Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, now we get to the real bill. If the Republicans can't repeal the Affordable Care Act, they're going to try and rot it from the…
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, now we get to the real bill. If the Republicans can't repeal the Affordable Care Act, they're going to try and rot it from the inside.
For the last few days, my Republican colleagues have been spinning this vote as a great populist effort to help the middle class. They explain that, even with these repeals, we can keep all the things we like, covering our kids till age 26, prescription drug help, banning the denial of coverage for those with preexisting conditions.
And legally, they aren't wrong. They're not lying. They're just confusing the people. These laws will still be in place; but realistically, in the real world in which we live, it will be hard to cover your kids and subsidize drugs if the insurance industry no longer exists in this country.
Without the healthy consumers the mandate guarantees, only the sickest and the costliest will be left, and prices will skyrocket.
We have a letter from the Congressional Budget Office that says that if we delay this, you can expect that the prices of insurance will go up and fewer people will be covered.
The reason you don't see any fur flying is because the insurance industry knows this isn't going anywhere. This is just a lot of political theater.
In Washington, we tried this. In 1993, the Democrats put in universal coverage and guaranteed issue. Everybody had a mandate, and you were going to get it. The insurance companies couldn't do otherwise. Two years later, the Republicans repealed the guaranteed mandate, leaving the insurance industry covering the sickest in the State of Washington. Within 3 years, there were no individual policies sold in the State of Washington.
We have run this game once in Washington State, and you are coming out here today and running it again. It's been tried in other States. You cannot have universal coverage without a mandate. You cannot have insurance reform that guarantees everybody insurance.
Now, this isn't prophecy on my part. This has happened. A lot of what you hear about around here is that people
are talking, well, gee, we got these terrible insurance rates going up.
They're not going up in Washington in our exchange. They're not going up in Oregon in the exchange. They're not going up in California in the exchange. Today, New York reports they're not going up in New York.
Anybody who stands out here and says insurance rates are out of sight simply is misleading the people.
We ought to vote ``no'' on this bill.
I reserve the balance of my time.
U.S. Congress,
Congressional Budget Office,
Washington, DC, July 16, 2013.
Hon. Dave Camp,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.
Dear Mr. Chairman: CBO and the staff of the Joint Committee
on Taxation (JCT) have begun a review of H.R. 2668, the
Fairness for American Families Act, but we have not yet
completed a cost estimate for the bill. On a preliminary
basis, however, we expect that enacting H.R. 2668 would have
the effect of reducing the deficit in 2014 and over the 2014-
2023 period. That initial conclusion is based on our prior
work on proposals to repeal the individual mandate
established in the Affordable Care Act.
The legislation would delay for one year the requirement
that nearly every resident of the United States have health
insurance coverage by January 1, 2014. The bill also would
shift by one year the schedule of penalties for people who do
not comply with the mandate.
CBO and JCT expect that, during the period of delayed
phase-in of the penalty for failing to comply with the
mandate, health insurance premiums for individually purchased
coverage would be higher under H.R. 2668 than they are
projected to be under current law. In addition, the number of
people with health insurance coverage would be reduced
relative to current law.
I hope you find this preliminary information useful; if you
wish further details, we will be pleased to provide them.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
Mr. Speaker, I will insert for the Record the report on the Ninth Indiana District and the people who will benefit from that bill when it goes into effect on the first of October.
Benefits of the Health Care Reform Law in the 9th Congressional
District of Indiana
Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent, one-stop shop to
compare health insurance policies, receive financial
assistance, and sign up for high-quality, affordable, and
secure insurance coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Young's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
8,300 young adults in the district now have health
insurance through their parents' plan.
More than 9,300 seniors in the district received
prescription drug discounts worth $13.7 million, an average
discount of $680 per person in 2011, $720 in 2012, and $700
thus far in 2013.
110,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
213,000 individuals in the district--including 45,000
children and 86,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
135,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 33,800 consumers
in the district received approximately $4.4 million in
insurance company rebates in 2012 and 2011--an average rebate
of $157 per family in 2012 and $99 per family in 2011.
Up to 40,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
255,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 91,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 35,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
I yield 2 minutes to the gentleman from North Carolina (Mr. Butterfield).
Mr. Speaker, I submit for the Record the report on the Third Congressional District of Minnesota and the people who will benefit from this act.
Benefits of the Health Care Reform Law in the 3rd Congressional
District of Minnesota
Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent, one-stop-shop to
compare health insurance policies, receive financial
assistance, and sign up for high-quality, affordable, and
secure insurance coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Paulsen's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
3,300 young adults in the district now have health
insurance through their parents' plan.
