I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks in accordance with the subject of the Special Order this evening. I want to, again, begin by thanking the Democratic leader for giving the…
I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks in accordance with the subject of the Special Order this evening.
I want to, again, begin by thanking the Democratic leader for giving the Congressional Black Caucus this time to focus on health care reform specifically, especially as the House is preparing to continue their attempts to repeal what we know is a good bill and a needed bill in this country.
Before I begin to yield time, I just want to recognize the 103rd anniversary of the NAACP. They have long been premier champions of health care and fought for health care as a right. They are committed to eliminating the racial and ethnic disparities in our health care system that plague people of color in the United States. Their 880 Campaign is based on the fact that over the past decade, because we have not eliminated health disparities, over 880,000 African Americans and other people of color have died premature deaths from preventable causes. That does not need to happen. So we continue that fight in health care reform. We have made great strides in it. And we look forward to implementing that law, despite the attempts to repeal today.
I want to congratulate the NAACP on their 103rd anniversary this evening, and I would like to yield such time as she may consume to the gentlelady from Texas, Congresswoman Eddie Bernice Johnson.
Thank you, Congressman Johnson. Thank you for beginning to lay out the issue before us this evening, as we know that we've done landmark legislation in passing the Affordable Care Act. It is now settled law and the Supreme Court has ruled and we have a lot of other work that the American people need us to do.
At this time I would like to yield such time as she may consume to the gentlelady from Florida, Congresswoman Corrine Brown.
I thank you, and I thank you for pointing out some of the benefits and the numbers of Americans who are enjoying those benefits already over these last 2 years. And those benefits, as you said, extend to all Americans, whether they live in Democratic districts or Republican districts. We want to make sure that people continue to be able to insure their children with preexisting disease, their young people up to age 26, to have our seniors and disabled and anyone who is insured be able to get that important preventive care without a co-pay, and begin to continue to strengthen the Medicare program as we have in the Affordable Care Act.
Absolutely.
Exactly.
That's correct. And as you said, there is a hardship provision so that if people just cannot afford it and fall in the cracks between the Medicaid expansion and the exchange, they will not have to pay. And it will be a very small percentage, one or two percent, that CBO has said would actually end up paying the penalty, and it's a very small penalty. Yes, for administrative purposes, it's collected through the IRS; but it's a penalty. And very few people would have to pay it.
As you said also in your statement, we pay anyway. And we pay more on the other end for not having everyone insured.
People who are not insured, or even people who are underinsured or who have a high co-pay, they have not gone for preventive care. Now they can get it without a co-pay. And without that preventive care, they end up in the emergency rooms in
the hospital when the illness has worsened and the cost is more. We can prevent that by having everyone insured and having everyone have preventive care.
I know people are saying that we are not reducing costs. You can't reduce costs in the first couple of years. But if you look out that 10- year period and even in the 10 years past that, you will see in many ways that the cost will be reduced.
That is correct. And we will be working with our State legislatures to make sure that they understand what is at stake. And I'm sure that the voters in their districts who are already enjoying those benefits and who are looking forward to finally having insurance that they can afford for the first time will be talking to them about what they feel is important.
I'm going to read some statements from some of the primary care physicians at the end of this Special Order, but they're beginning to weigh in. And based on what I was reading today, they are weighing in pretty favorably. And they will benefit as well. It is change, and change is difficult no matter what. But they will benefit as well, and they are beginning to speak up.
I'm the first female physician. I'm the only physician in the CBC, but there are other physicians in Congress.
I was the first. We have one other elected in this Congress.
Physicians and other providers, the thing that we don't talk about a lot is the jobs that will be created through this Affordable Care Act. We did finally pass a transportation bill, and thank God that will begin to create some jobs and save some jobs, but the health care reform bill is also a job-creating bill. It's projected it will create about 4 million jobs of all kinds over the 10-year period. So we've been creating jobs as well in the Affordable Care Act.
