Mr. President, first let me thank Senator Boxer for putting into the Record the history of how we fought for Medicare, how we went through a lot of the health care fights, and what we have stood for in protecting the American public for…
Mr. President, first let me thank Senator Boxer for putting into the Record the history of how we fought for Medicare, how we went through a lot of the health care fights, and what we have stood for in protecting the American public for affordable, quality health care. I applaud her and agree with the comments she has made.
I think it is very interesting to point out the contrast to the passage of the Affordable Care Act that has been law now since March 23, 2010. It went through hearing after days of hearings in the House and in the Senate. It went through days of markups in the committee, where hundreds of amendments
were offered in both the House and the Senate. We had a long debate on the floor of the Senate and the floor of the House. We reconciled the differences between the two Houses. It went through the regular process. We spent as much time on that bill, I think, as we have spent on any major bill. And yet there were differences. The bill was passed and signed into law.
When we expanded Medicare--and I was in the House at the time on Medicare Part D. I also voted against it. Most Democrats voted against it. We voted against it for the reason the Senator just said--the coverage gap, the doughnut hole, that we knew seniors would still not be able to afford coverage. There was no public option, as the Senator remembers.
It was all private insurance. They did not pool the total purchasing power to reduce the cost of prescription drugs--another matter that we felt very strongly that we were overpaying. And we are overpaying for prescription drugs, as a result of that change.
By the way, it was not paid for. It was estimated to cost $400 billion, and there was no offset of cost. So we were worried it would have an impact on the affordability of the Federal Government to pay the bill. So we all voted against it. Many of us did.
And it became law.
Senator Boxer is absolutely right: When that bill passed, we came together and said: Let's make it better. We lost the battle on the floor. It became the law. Let's try to make it work. And we did that, Democrats and Republicans.
We are now into 3 years under the Affordable Care Act, and all we get from the Republicans is repeal after repeal after repeal--no effort to deal with legitimate problems of implementation that we would like to work together to do.
What a difference. Instead, they are using the process of holding hostage the Federal Government from being in operation in order to advance their extreme agenda.
It has been nearly 20 years ago when the Government shut down because the Republicans decided it would be better to close government to prove their point. Well, they were wrong then. We recognized the cost of a government shutdown and the inconvenience to the American people and the damage to our economy. Yet Monday night we run the risk of another government shutdown because the Republicans are holding hostage the continuation of government to try to move forward their extreme agenda.
Let me talk a little bit about this. Let me talk about what it would mean if we were, in fact, to pass the continuing resolution that was passed by the House. We are not going to do that. We are not going to pass that. Everybody knows we are not going to pass that. But I think the American people need know what would happen if that did pass and we did defund the Affordable Care Act.
I could talk a lot about provisions that have already taken effect. I could talk about the fact that in my State of Maryland, 46,000 families have taken advantage of putting their children on their health insurance policies to age 26. If you repeal the Affordable Care Act, those 46,000 families will have to find another way to take care of the health insurance for their children.
I could talk about the fact that come January, we will eliminate lifetime caps on health insurance. How many families have had to go through bankruptcy because they cannot afford health coverage? They may have insurance, but their caps put them into bankruptcy. Well, that is gone. If you repeal the Affordable Care Act, we are back to the arbitrary limits.
How many families have told us about preexisting condition restrictions that are in their health insurance policies? We have already corrected that for children. That is already the law. Come January, there will be no further preexisting conditions. Women will not be discriminated against in health premiums. Pregnancies will no longer be considered a preexisting condition. Being a victim of domestic violence will no longer be considered a preexisting condition.
I could cite, and I am sure the Presiding Officer could too, examples in our own States where people have not been able to get full coverage. I have a family in Montgomery County that had to take out two insurance policies and pay two separate premiums for the family because of preexisting condition restrictions. That is history. If you pass the resolution that came over from the House, that is all gone, we are back to how it used to be.
I know we talk a lot about affordability. I want to talk a moment about that. Because before we passed the Affordable Care Act, we got letter after letter from individuals and businesses about their premiums going up. They had to cut back coverage, and they required the employee to pay more. The benefits were less, and the premiums were higher. We were seeing double-digit cost increases in health care.
Well, now we have a quality product, a guarantee that essential benefits are going to be in there. We have protection that at least 80 to 85 percent of the premium dollar must actually go to benefits. If it does not go to benefits, you get a rebate, you get a refund. In my State of Maryland, 44,000 Marylanders are getting rebates because their premiums were too high. The average rebate is $143 a family--$13 million in rebates.