More than 8,800 seniors in the district received
prescription drug discounts worth $12.2 million, an average
discount of $620 per person in 2011, $680 in 2012, and $1,070
thus far in 2013.
108,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
220,000 individuals in the district--including 54,000
children and 87,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
150,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 16,600 consumers
in the district received approximately $1.4 million in
insurance company rebates in 2012 and 2011--an average rebate
of $303 per family in 2012 and $160 per family in 2011.
Up to 40,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
282,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
53,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 42,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
I now yield 3 minutes to the gentleman from Michigan (Mr. Dingell). He's been here for a number of years, always fighting for health care, and he is living proof that the price of liberty is eternal vigilance. He's here today fighting for health care, just like he did the first day he got here.
(Mr. DINGELL asked and was given permission to revise and extend his remarks.)
Mr. Speaker, according to a report on the First Congressional District of Tennessee, 5,800 young adults have insurance on their parents' plan, 13,000 seniors receive prescription drug benefit reductions, and 168,000 seniors are now eligible for preventive care that's free. And on and on it goes.
Benefits of the Health Care Reform Law in the 1st Congressional
District of Tennessee
committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, july 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and
protections to tens of millions of American families almost
immediately after it was signed into law by President Obama.
But the largest benefits of the law will become available to
consumers on October 1, 2013, when health insurance
marketplaces open in all 50 states. These marketplaces will
offer individuals, families, and small businesses an
efficient, transparent one-stop shop to compare health
insurance policies, receive financial assistance, and sign up
for high-quality, affordable, and secure insurance coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Roe's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
5,800 young adults in the district now have health
insurance through their parents' plan.
More than 13,100 seniors in the district received
prescription drug discounts worth $16.9 million, an average
discount of $580 per person in 2011, $630 in 2012, and $680
thus far in 2013.
168,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
177,000 individuals in the district--including 34,000
children and 75,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
168,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 26,000 consumers
in the district received approximately $3.7 million in
insurance company rebates in 2012 and 2011--an average rebate
of $69 per family in 2012 and $201 per family in 2011.
Up to 36,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
190,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 103,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 28,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
I yield 1 minute to the leader of the Democratic Party, the gentlewoman from California (Ms. Pelosi).
Mr. Speaker, I would like to insert letters from consumer groups opposing the bill--Easter Seals, American Diabetes Association, American Heart Association, and others.
I also would like to enter into the Record the report on the Fifth Congressional District of Virginia and those who will benefit from the Affordable Care Act.
Benefits of the Health Care Reform Law in the 5th Congressional
District of Virginia
committees on energy and commerce, ways and means, and education and
the workforce, democratic staff Report, july 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Hurt's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
5,900 young adults in the district now have health
insurance through their parents' plan.
More than 11,400 seniors in the district received
prescription drug discounts worth $15.6 million, an average
discount of $590 per person in 2011, $720 in 2012, and $800
thus far in 2013.
165,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
201,000 individuals in the district--including 37,000
children and 87,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
188,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 57,300 consumers
in the district received approximately $4.6 million in
insurance company rebates in 2011 and 2012--an average rebate
of $115 per family in 2011 and $88 per family in 2012.
Up to 37,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
235,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 91,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 51,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
I now yield 5 minutes to the minority whip, the gentleman from Maryland (Mr. Hoyer).
I yield the gentleman an additional 30 seconds.
Mr. Speaker, I yield myself 30 seconds to report on the Seventh Congressional District of Virginia, where the promises have been kept:
4,500 young adults have health insurance on their parents' plan;
10,000 seniors have received help with their drug costs;
112,000 seniors are now eligible for preventive care at no cost;
288,000 people in the Seventh District now have insurance that does not have lifetime limits.
The promises have been kept in the Seventh District.
Benefits of the Health Care Reform Law in the 7th Congressional
District of Virginia
committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, july 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Cantor's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
4,500 young adults in the district now have health
insurance through their parents' plan.
More than 10,000 seniors in the district received
prescription drug discounts worth $13.6 million, an average
discount of $580 per person in 2011, $730 in 2012, and $800
thus far in 2013.
112,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
236,000 individuals in the district--including 56,000
children and 95,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
222,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 67,300 consumers
in the district received approximately $5.4 million in
insurance company rebates in 2011 and 2012--an average rebate
of $115 per family in 2011 and $88 per family in 2012.