I would like to yield such time as she might consume to the gentlelady from Ohio, Congresswoman Fudge.
Thank you.
Congresswoman Fudge, you're right. This is not a win for Democrats. It's not a win for the President. This is a win for the American people.
Thank you for bringing up the rebates, the $1.1 billion in rebates. In addition to the rebates--because some insurance companies have spent over their 80 percent that has to be provided in service--the Secretary has been able, in at least 12 States already, to keep the increases in premiums at 10 percent or less. That's another function of the Affordable Care Act. And you know our constituents have been crying out over the increases in premiums that they've been experiencing every year, and now the Affordable Care Act gives the Secretary the authority to keep those premiums within not more than a 10 percent increase.
Thank you.
So as my colleagues have all said, the Supreme Court has upheld the law. It is settled law. It's time for us to move on.
This is landmark legislation, landmark legislation like Social Security, Medicare, Medicaid, and SCHIP. We have a lot more work that the American people need us to do:
We need to continue the middle-income tax cuts.
We need to pass the American Jobs Act.
We need to continue to address the issue of the mortgages that are causing people to lose their homes. I was reading today in one of the papers that African Americans are expected to bear the burden of the mortgage fallout for many years to come, longer than everyone else.
And then we also have to implement the Affordable Care Act. We have the exchanges. I know there is a lot of talk about the exchanges and whether we'll be able to provide the subsidies, but what we ought to be doing is working together to make sure that that very important part of this law can be fully implemented.
We're talking about the working poor, people who are doing the right thing, being responsible, working and trying to take care of their families. It would be so unfair to them, now that they see within their reach affordable health care, to take that away. We're going to pay for it either now or we're going to pay for it later, as Congresswoman Brown was saying. It's less to pay on this side and ensure that everyone has access to the services that they need to keep them healthy and to keep them from developing those catastrophic illnesses.
I want to talk a little bit about what the Congressional Black Caucus, the Congressional Hispanic Caucus, and the Congressional Asian American Caucus have done in crafting this health care bill.
Congresswoman Fudge is right. We didn't start just before the bill was passed. We actually started before the debate began in the Congress. We developed benchmarks.
We call ourselves the Tri-Caucus.
We decided very early that insurance would never be enough for our communities that have been left out of the health care mainstream for so long and that health equity had to be a goal of any bill that we passed, so the Tri-Caucus worked together. We worked very hard. We met with House and Senate leadership. We met with the White House several times to ensure that the benchmarks that we set for our communities were going to be met, so that, really, this bill would provide access to quality health care for all Americans--not just a few, but for all Americans.
We hear a lot about the consumer protections:
The fact that children cannot be denied insurance if they have a preexisting disease, which is important to us;
The fact that our young people can stay on our insurance until 26 years old;
The fact that there are no lifetime and annual limits, and all of those important provisions that we hear about all of the time.
But I want to talk a little bit about some of the health equity provisions, because this bill prevents discrimination. It defines what a health disparity is and a health disparity population, and it makes sure that all of the research in the bill, all of the task forces, all of the institutes, the comparative effectiveness research, all of those include monitoring and having a goal of eliminating health disparities in their mandate. There are incentive payments to providers if they can demonstrate that they have eliminated health disparities.
Health disparities actually cost this Nation. In a study done by the Joint Center for Political and Economic Studies, they've shown where, just over a 3-year period, $1.24 trillion was lost in direct and indirect costs just because of health disparities.
We expanded, of course, the coverage in the consumer protections-- Medicaid expansion, which we really urge all of the States to provide for their citizens who are at 133 percent or under the Federal poverty level.
The territories, despite the vote to repeal our funding, that funding still stands. My territory is enjoying a great increase in funding. We have not lifted the cap. We are not getting State-like treatment, but for the very first time, many of the territories may be able to cover at least up to 100 percent of the Federal poverty level with the substantial increases that the Affordable Care Act provided.
We also have limited funding to set up exchanges, and the consumer protections and capacity building grants applied to the territories, which really need them.
