Rep. Jackson Lee Issues Statement on Senate Vote on ACA Repeal

WASHINGTON, July 26 -- Rep. Sheila Jackson Lee, D-Texas, issued the following speech, which was published in the Congressional Record on July 25, on the Senate vote on Affordable Care Act repeal:

Mr. Speaker, today, in a move that is a betrayal to the American people, the Senate voted 51 to 50 on a motion to advance debate on a piece of Republican legislation that would do away with most of the Affordable Care Act.

Reaching a 51-50 vote, where the tie was broken by Vice President Mike Pence, has been a struggle for Republican Members of the Senate because they realize that a repeal of Obamacare would result in tragedy for millions of Americans.

I want you to know that I oppose this and previous versions of Obamacare repeal for several compelling reasons:

1. Trumpcare forces families to pay higher premiums and deductibles, increasing out-of-pocket costs.

2. Trumpcare will take away health care from 24 million hardworking Americans.

3. Trumpcare would gut essential health benefits and protections for Americans with pre-existing conditions.

4. Trumpcare forces Americans aged 50-64 to pay premiums five times higher than what others pay for health coverage, no matter how healthy they are.

5. Trumpcare shortens the life of the Medicare Trust Fund and ransacks funds that seniors depend on to get the long-term care they need.

Eighty-five months ago, on March 23, 2010, President Barack Obama redeemed a promise that had been unfulfilled for nearly a 100 years, when he signed into law the landmark Affordable Care Act passed by the Democratic controlled 111th Congress.

Seven years later, the verdict is in on the Affordable Care Act: the American people have judged it a success.

As reflected in the most recent public opinion polls, 61% of Americans approve of Obamacare and oppose efforts to repeal it, the highest approval rates on record to date and continuing an inexorable upward trend over the past several years.

The reason Americans are adamantly opposed to Republican repeal efforts, including the third iteration of Trumpcare now before us, is that Obamacare is no longer a bogey cooked up in Republican talking points but a life-saving and life affirming measure that they have experienced in their own lives.

Americans think it is beyond crazy to repeal a law that has brought to more than 20 million Americans the peace of mind and security that comes with knowing they have access to affordable, high quality health care.

Mr. Speaker, before the passage of the Affordable Care Act, 17.1 percent of Americans lacked health insurance; today nearly nine of ten (89.1 percent) are insured, which is the highest rate since Gallup began tracking insurance coverage in 2008.

Because of the Affordable Healthcare Act:

1. Insurance companies are banned from discriminating against anyone, including 17 million children, with a preexisting condition, or charging higher rates based on gender or health status;

2. 6.6 million young adults up to age 26 can stay on their parents' health insurance plans;

3. 100 million Americans no longer have annual or lifetime limits on healthcare coverage;

4. 6.3 million seniors in the "donut hole" have saved $6.1 billion on their prescription drugs;

5. 3.2 million seniors now get free annual wellness visits under Medicare, and

6. 360,000 small businesses are using the Health Care Tax Credit to help them provide health insurance to their workers;

7. Pregnancy is no longer a pre-existing condition and women can no longer be charged a higher rate just because they are women.

We are becoming a nation of equals when it comes to access to affordable healthcare insurance.

Mr. Speaker, with all of this progress, and the prospect for more through further refinements, who in their right mind would want to go back to how it used to be?

The answer seems to be only the President and House Republicans who call the Affordable Care Act and its enviable record of success a "disaster."

Americans know a disaster when they see one and they see one in the making: it is called "Trumpcare," masquerading as the "American Health Care Act," which will force Americans to pay more, get less, decimate the Medicare and Medicaid programs, and give a massive tax cut for top 1 percent.

Americans are right to be alarmed and angered by what the Trump Republicans are trying to do by rushing to vote on a Trumpcare bill before it can be scored by highly respected and nonpartisan Congressional Budget Office.

What we do know for sure is that this Trumpcare bill is a massive $900 billion tax cut for the wealthy, paid for on the backs of America's seniors, the vulnerable, the poor, and working class households.