Up to 43,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
288,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 74,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 42,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
Mr. Speaker, I now yield 3 minutes to the gentleman from California (Mr. Becerra).
Mr. Speaker, I yield myself 30 seconds so that I can inform the body of the effect on the Fifth Congressional District of the State of Washington:
7,000 adults, young adults, are on their parents' plan;
5,600 seniors have had benefits around their drug costs;
89,000 who have lacked health insurance now have it.
All of this is because of the Affordable Care Act.
Benefits of the Health Care Reform Law in the 5th Congressional
District of Washington
Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. McMorris
Rodgers's district. It also provides the first picture of the
impacts of the law in districts redrawn or newly created
following the 2010 Census. As a result of the law:
7,900 young adults in the district now have health
insurance through their parents' plan.
More than 5,600 seniors in the district received
prescription drug discounts worth $7.5 million, an average
discount of $620 per person in 2011, $660 in 2012, and $1,070
thus far in 2013.
113,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
180,000 individuals in the district--including 36,000
children and 75,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
167,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 700 consumers in
the district received approximately $100,000 in insurance
company rebates in 2012 and 2011--an average rebate of $512
per family in 2012 and $185 per family in 2011.
Up to 36,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
203,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
89,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 45,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more
secure, higher quality coverage and many will be eligible for
financial assistance.
Mr. Speaker, I now yield 2 minutes to the gentleman from Texas (Mr. Gene Green).
Mr. Speaker, I would like to enter into the Record a report on the effects of the Affordable Care Act on the Tenth District of Michigan.
Benefits of the Health Care Reform Law in the 10th Congressional
District of Michigan
Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent, one-stop shop to
compare health insurance policies, receive financial
assistance, and sign up for high-quality, affordable, and
secure insurance coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Miller's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
4,900 young adults in the district now have health
insurance through their parents' plan.
More than 8,900 seniors in the district received
prescription drug discounts worth $11.8 million, an average
discount of $610 per person in 2011, $780 in 2012, and $630
thus far in 2013.
130,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
210,000 individuals in the district--including 47,000
children and 86,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
177,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 17,100 consumers
in the district received approximately $2.5 million in
insurance company rebates in 2012 and 2011--an average rebate
of $138 per family in 2012 and $214 per family in 2011.
Up to 41,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
243,000 individuals in the district now have insurance that
cannot place lifetime limits on their overage and will not
face annual limits on coverage starting in 2014.
Up to 73,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition: In addition, the 39,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
Mr. Speaker, I now yield 2 minutes to the gentlewoman from Illinois (Ms. Schakowsky).
Mr. Speaker, I yield 3 minutes to the gentleman who helped write this bill 4 years ago and is here today to defend it, the gentleman from California (Mr. Miller).
(Mr. GEORGE MILLER of California asked and was given permission to revise and extend his remarks.)
I yield myself 30 seconds.
There are 8,300 young adults who are still getting insurance on their parents' plans; more than 8,500 seniors are receiving prescription drug discounts; 86,000 seniors are now receiving preventative care without having to pay for it under the Medicare program; 195,000 now have health insurance that covers preventative care with no co-pays and insurance; and on and on and on it goes.
I enter into the Record the health care reform law as it affects the 11th Congressional District of Georgia.
Benefits of the Health Care Reform Law in the 11th Congressional
District of Georgia
committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, july 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Gingrey's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
8,300 young adults in the district now have health
insurance through their parents' plan.
More than 8,800 seniors in the district received
prescription drug discounts worth $12.6 million, an average
discount of $620 per person in 2011, $760 in 2012, and $900
thus far in 2013.
86,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
195,000 individuals in the district--including 47,000
children and 78,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
169,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 19,900 consumers
in the district received approximately $2.8 million in
insurance company rebates in 2012 and 2011--an average rebate
of $82 per family in 2012 and $134 per family in 2011.
Up to 43,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
248,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 129,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 45,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I enter into the Record the effect of the Affordable Care Act on the Sixth Congressional District of Tennessee.
Benefits of the Health Care Reform Law in the 6th Congressional
District of Tennessee
committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, July 2013
The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Black's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
5,600 young adults in the district now have health
insurance through their parents' plan.
More than 9,800 seniors in the district received
prescription drug discounts worth $12.7 million, an average
discount of $590 per person in 2011, $640 in 2012, and $690
thus far in 2013.