We included the Indian Health Improvement Act.
We expanded community health centers and school-based health centers within the bill.
We provide for community health worker grants. In communities that have not had the benefit of robust health care services, it's important that people that they trust in the community can help them understand this law and help to make that connection to the health services that will be provided. That's what the community health worker grants would do.
They have community transformation grants.
We tried to include a program that we've been working on called Health Empowerment Zones. We didn't quite get that, but we have funding for communities where those health services have not been available, to be able to prepare that community and to begin to build some infrastructure so that every community can have the benefits of this bill.
We mandated that not-for-profit hospitals create a community health needs assessment every 3 years, and we created a Community Preventive Services Task Force.
Having community-focused, community-developed, community-driven, community-implemented programs is where we're going to see the biggest improvement in health care, especially in communities of color and communities that are poor and our rural communities in our territory.
The bill ensures that Federal health care programs collect and report data on race, ethnicity, sex, primary language, and disability status. We address health care disparities in Medicaid and SCHIP by standardizing data collection requirements.
Again, in comparative effectiveness, we were able to make sure that that research will include racial and ethnic subgroups, women and people with co-morbidities. We establish a National Health Care Workforce Commission that requires reporting. For the very first time in this country, we have a national strategy at prevention, and we have a national strategy to eliminate health disparities, for the very first time, all from the Affordable Care Act.
We increase the National Health Service Corps and loan repayment programs, expanded Centers of Excellence, and we made sure to invest in Historically Black Colleges and Universities and Minority-Serving Institutions.
We're going to have to greatly expand our health care workforce on all levels to take care of the 30-plus million new people who will be coming into the system, and we want to make sure that that workforce reflects the diversity of our country, and that the now underrepresented minorities have a chance to get some of those jobs and be able to provide some of those services for the communities that they come from.
We provide support for cultural competence training for health care professionals, grants to the health care workforce, to provide culturally and linguistically appropriate services. We require the dissemination of information adapted to a variety of cultural, linguistic, and educational backgrounds so that everyone can understand what it is we're trying to do and be able to access the services.
Mental health and substance abuse parity was included. We included dental services in the basic package for children. We would have wished that it could be in the basic package for all people, but we were able to get it in children.
We establish a prevention and public health fund, and I know the Republican leadership has been trying to repeal that fund, to deplete that fund, but this is an attempt to change the paradigm of how we deal with health care in this country, not to just be dealing with the acute, expensive, long-term care, but to focus on prevention. An ounce of prevention is still worth a pound of cure.
We strengthened and expanded the Office of Women's Health. We elevated the Office of Minority Health to the Office of the Secretary. We've created new Offices of Minority Health in the Food and Drug Administration, Centers for Medicare and Medicaid Service, SAMHSA, and other agencies where it's really critical that we have that input that really zeros in on the health care of the minorities who are the people who are really underserved and create some of the costs that we're trying to reduce. If we can take care of all of the people in this country, the costs will go down.
We elevated the Center on Minority and Health Disparities to a national institute at NIH, and they're doing great work with all of our universities across the country.
What we've come to understand is that when you're dealing with health, especially when you're looking from a community level, you can't just focus on disease. You have to look at the environment that people live in. And for the very first time we have a National Prevention, Health Promotion, and Public Health Council headed by our Surgeon General.
That council brings about 17 agencies of government together to plan and to look at the impact of their programs, policies, initiatives that help, and to really plan how we can create an environment in our communities and in our country that supports wellness and supports prevention and supports good health, so that people can walk in their neighborhoods, so that they could have fresh fruit and vegetables in their
neighborhoods and other things like that so we can deal with the obesity problem, so we can deal with smoking cessation, and all the things that contribute to poor health and really increase the costs. When we look at communities and focus on community prevention, that's where we're going to reduce the cost of health care.
So, I wanted to just say a word about Medicare because I am so tired of hearing about $500 billion taken out of--cut from Medicare. Now, that's a misinterpretation of what really happened. That $500 billion comes from cutting waste, fraud, and abuse in part.