Trump gave the game away on March 20, 2017 in one of his trademark pep rallies:

"We want a very big tax cut, but cannot do that until we keep our promise to repeal and replace the disaster known as Obamacare."

This "Robin Hood in reverse" bill is unprecedented and breathtaking in its audacity--no bill ever tried to give so much to the rich while taking so much from the poor and working class.

When they were forced to pull Trumpcare 1.0 from the floor because they lacked the votes to pass, House Republican leaders responded by adding an amendment (Trumpcare 2.0) that made the original bill even worse.

Trumpcare 2.0 would allow states to jettison existing essential health benefit requirements, thereby permitting health plans covering millions of people once again to exclude coverage for maternity and newborn care, pediatric dental and vision services, mental health and substance use services, and other crucial benefits.

All this accomplished was a hemorrhaging of support from the moderate wing of the Republican Conference who feared the repercussions of leaving millions of Americans with preexisting conditions without health insurance so the Trump Republicans invented Trumpcare 3.0 to provide $8 billion over five years to offset the cost of setting up separate pools or premium assistance programs for people with pre- existing conditions.

Mr. Speaker, this pittance is not designed or intended to help real people with real preexisting conditions, but to provide the cover for House Republicans to walk the plank.

According to the Kaiser Family Foundation, at least $25 billion per year would be required, not $8 billion spread out over five years as provided for in Trumpcare 3.0.

Trumpcare represents the largest transfer of wealth from the bottom 99 percent to the top 1 percent in American history.

This callous Republican scheme gives gigantic tax cuts to the rich, and pays for it by taking insurance away from 24 million people, leaving 52 million uninsured, and raising costs for the poor and middle class.

In addition, Republicans are giving the pharmaceutical industry a big tax repeal, worth nearly $25 billion over a decade without demanding in return any reduction in the cost of prescription and brand-name drugs.

To paraphrase Winston Churchill, of this bill, it can truly be said that "never has so much been taken from so many to benefit so few."

The Pay-More-For-Less plan destroys the Medicaid program under the cover of repealing the Affordable Care Act Medicaid expansion.

CBO estimates 14 million Americans will lose Medicaid coverage by 2026 under the Republican plan.

In addition to terminating the ACA Medicaid expansion, the bill converts Medicaid to a per-capita cap that is not guaranteed to keep pace with health costs starting in 2020.

The combined effect of these policies is to slash $880 billion in federal Medicaid funding over the next decade.

The cuts get deeper with each passing year, reaching 25 percent of Medicaid spending in 2026.

These steep cuts will force states to drop people from Medicaid entirely or ration care for those who most need access to comprehensive coverage.

The Pay-More-For-Less plan undermines the health care safety net for vulnerable populations.

Currently, Medicaid provides coverage to more than 70 million Americans, including children, pregnant women, seniors in Medicare, people who are too disabled to work, and parents struggling to get by on poverty-level wages.

In addition to doctor and hospital visits, Medicaid covers long-term services like nursing homes and home and community-based services that allow people with chronic health conditions and disabilities to live independently.

To date, 31 states and D.C. have expanded Medicaid eligibility to low-income adults, which, when combined with the ACA's other coverage provisions, has helped to reduce the nation's uninsured rate to the lowest in history.

Trumpcare throws 24 million Americans off their health insurance by 2026 according to the Congressional Budget Office.

Mr. Speaker, low-income people will be hit especially hard because 14 million people will lose access to Medicaid by 2026 according to CBO.

Trumpcare massively shifts who gets insured in the nongroup market.

According to CBO, "fewer lower-income people would obtain coverage through the nongroup market under the legislation than current law," and, "a larger share of enrollees in the nongroup market would be younger people and a smaller share would be older people."

The projected 10 percent reduction in premiums is not the result of better care or efficiency--it is in large part the result of higher- cost and older people being pushed out of a market that is also selling plans that provide less financial protection.

People with low incomes suffer the greatest losses in coverage.

