Mr. Speaker, I thank the gentlewoman from the Virgin Islands. And I always enjoy hearing from the gentlewoman from the Chicago area, and I appreciate everything that she is doing as well. It is interesting the President posed that…
Mr. Speaker, I thank the gentlewoman from the Virgin Islands. And I always enjoy hearing from the gentlewoman from the Chicago area, and I appreciate everything that she is doing as well.
It is interesting the President posed that question: What do you have to lose?
What he was referencing to was the African-American community. Instead of offering anything of substance, he just put out that very simple question.
I have got to tell you that it is pretty evident what we have to lose now. It is not only a lot of the gains that were made under the Obama Administration, but something that is near and dear to all of us, and that is health care.
I think about the district that I represent, and 40,000 people or more have actually been covered because of the Affordable Care Act. They will probably lose that insurance if TrumpCare were to become law. And if you represent low-income families and workers out there, that is a scary prospect.
It is already bad enough that the State of Texas made probably what is considered one of the biggest policy blunders in Texas State legislative history when they decided not to expand Medicaid, which left so many others statewide, including in the district I represent, again, off of the insurance rolls.
What do you have to lose?
God, there are so many ways and so many areas that I can sort of describe what you would have to lose. The first thing I think about is, in the Dallas/Fort Worth area, if you lose your insurance, of course, that means that the burden is going to fall back on John Peter Smith Hospital, which is one of our county hospitals in the north Texas area, and Parkland Hospital in Dallas.
So instead of people having insurance that they pay into, that they have where they can go and see a doctor, they will end up back in the county hospital rolls and, of course, that will end up costing the taxpayers more money.
During President Trump's first 50 days, the Republicans introduced this legislation that, again, will just decimate the progress that so many people around the country have seen under the Affordable Care Act.
This Thursday, as we actually mark the seventh anniversary of the signing of the Affordable Care Act, the House is set to vote on the Republicans' healthcare replacement. Ironically, on a day that we should be celebrating the tremendous progress our country has made since this landmark law's passage, we will be defending the merits in our continued battle to fight its repeal.
So what does the Black community have to lose?
Again, we pose that question. The Congressional Budget Office--and there is a Republican appointee that runs that office, by the way--says that 24 million people are going to lose their healthcare insurance. Of those 24 million who are set to be kicked off of their healthcare plan and sent out to nowhere, African Americans are going to be hit the hardest.
The ACA boosted the African-American insured rate from 79 percent to 88 percent, just slightly below the 91 percent national figure. Some of those gains stem from Medicaid expansion under the ACA, where nearly 15 million of the nearly 40 million African Americans gained coverage.
That is what I was talking about a little bit earlier, Representative Plaskett. In Texas, we did not get to benefit from that. That would have been a huge benefit to us. Again, it is really considered one of the biggest policy blunders in the country.
As you see, Republican governors are actually afraid right now that the Medicaid expansion that has benefited their States that they are going to lose out on that because of this repeal that is going to take place. They are pushing back. They are saying this whole TrumpCare and RyanCare plan is a hot mess and that they absolutely want nothing to do with it.
It is also important to remember, under the Republican plan, the decision to cut $880 billion from Medicaid over the next 10 years will translate into millions of African Americans potentially losing health care. While these numbers are alarming, it is the human impact that cannot be lost on GOP colleagues.
I have heard directly from constituents that I serve how the ACA has improved or saved their lives, and I would like to actually share some of those stories with you today.
One of the constituents that I serve worked for the same company for 35 years but was forced to retire because of declining health before he was eligible for Medicare. He faces drug costs of over $500 per day and requires a lifesaving procedure four times a year that costs $14,000 per treatment. You can imagine what $14,000 per treatment would do, and that is four times a year. Overall, his medical costs per month is $15,000.
With the implementation of the Affordable Care Act, he had access to quality care that helped ease his financial burden. Under the Republican plan, this hardworking man, this taxpayer, this person that has worked hard, that worked for one company for 35 years--that used to mean so much in this country when people would give 35 years to one company and expected to be treated right--under the Republican plan, this hardworking man would pay thousands of dollars in out-of-pocket medical expenses for lifesaving care that would not be covered by this disastrous plan that we are actually going to have to take a vote on on Thursday.
It is stories like that that I think are really sad and why we need to tap the brakes and see what we can do to help make the current healthcare plan that we have, the ACA, stronger and better, to help out people like this gentleman who are going to be left out in the cold.
You have to really be wondering what our Republican colleagues are thinking, because it is not just the constituents that I represent. It is many of the constituents that they represent, too. I can tell you that out in the Dallas/Fort Worth metroplex, while I do represent largely urban areas--Dallas, Fort Worth, Irving, Grand Prairie, Arlington--I know that there are a lot of people that live out in these rural areas, that live outside of Dallas and Fort Worth, that live outside of Dallas County and Tarrant County. They consider themselves conservatives, and I can tell you that they cannot afford $14,000 per treatment; but if the Republicans pass their plan, that is what they are going to be left with and they are not going to be able to afford it. They are not going to get the care that they need, and that is what they need to understand tonight and that is what the Republicans need to understand tonight.
