View From the Speaker’s Office Tonight
Sunday, March 21st, 2010 by KarinaOur staff cheered Speaker Pelosi and Whip Clyburn after the historic passage of health reform:
Our staff cheered Speaker Pelosi and Whip Clyburn after the historic passage of health reform:
Speaker Pelosi’s closing remarks urging an aye vote for comprehensive health insurance reform:
Transcript:
“Thank you, my colleagues. Thank you, Mr. Speaker. I thank the gentleman for yielding. I thank all of you for bringing us to this moment.
“It is with great humility and with great pride that we tonight will make history for our country and progress for the American people. [Applause] Just think–we will be joining those who established Social Security, Medicare, and now tonight health care for all Americans. [Applause]
“In doing so, we will honor the vows of our founders, who in the Declaration of Independence said that we are 'endowed by our Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.' This legislation will lead to healthier lives, more liberty to pursue hopes and dreams and happiness for the American people. This is an American proposal that honors the traditions of our country. [Applause]
“We would not be here tonight, for sure, without the extraordinary leadership and vision of President Barack Obama. [Applause] We thank him for his unwavering commitment to health care for all Americans.
“And this began over a year ago under his leadership in the American Recovery and Reinvestment Act, where we had very significant investments in science, technology, and innovation for health care reform. It continued in the President's budget a few months later, a budget which was a statement of our national values, which allocated resources that were part of our value system. And in a way that stabilized our economy, created jobs, lowered taxes for the middle class and did so, and reduced the deficit, and did so in a way that had pillars of investment, including education and health care reform–health care reform and education, equal opportunity for the American people. [Applause]
“And this legislation tonight, if I had one word to describe it would be 'opportunity,' with its investments in education and health care as a continuation of the President's budget. We all know, and it has been said over and over again, that our economy needs something new, a jolt. And I believe that this legislation will unleash tremendous entrepreneurial power into our economy. Imagine a society and an economy where a person could change jobs without losing health insurance, where they could be self-employed or start a small business. Imagine an economy where people could follow their passions and their talent without having to worry that their children would not have health insurance, that if they had a child with diabetes who was bipolar or pre-existing medical condition in their family, that they would be job-locked. Under this bill, their entrepreneurial spirit will be unleashed. [Applause]
“We all know, we all know that the present health care system and insurance system, health insurance system in our country is unsustainable. We simply cannot afford it. It simply does not work for enough people in terms of delivery of service and it is bankrupting the country with the upward spiral of increasing medical costs.
“The best action that we can take on behalf of America's family budgets and on behalf of the federal budget, is to pass health care reform. [Applause]
“The best action we can take to strengthen Medicare and improve care and benefits for our seniors is to pass this legislation tonight, pass health care reform. [Applause]
“The best action we can do to create jobs and strengthen our economic security is pass health care reform. [Applause]
“The best action we can take to keep America competitive, ignite innovation, again unleash entrepreneurial spirit is to pass health care reform. [Applause]
“With this action tonight, with this health care reform, 32 million more Americans will have health care insurance. And those who have insurance now will be spared being at the mercy of the health insurance industry with their obscene increases in premiums, their rescinding of policies at the time of illness, their cutting off of policies even if you have been fully paying but become sick, the list goes on and on about the health care reforms that are in this legislation: insure 32 million more people, make it more affordable for the middle class, end insurance company discrimination based on pre-existing conditions, improve care and benefits under Medicare, and extending Medicare's solvency for almost a decade, creating a healthier America through prevention, through wellness and innovation, create 4 million jobs in the life of the bill and doing all of that by saving the taxpayer $1.3 trillion dollars. [Applause.]
“Another Speaker, Tip O'Neill once said: 'All politics is local.' And I say to you tonight that when it comes to health care for all Americans, 'All politics is personal.'
“It's personal for the family that wrote to me who had to choose between buying groceries and seeing a doctor. It's personal to the family who was refused coverage because their child had a pre-existing condition — no coverage, the child got worse, sicker. It's personal for women — after we pass this bill, being a woman will no longer be a pre-existing medical condition. [Applause.]