CBO projects the uninsured rate for people in their 30s and 40s with incomes below 200 percent of poverty will reach 38 percent in 2026 under this bill, nearly twice the rate projected under current law.

Among people aged 50-64, CBO projects 30 percent of those with incomes below 200 percent of poverty will be uninsured in 2026.

Under current law, CBO projects the uninsured rate would only be 12 percent.

Being uninsured is not about "freedom."

Speaker Ryan has argued that people will happily forgo insurance coverage because this bill gives them that "freedom."

The argument makes as much sense as the foolish claim that slaves came to America as "immigrants" seeking a better life.

The freedom to be uninsured is no freedom at all to people in their 50s and 60s with modest incomes who simply cannot afford to pay thousands of dollars toward premiums.

They do not really have a choice.

The claim of our Republican friends that Trumpcare provides more freedom to all Americans calls to mind the words of Anatole France:

"The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread from the market."

Trumpcare raises costs for Americans nearing retirement, essentially imposing an "Age Tax."

The bill allows insurance companies to charge older enrollees higher premiums than allowed under current law, while reducing the size of premium tax credits provided.

Again, these changes hit low-income older persons the hardest.

A 64-year-old with an income of $26,500 buying coverage in the individual market will pay $12,900 more toward their premiums in 2026, on average.

Trumpcare raises costs for individuals and families with modest incomes, particularly older Americans.

Mr. Speaker, a recent analysis found that in 2020, individuals with incomes of about $31,000 would pay on average $4,000 more out of pocket for health care--which is like getting a 13 percent pay cut.

And the older you are, the worse it gets.

An analysis by the Urban Institute estimates that for Americans in their 50s and 60s, the tax credits alone would only be sufficient to buy plans with major holes in them, such as a $30,000 deductible for family coverage and no coverage at all of brand-name drugs or many therapy services.

Another reason I oppose the Trumpcare bill before us is because its draconian cuts in Medicaid funding and phase-out of Medicaid expansion put community health centers at risk.

Community health centers are consumer-driven and patient-centered organizations that serve as a comprehensive and cost effective primary health care option for America's most underserved communities.

Community health centers serve as the health care home for more than 25 million patients in nearly 10,000 communities across the country.

Across the country, 550 new clinics have opened to receive 5 million new patients since 2009.

Community health centers serve everyone regardless of ability to pay or insurance status:

1. 71 percent of health center patients have incomes at or below 100 percent of poverty and 92 percent have incomes less than 200 percent of poverty;

2. 49 percent of health center patients are on Medicaid; and

3. 24 percent are uninsured;

4. Community health centers annually serve on average 1.2 million homeless patients and more than 300,000 veterans.

Community health centers reduce health care costs and produce savings--on average, health centers save 24 percent per Medicaid patient when compared to other providers.

Community health centers integrate critical medical and social services such as oral health, mental health, substance abuse, case management, and translation, under one roof.

Community health centers employ nearly 190,000 people and generate over $45 billion in total economic activity in some of the nation's most distressed communities.

Community health centers are on the front lines of every major health crisis our country faces, from providing access to care (and employment) to veterans to addressing the opioid epidemic to responding to public health threats like the Zika virus.

We should be providing more support and funding to community health centers, not making it more difficult for them to serve the communities that desperately need them by slashing Medicaid funding.

The Trumpcare Republican plan leaves rural Americans worse off.

Health insurance has historically been more expensive in rural areas because services cost more and it is hard to have a stable individual market with a small population.

Mr. Speaker, under the Affordable Care Act, premium subsidies are tied to local costs, which helps keep premium costs down.

But they are not under the Republican plan.

So, under the Republican plan residents in rural areas, who tend to be older and poorer, will pay much more and get much less health insurance.

At the end of the day, the powerful and compelling reasons to reject Trumpcare lie in the real world experiences of the American people.

Mr. Speaker, let me briefly share with you the positive, life affirming difference made by the Affordable Care Act in the lives of just three of the millions of Americans it has helped.