The only thing that they can guarantee individuals, like I just talked about, is that they are going to be paying a whole lot more for a lot less coverage. I think that is really a shame.
Another constituent was forced to pay $100 per month for medically necessary birth control pills after her husband lost his job in 2010. Luckily, the Affordable Care Act provided access to health care, and now her birth control that she needs is covered in full. And that is important, too.
We have actually seen teen pregnancy rates in this country drop all over the country, which is good. Because when people can afford to start a family when they are ready, when they are financially ready to start a family, those kids are more likely to do better in school. They are more likely to be in a stable household. They are more likely to get the education that they need to be able to achieve the things they want to achieve when they leave the house. So there are a lot of these initiatives around the country where we have really seen teen pregnancy rates drop 20, 30 percent or more. It has been great.
I can tell you that in Dallas County, while the teen pregnancy rate is dropping all over the country, we have actually seen it rise at an alarming rate.
So what does that tell me?
That tells me that if you see the teen pregnancy rate going up and that you are going to kick all these people off their health care, that is going to be more of a strain on the social service system.
Republicans used to pretend like they were for people to have an opportunity to get off the system. But once you take people's birth control away and not give them the options that they need for family planning, you are increasing the social services. The Republican CBO report actually points that out, and they are still going ahead with this. So I think that that is really what is sad.
I think overall what we want to get at tonight is that the Affordable Care Act has been a lifeline for African Americans and African-American families. The full repeal will snatch the safety net out from under the Black community.
Despite the lies that our colleagues across the aisle and in the White House want to spread about the ACA, my colleagues and I will continue to defend it to the very end because it turns out that the Black community has a lot to lose under the Republican healthcare plan.
I am so glad that so many of our colleagues came out tonight. I am glad that you are here helping lead this hour because we need to get the word out. We can stop something really devastating from happening here. The thing about it is that we really need to try to stop something devastating from happening on a bipartisan basis, such as people losing their health care, getting left out in the cold, being kicked off of their health insurance; trying to figure out, if they have a preexisting condition, how they are going to afford being pushed back into a high-risk pool.
What is this going to do to so many Americans? We are here focusing on the African-American community tonight with the Congressional Black Caucus, but what is this going to do to all Americans?
It is going to hurt them. It is going to hurt their bottom line. It is going to hurt their families. It is going to leave them in financial disrepair. I think it is going to be a sad day for our country.
Instead of trying to destroy something, we need to be trying to work together to try to strengthen the current system and make sure that all Americans have the opportunity to be covered.
Absolutely, Representative Plaskett. And one of our colleagues, who also happens to be my neighbor, Eddie Bernice Johnson, you can easily make the argument that she knows something about health care, considering that she worked in the healthcare arena before she came to Congress. And not only did she work in the healthcare arena, she has a lot of people that were uninsured that live in her district that are now insured because of the Affordable Care Act.
So, again, not only does she have that healthcare experience, she has been out in the community and has met with people for many years now on health care, even before she came to the Congress, when she was in the State Senate; so she has sat down and she has talked to people. She understands why it is important for people to have health care. She understands why it can be financially hard on people when they are hit by a catastrophic illness.
She gave a speech on the House floor--or she has a speech that she is going to submit--where she talks about the fact that the district that she represents, the uninsured rate dropped 27.3, all the way down to 20.8 percent; and that was a huge benefit for the constituents that she serves on a daily basis.
I mentioned Parkland Hospital a little bit earlier. Parkland Hospital is a Dallas County public hospital. Parkland Hospital provided $1 billion in uncompensated care in 2015--$1 billion. And if this RyanCare-TrumpCare bill were to become law, you can imagine what a large system like Parkland, that already provides so much in uncompensated care, what they are going to be hit with. It is going to be absolutely devastating.
I already talked about the fact also that Texas--and Representative Johnson mentions Medicaid in her letter. I have already talked about the fact that Texas made a big public policy blunder and decided not to take the money that the Federal Government was going to give them to help expand Medicaid coverage. They just prefer to just leave all those people uninsured.
So now one of the things that will happen under this GOP bill that the Congresswoman points out is that the money will be sent to people in a block grant; and you can imagine the shortfalls that that would create, particularly in a large State like Texas, because there are going to be shortcomings. So hospital systems like Parkland, like John Peter Smith, they are really going to be hit with a hammer were this ever to pass and become law just because they are already being pushed so much.
Again, what just doesn't make any sense is that the Republicans so prided themselves for so many years about being the party that was about self-empowerment and helping people out, so
now they want to kick people off of their insurance and leave them out in the cold and have them start going back to Parkland, start going back to John Peter Smith because they are not going to be able to afford their insurance anymore under this. It doesn't make any sense.