With the House-passed continuing resolution, that is gone. Those protections are no longer in the law. We are back to how it used to be: no guaranteed coverage, no guaranteed benefits, no guaranteed value.
There is another aspect to this, one that I am very proud of. The United States will at last join the industrialized nations in the world and say that we are going to make affordable health care available to every person, every American in our country. I think that is an important point. I have 800,000 people in my State of Maryland who do not have health coverage today--800,000.
Now, come October 1, next Tuesday, they are going to be able to go to the Maryland Health Connection and get health coverage. But guess what. They are going to have a variety of plans they can choose from. They can make their decision. But a large number, over 85 percent--87 percent--of the people who will be going to the Maryland Health Connection, it has been estimated, are going to be entitled for help in paying for those premiums--87 percent.
We talked about the individual mandates. What we provided was an affordable option so everyone can be in the system. We want universal coverage because we think it is the right policy. Everybody should be covered. We want universal coverage because we think it is wrong for someone who has health insurance to pay for someone who does not have health insurance because they use the health facility and do not pay for it, and we pay more as a result of that. Hospital costs are more, physician costs are more. We think everybody should pay their fair share.
But we make it affordable. Eighty-seven percent will be entitled to help. Those who go through the Maryland Health Connection and are enrolled in Medicaid obviously are going to get their help. We have expanded that coverage. Those who go into the exchanges--and Maryland is one of those States that the State will be operating the exchanges.
The overwhelming majority will be entitled to some help in the payment of those premiums. If the House-passed resolution were to become law, and it is not going to become law--the purpose for sending it over here was to make it hostage in the closing of our government. If it became law, that help would be gone. These uninsured have no prospect of getting health coverage, and the inefficiencies of our system continue, the use of emergency rooms, the lack of preventive care continues.
The Senator from California Mrs. Boxer talked about the Medicare system. Let me take a moment about the Medicare system, because this is very important. The so-called doughnut hole, that prescription drug gap of coverage, is being closed as a result of the passage of the Affordable Care Act. How many seniors fell into that doughnut hole and literally could not afford their prescription drugs? We closed that in the Affordable Care Act. In my State of Maryland, 50,000 seniors benefited from that--50,000 seniors. If we
pass the bill that came over from the House, those 50,000 seniors would be calling our office every day finding out what happened to that coverage they lost. You better believe our phones would be ringing about why are we taking away their benefits.
It is even more who are benefiting from the preventive health care services. They do not have to pay copayments. About half a million Marylanders are eligible for that benefit--who are taking advantage, 34 million nationwide. They would lose that preventive health care service that they have today as a result of the passage of Affordable Care Act. That is gone if the House-passed resolution were to become law.
Probably even more serious than that, and Senator Boxer alluded to it, the passage of the Affordable Care Act improved the solvency of the Medicare system for a decade. You repeal the Affordable Care Act, you are back with whether Medicare itself will be a solvent program.
I could go on and on. We have provisions in the Affordable Care Act that are working to prevent fraud within the Medicare system, saving taxpayers dollars. That is gone. We help to make sure that the Medicare Advantage plans are properly paid. That is gone. All of that is repealed if the House resolution were passed, which it will not be. I will make it clear. It was sent over to us with a strategy to put the government operations in jeopardy. There are many on the other side who believe it is a good idea to close the government. That is their objective. Even the Republicans admitted this strategy would not work to actually defund the Affordable Care Act.
I think we should at least talk about what impact it would have. I hear my colleagues talk frequently about small business. I have had a lot of forums with small businesses in Maryland. I must tell you, yes, small businesses are concerned about whether they can afford the cost of their employees and health benefits. They are concerned about it. That is a legitimate issue. But let's talk about what are the circumstances without the passage of the Affordable Care Act. Well, they are on their own. They do not have large markets. They have to pay more than large companies have to pay. They do not have a lot of options.
Under the exchanges, under Maryland Health Connection, they will get different opportunities that they did not have before, more affordable coverage that they did not have before. There are credits available to help them pay for their health insurance. If you have less than 50 employees, there is not a single new mandate in this law for a small business. So this is good news for small companies. That is gone if the resolution that passed the House were to become law. It is not going to become law. My Republican colleagues know it is not going to become law.
I think it is important to point that out. What happens if we do not get to an agreement by Monday night? That is possible. That is possible. We are going to send back a continuing resolution to the House. We do not know whether they are going to accept it. What happens? Well, I can tell you this. I represent the State of Maryland. I represent a lot of Federal workers. I tell you something, they have been through furloughs, they have been through pay freezes, they have been put to the test. They have been asked to do a lot more work with less workers. We have less per capita workers than we have had in modern times on a per capita basis of Federal workers. They have been asked to do more with less. They have already contributed greatly to reducing the deficit.