134,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
184,000 individuals in the district--including 40,000
children and 74,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
188,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 26,900 consumers
in the district received approximately $3.9 million in
insurance company rebates in 2012 and 2011--an average rebate
of $69 per family in 2012 and $201 per family in 2011.
Up to 40,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
217,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 101,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 37,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
I now yield 1\1/2\ minutes to the gentlelady from Texas (Ms. Jackson Lee).
Mr. Speaker, I inquire as to whether the gentleman from Georgia is prepared to close.
Mr. Speaker, I yield myself such time as I may consume.
I have in my hand here a letter signed by 30 economists from Harvard, Yale, MIT, Stanford, Rice, the University of Chicago, and everybody else, all of whom say we need a mandate. If this mandate were taken out of the law, the Affordable Care Act would be dead. What they say is that the individual mandate does not specify what care people receive; it simply requires people to pay a reasonable amount for any care that they may ultimately receive.
No less a conservative than Mitt Romney, the Republican nominee for President, noted when signing the Massachusetts equivalent of the individual mandate:
Some of my Libertarian friends balk at what looks like an
individual mandate. But remember, someone has to pay for the
health care that must, by law, be provided: either the
individual pays or the taxpayers pay.
Everyone in this body spends $1,000 a year beyond their own health care costs paying for the uninsured in this country. People walk into the emergency room and they get taken care of because the hospital cannot refuse them and the doctor cannot refuse them, and so they're taken care of and then it's passed on to you and me.
The individual mandate says everybody should pay according to their ability.
Going on, Mr. Romney said:
A free ride on the government is not libertarianism.
Everywhere they've tried this without subsidies and mandates, it has failed. They say in the five States that have tried comprehensive insurance market reform without an individual mandate, healthy people choose to stay out of insurance, sick people took it up, and the premiums go up. That's exactly what the CBO says.
So what you are saying, by repealing the individual mandate, is you want to drive up the costs on the people who now have insurance. That's a very strange political position to be taking.
I must say, I listened to all these people who don't like the individual mandate and all this stuff. If you spend 2 years ranting about the Affordable Care Act and you run a campaign and spend hundreds of millions of dollars and rant against the Affordable Care Act, it's not surprising that people may be a little confused.
When I was in medical school in 1963, the American Medical Association spent 3 or 4 years ranting against Medicare; and when the people went out to enroll people for Medicare, they got the door slammed in their face. Old people said, I'm not going to have that kind of government health care in my house. Well, let me tell you something. If you tried to take Medicare out now, you would find you have taken on a really ugly junkyard dog. You're not going to take out Medicare in this country now.
You can confuse people for a while, but as they see and as I reported on everybody's district, it is already affecting kids who didn't have insurance because of a preexisting condition; it's affecting kids who didn't have insurance from their job and are now on their parents' insurance; it took away lifetime limits on care; it took away all the things that people worry about when they want health care security. They now have it, and you're saying let's take the individual mandate out and have the whole house come down, because that's what these economists have said.
I enter this letter into the Record, and I yield back the balance of my time.
Why We Need the Individual Mandate
The Patient Protection and Affordable Care Act (ACA)
requires people to buy health insurance when they can afford
to do so. This ``individual mandate'' is essential to address
two features of current health insurance markets: the fact
that millions of people cannot afford health insurance
coverage, and the fact that insurance companies frequently
charge high or unaffordable premiums to people who need
insurance most--those suffering from costly illness or
injury.
This mandate is one of three pillars that together support
ACA's private market approach. The first pillar is insurance
market reform--ending the ability of insurance companies to
discriminate against sick or injured people with high medical
costs. Subsidies to help Americans of modest means gain
access to affordable health coverage provide the second
pillar. The individual mandate provides the third pillar. It
requires people to obtain insurance so long as that coverage
is affordable. The mandate expresses a basic obligation of
citizenship as well as an economic reality. Without the
mandate, some people will choose to gamble or to free-ride,
undermining the fairness and financial stability of the
health insurance system.
Few of the uninsured could personally finance medical
treatment for a serious illness or injury. Moreover, this
country embraces the fundamental principal that everyone
should have to minimally decent medical treatment when
needed, without regard to ability to pay. Federal legislation
and the custom and practice of health care providers embody
this principle. A healthy individual's decision to forego
affordable insurance coverage thus imposes real costs on
others, while raising premiums on many people with serious
medical needs who require the most help.