All of those are absolutely good points, and I was talking about the uncompensated costs there for public hospitals. The one thing that I did not mention--and everybody knows this--is that if you don't have insurance and you do find yourself having to depend on the county hospital system or the public hospital system in your area, and those lines get longer and longer, which is what would happen if this bill were repealed--people have to remember that if someone is having an emergency and they know that the lines at the county hospital are just out of control and long, they are going to go to the private hospital.
They are going to go to the nonprofit hospital like in Dallas County that could be Baylor, that could be Huguley, and those hospitals are going to take on uncompensated costs. That is what is going to end up happening. They can't get a regular appointment there without insurance, but if they go to the hospital emergency room, they can't be turned away. Not only is it going to be a burden on our county hospital system, it is going to be a burden on our nonpublic providers as well.
Again, one thing to remember is that, before the Affordable Care Act, we had over 1 million people in Dallas-Fort Worth that did not have insurance. Just in the congressional district, alone, that I represent, I have the largest uninsured rate out of any congressional district in the entire country. That surprises a lot of people just because of the growth and the opportunities that the Dallas-Fort Worth area have been blessed with. But I actually have the largest uninsured rate out of any congressional Member in the country.
So when you think about the district that I represent and then you expand that across the Dallas-Fort Worth metroplex, you are talking about 1 million people in a very prosperous area that still find themselves without insurance. That is scary.
I mentioned a little bit earlier the district I represent, the uninsured rate has gone from 37.9 percent to 31.4 percent since ACA was implemented; 2,003 individuals in the district now have health insurance that covers preventive services like cancer screenings and flu shots.
When you start talking about kidney dialysis, for instance, I visited a kidney dialysis center in Dallas County shortly after I was first sworn in. I was taking a tour of the kidney dialysis center, and I asked the doctor who was in charge of the center, I said: Wow, there are a lot of younger people in here.
About 60 percent of the patients were African American. About 40 percent were Hispanic. There was one White patient that was in there.
The lady said: It doesn't matter where you go. If you go to visit any of our clinics or any of our kidney dialysis centers, this is what a typical day looks like.
I asked her: Is it hereditary? What is going on? I don't understand what the problem is here.
She said: No. A lot of it is because they weren't receiving the care that they needed.
The sad part about that, she went on to explain to me, is sometimes it can be a person who has high blood pressure issues, and if they had just gotten those high blood pressure issues addressed, it could have been the difference between them taking some high blood pressure medicine instead of them basically having to give up their careers and go and sit in a chair to receive dialysis treatment 3, 4 days a week, 2 to 3 hours each time. That is sad.
She also talked about diabetes and how some people have diabetes, and they don't get that diabetes treated in time. Maybe they didn't even know they had diabetes. Again, type 2 diabetes is something very treatable. You can imagine the difference between treating somebody, giving them a prescription to treat their type 2 diabetes or their high blood pressure versus your earning capacity being greatly diminished by you having to go sit in a chair 2, 3, or more times 3 or 4 days a week versus if they had just been able to go see a primary care physician.
That is the type of thing that the Affordable Care Act is doing, giving people the opportunity to go and get those things treated before they become more costly to the system. That is something that is being missed.
The other thing that I think scares everybody--and it doesn't matter if you, again, live in my district or you live in the one of many districts in the Dallas-Fort Worth metroplex, when you start talking about people who have preexisting conditions and you start talking about the fact that people are going to lose consumer protections that have been put in place under the Affordable Care Act and that they are going to see those consumer protections killed--like the prohibition on annual and lifetime limits, protection against unfair policy rescissions and coverage of preexisting conditions--again, if you see the ACA repealed, it is people like that who, for the first time, didn't have to worry about those limits, and they are going to see that snatched away from them. That is just really one of the tragedies.
Mr. Speaker, 27,000 people in the district that I represent, again, received financial assistance to purchase marketplace coverage in 2016. Now they are going to risk being uninsured again, and the insurance is going to be unaffordable under the Republican plan. There are just so many stories like that.
One of the things that I didn't point out about some of the people that are going to lose some of these consumer protections is that some of those people have worked really hard on their jobs, they are still working on their jobs, and they are going to be hit with those lifetime limits. It is going to be completely unfair to them while they are out there working hard every day. It was something they didn't have to worry about before, or at least when the ACA was put in place. If the ACA is repealed, they are going to be subject to that, too.
I think the narrative that has been put out there by the Republicans is that, no, it is just people that are taking advantage of the system. But understand, there are people that fall into these categories that we are talking about right now that get up and they
go and work hard every day--every single day--and they have health insurance on their jobs, and they are going to be greatly impacted by this.
Speaking of people who go and work hard on their job every day, one of the things that I know that a lot of Democrats would like to see put in place--and even some Republicans have said they would like to see put in place--is they want to see the Cadillac tax repealed. That is not happening under this Republican plan. That is completely out of it.
So, again, there are a lot of problems with this and a lot of unfairness about this, about the people that are going to be harmed and affected. I hope that we can work in a bipartisan manner to really stop this from happening. And again, like we are here talking about tonight, the African-American community, in particular, will really be hit very, very hard.