Once again, come Tuesday morning, they are going to be asked in some cases to show up for work not knowing whether they will get paid, in other cases, to stay home not getting paid, trying to figure out again how they are going to pay their bills. They have rent payments and mortgage payments and food payments. Guess what. That is going to have a major impact on our economy. Make no mistake about it, it will hurt our economy. We have been through this. We have seen this movie before. It hurts our economy. It hurts our country. This is a self-inflicted crisis. This is totally avoidable. If that happens, yes, people will be terribly inconvenienced.
You ask the 10,000 people a day who elect to enroll in Medicare and there is no one there to enroll them in Medicare. What are they going to do? You ask the person who needs a passport and cannot get a passport, what are they going to do? I can go through a whole host of things. In 1995 and 1996, I think it was estimated 9 million people who had planned to go to national parks did not go to national parks.
It is a cumulative effect. Why are we doing this? To advance our agenda? No, it is not going to pass. Why are we not using regular order? This is costly to our economy, it is costly to American families. It is causing a slowdown in the recovery of our economy. An even greater concern is that in a couple of weeks, middle of October, we are talking about going through this again perhaps on whether we will pay our bills. The limit that we have deals with whether we can pay the expenses that have already been incurred. This is not about new spending. This is about money that has already been spent, will we pay the bill when the bill is received?
In the House-passed resolution, they said: Well, we will prioritize. We will pay some but not all. I do not know how you can do that. Administratively, I do not know how you can do that. You certainly are going to make it much more difficult to deal with those that are not in the priority category. So we become a selective deadbeat? We say we are not going to pay contractors, we are not going to pay doctors, we are not going to pay workers? I mean, who are we not going to pay? They have already done the work. They have already provided the services. They have responsibilities. They expect us to pay our bills.
It does not work. We have been through this before in the last Congress. We saw. It hurt America's reputation. We came close. We did not go over the cliff. But just coming close presented a huge problem for this country. If we actually go over the cliff and do not pay our bills, it will be very costly to the American taxpayers. Interest rates will go up on our national debt. It will go up. That will cost the taxpayers more money. For what? Another self-inflicted crisis by the Republicans to advance their extreme agenda.
We have the votes here to pass what we call a clean CR, a clean extension of paying our bills. We have the votes here. There is a majority of us prepared to vote for that. We have said that. We have shown that. But, instead, it is being held hostage to an extreme agenda and trying to shortcut the regular process. What is the regular process? The regular process is we do our work, they do their work, the House, the Senate go to conference, work it out.
Yes, there is a Republican-controlled House. Yes, there is a Democratic-controlled Senate. We do not have 60 votes but we have a majority. In the White House is President Obama. So that is what the voters gave us. Our responsibility is to work with that.
We did. The House passed a budget. I did not like the budget. I did not like their budget. But that is a democracy. They passed their budget. We passed a budget here. Our Republican friends said we probably will not do it. We did it. We did not pass that last week, we passed that months ago. And what we said is, okay, let's go to conference, work out the difference. It will not be everything I want, it will not be everything the Republicans want. That is how the process works.
Republicans will not sit down and talk with us. They will not let us go to conference. They will not let us work out a budget. So when you look at why we have not been able to reach a budget by October 1, it starts with the fact that we have not been able to sit around a table to work out our differences because the Republicans will not let us go to conference. That is a fact. So we have got to get to conference. We have got to get that done.
In the meantime, do not hold the government hostage, or paying our bills hostage, because all that does is create additional costs, hurts America's reputation, hurts our economic recovery. It does not at all advance a final resolution of an orderly process in which we work out the problems of this country.
I urge my colleagues to put America's interests first, stop the games we are playing and threats we are making. We are coming too close. Too many people we are again telling: We do not
know whether you are going to get a paycheck next week. What do you do if you are a worker or contractor and you do not know if you are going to get a paycheck next week?
You are already cutting back on your commitments. This is already hurting our economy. Every day we wait it hurts our economy. That is why a host of us are upset that we had to waste yesterday. It would have been nice to be able to use yesterday to resolve this issue. Every day we wait costs our economy, it costs our country. Let's pass the necessary legislation to keep government operating and pay our bills. Let's sit down as we should and work out the budget problems in a way that is befitting the tradition of the Senate.
I yield the floor.