The individual mandate does not specify what care people
receive. It simply requires people to pay a reasonable amount
for any care they may ultimately receive. No less a
conservative than Mitt Romney noted, when signing
Massachusetts' equivalent of the individual mandate: ``Some
of my libertarian friends balk at what looks like an
individual mandate. But remember, someone has to pay for the
health care that must, by law, be provided: Either the
individual pays or the taxpayers pay. A free ride on the
government is not libertarian.''
The ACA's individual mandate is based on Massachusetts's
successful 2006 reforms. That landmark effort covered about
two-thirds of the formerly uninsured, while reducing premiums
for individual purchasers by about 50% relative to national
trends--with strong public support.
In contrast, insurance reform without subsidies and
mandates has consistently failed. In the five states that
have tried comprehensive insurance market reform without an
individual mandate, healthy people chose to stay out of
insurance, sick people took it up, and premiums increased.
Only broad participation in insurance markets can end the
cycle of insecure coverage and high costs.
The Obama Administration's recent decision to delay ACA's
requirement that large- and medium-sized employers sponsor
coverage for their employees or pay a penalty is independent
of the individual mandate. The employer assessment is
designed to bolster the ACA's financing and to ensure equity
between large firms who do and do not provide insurance. This
assessment will have only a very small impact on employers,
since 97% of firms with more than 50 employees already offer
insurance. The individual mandate stands in stark contrast,
as nearly one in five non-elderly Americans is currently
uninsured.
Delaying the employer assessment has almost no effect on
the implementation of the ACA. The only important effect will
be to raise one fewer year of revenue from this
component of the law. In contrast, delaying the individual
mandate would cut at the core of the vision of private-market
based insurance market reform.
Requests to delay the individual mandate are really
requests to gut the Affordable Care Act. Millions of
Americans face immediate health care needs and financial
challenges addressed by health reform. They cannot wait.
Signers
Henry Aaron, Senior Fellow and Bruce and Virginia
MacLaury Chair in Economic Studies, Brookings
Institution; Kenneth J. Arrow, Professor Emeritus,
Stanford University; Susan Athey, Professor of
Economics, Stanford Graduate School of Business; Linda
J. Blumberg, Senior Fellow, Health Policy Center, The
Urban Institute; Len Burman, Director, Tax Policy
Center, Urban Institute; Amitabh Chandra, Professor of
Public Policy, Harvard University; Philip J. Cook, ITT/
Terry Sanford Professor of Public Policy, Duke
University; David Cutler, Otto Eckstein Professor of
Applied Economics, Harvard University; Claudia Goldin,
Henry Lee Professor of Economics, Harvard University;
Jonathan Gruber, Professor of Economics, Massachusetts
Institute of Technology; Vivian Ho, Baker Institute
Chair in Health Economics, Rice University; John
Holahan, Institute Fellow, Urban Institute; Jill
Horwitz, Professor of Law, University of California at
Los Angeles; Genevieve M. Kenney Co-Director and Senior
Fellow Health Policy Center, Urban Institute, Frank
Levy, Lecturer, Department of Health Care Policy,
Harvard Medical School; Peter H. Lindert, Distinguished
Research Professor of Economics, University of
California at Davis; Eric S. Maskin, Adams University
Professor, Harvard University; Alan C. Monheit, Ph.D.,
Professor of Health Economics, Rutgers University
School of Public Health; Richard Murname, Juliana W.
and William Foss Thompson Professor of Education and
Society, Harvard Graduate School of Education; Joseph
Newhouse, John D. MacArthur Professor of Health Policy
and Management, Harvard Medical School; Harold Pollack,
Helen Ross Professor of Social Service Administration,
University of Chicago; Matthew Rabin, Edward G. and
Nancy S. Jordan Professor of Economics, University of
California at Berkeley; James B. Rebitzer, Professor of
Management, Economics, and Public Policy and Everett V.
Lord Distinguished Faculty Scholar, Boston University
School of Management; Meredith Rosenthal, Professor of
Health Economics and Policy, Harvard School of Public
Health; Christopher Ruhm, Professor of Public Policy
and Economics, University of Virginia; Jonathan
Skinner, James O. Freedman Presidential Professor of
Economics, Professor of Community and Family Medicine,
Dartmouth College; Katherine Swartz, Professor, Harvard
School of Public Health; Paul N. Van de Water, Senior
Fellow, Center on Budget and Policy Priorities; Kenneth
E. Warner, Avedis Donabedian Distinguished University
Professor of Public Health, Dept. of Health Management
& Policy, University of Michigan School of Public
Health; Stephen Zuckerman, Co-Director and Senior
Fellow, Heath Policy Center, The Urban Instituted;
