like that--to the families who are dealing with situations like that, that is a big deal. That means a lot to them. And that is helping them out.
So, as Americans, when you hear folks talk about repealing this law, I hope that we all fully understand exactly what we would be going back to. And those legislators who propose repealing it are irresponsible if they don't provide to the American people a full alternative and an explanation for what that alternative would do for them and what it would cost for the country. You know what the Affordable Care Act is about. We have seen no plan on the other side.
So as I close, I would like to say ``thank you'' to all the Members of Congress from different places in the Nation who joined me today in talking about this milestone for the Affordable Care Act. I am very personally glad that over 7 million people have now signed up and are benefiting. And millions more are benefiting through Medicaid expansion, college students, and all of these people who won't be kicked off of insurance because they have hit lifetime caps. Or, you know, somebody that tries to get insurance, and the insurance company sends them a letter back saying, we can't insure you because you have a preexisting condition, or your doctor submits a bill to the insurance company, as it used to be, and the insurance company writes back saying, Well, you know what, we are not going to cover that $3,000 bill because you had a preexisting condition. That is what repeal would be about, going backward.
So with that, Mr. Speaker, I yield back the balance of my time.
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