I was reading in an article in the paper just today that Medicare could probably save $70 billion just in 1 year, in 2010, by really zeroing in on waste, fraud, and abuse and implementing some of the recommendations of the General Accountability Office--they could save $70 billion in 1 year. Multiply that by ten, I think it comes up to $700 billion, which is more than the $500 billion that the Republicans keep saying we took out of Medicare.
We didn't. We made payments fairer, remember, by making the payments more equitable across the board. So we may have lowered some of the reimbursement rates for Medicare Advantage, but we were able to still keep some of the better, more effective Medicare Advantage programs in place.
We began to close the doughnut hole. We took some of that money to close the doughnut hole so that over the 10-year period there will be no time that a senior or a person with disability will have to pay the full cost of their medication.
We are providing preventive care with no copayments and an annual physical exam with no copayment. And in addition to all of that, with that $500 billion, we extended the life of Medicare by 8 years.
So I just want to clear that up. We did not take $500 billion out of Medicare. We used it to reinvest into Medicare, to make it stronger, to provide more services and more benefits for the beneficiaries.
Of course, health care reform will take an investment, but it will reduce costs over time. We'll reduce disparities, we'll have better end-of-life care with planning by individuals and their families, we'll have that community-based prevention, obesity prevention, smoking cessation and health policy and every policy that I talked about. And all of that will reduce the cost of health care.
I just want to close by just reading a few statements from some physicians. I'm a primary care physician, a family physician myself. And Medscape today published an article from a primary care round table. And I know the doctors who spoke here said many, many things. I just want to quote a sentence or two from several of them.
Charles P. Vega, M.D. At the end of his statement he says:
The Supreme Court decision breathes life into the health
care reform movement at a critical time, and we need to take
advantage of this fortune, not only to implement the most
important parts of the Affordable Care Act, but also to start
building towards the next logical steps in health care
reform, beginning with an efficient public option that
emphasizes smart, quality care.
And Dr. Robert W. Morrow says:
And now we're in a regulatory space where the health of the
public could take precedence over the profits of the
commercial health plans. And why not?
Dr. Roy M. Poses, M.D., says of the Supreme Court ruling:
The news is not bad. We're probably, on balance, somewhat
better off with some health care insurance reform than none.
However, we're still a long way from meaningfully addressing
concentration and abuse of power in health care. There will
be no rest for the weary bloggers of the Health Care Renewal.
Another doctor, Dr. Li, says:
My take is that the plan is not as good as what's being
touted by the left, but it's far better than what's being
said by the right.
And Dr. Robert M. Centor says:
Clearly, upholding the individual mandate allows the U.S.
to approach universal health care. Universal health care is
such a worthy goal that we must applaud this victory.
Dr. Mark Williams says:
For me the Supreme Court ruling on the ACA implies at least
a period of relative clarity and less uncertainty, despite
much political rhetoric. In short, we now have some time for
planning and innovation.
And he also says:
Healthcare is too precious to be considered a business or a
marketplace commodity. Whatever system we choose must commit
itself to the needs of the population and the global
community, not simply to our own personal needs. It must be
based on needs and not simply on service expansion.
And lastly, from my own American Academy of Family Practice, they say:
Having the mandate upheld is consistent with what has been
AAFP policy for over 20 years. We have advocated for health
care coverage for everyone and access to at least basic
health services, including good primary care with prevention
and chronic illness care. You can argue whether the mandate
is the only means to get there, but at least in the analyses
that I've seen, it was one of the best identified ways to get
everyone covered.
And so, the American people, when you ask them about the different provisions of the law, an overwhelming majority really supports the provisions that we've been able to provide for them in health care reform.
Many physicians are touting the Supreme Court decision and the law. I think, if we can all forget about the political rhetoric of repeal and just work together to make sure that it's implemented in the best way possible, we will really be doing what the American people have sent us here to do.
With that, I yield back the balance of my time.