“It's personal for a senior gentleman whom I met in Michigan, who told me about his wife who had been bed-ridden for 16 years. He told me he didn't know how he was going to be able to pay his medical bills. As I said to you before, I saw a grown man cry. He was worried that he might lose his home — that they might lose their home because of his medical bills and he didn't know how he was going to pay them. And most of all, he was too embarrassed to tell his children and ask them for help. How many times have you heard a story like that?
“And it's personal for millions of families who've gone into bankruptcy under the weight of rising health care costs. In fact, many, many, many — a high percentage of bankruptcies in our country are caused by medical bills that people cannot pay. And it's personal for 45,000 Americans and their — families who have lost a loved one each year because they didn't and couldn't get health insurance.
“That is why we're proud and also humbled today to act with the support of millions of Americans who recognize the urgency of passing health care reform. And more than 350 organizations, representing Americans of every age, every background, every part of the country, who have endorsed this legislation. Our coalition ranges from the AARP, who said that our legislation 'improves efforts to crack down on fraud and waste in Medicare, strengthening Medicare for today's seniors and future generations.' I repeat: 'Improves efforts to crack down on fraud and waste in Medicare, strengthening the program for today's and future generations of seniors.' To the American Medical Association, the Catholic Health Association, the United Medical — the United Methodist Church, and Voices of America's Children. From A to Z — they are sending a clear message to Members of Congress: Say yes to health care reform. [Applause.]
“We have also reached this historic moment because of the extraordinary leadership and hard work and dedication of all the Members of Congress, but I want to especially recognize our esteemed Chairs — Mr. Waxman, Mr. Rangel, Mr. Levin, Mr. Miller, Mr. Spratt, Ms. Slaughter — for bringing this bill to the floor today. Let us acknowledge them. [Applause.]
“And I want to acknowledge the staff of the committees and of the leadership — they have done a remarkable job — dazzling us with their knowledge and their know-how. [Applause.] I would like to thank on my own staff: Amy Rosenbaum, Wendell Primus, and Arshi Siddiqui.
“And now, I want to just close by saying this. It would not be possible to talk about health care without acknowledging the great leadership of Senator Edward Kennedy, who made health care his life's work. [Applause.]
“In a letter to President Obama before he passed away — he left the letter to be read after he died. Senator Kennedy wrote that: 'Access to health care is the great unfinished business of our society.' That is until today. [Applause.]
“After more than a year of debate, and by the way, the legislation that will go forth from here has over 200 Republican amendments, and while it may not get Republican votes and be bipartisan in that respect, it is bipartisan in having over 200 Republican amendments. [Applause.]
“After a year of debate and hearing the calls of millions of Americans, we have come to this historic moment. Today, we have the opportunity to complete the great unfinished business of our society and pass health insurance reform for all Americans that is a right and not a privilege. [Applause.]
“In that same letter to the President, Senator Kennedy wrote, what is 'at stake' he said, 'At stake are not just the details of policy but…the character of our country.'
“Americans will look back on this day as one which we honored the character of our country and honored our commitment to our nation's founders for a commitment to 'life, liberty, and the pursuit of happiness.'
“As our colleague John Lewis has said, 'We may not have chosen the time, but the time has chosen us.' We have been given this opportunity. I urge our — an opportunity — stay right up there with again, Social Security, Medicare, health care for all Americans. I urge my colleagues in joining together in passing health insurance reform — making history, making progress, and restoring the American dream.
“I urge an aye vote. Thank you.”
By a vote of 219-212, the House passed comprehensive health insurance reform, sending the bill to the President:
By a vote of 220-211, the House passed the reconciliation bill to improve the Senate bill, sending it to the Senate:
HEALTH CARE & FAMILIES
WHY WE NEED REFORM
Since 2000, employer-sponsored health insurance premiums have more than doubled – a rate three times faster than cumulative wage increases.
The average cost of an employer-based family health insurance policy in 2009 was $13,375 — that's $1,115 a month – nearly the annual earnings of a full-time minimum wage job. Up from $12,680 in 2008 and $6,462 in 1996.
Almost 75 percent of individuals looking for coverage on the individual market never bought a plan, with 61 percent citing premium cost as the primary reason.
In 2007, 60% of personal bankruptcies were reported to be related to medical costs.
Over 47 million Americans are uninsured. In 2008, 23 million uninsured were employed adults and 7.3 million were children.
Families pay a “hidden insurance tax” of more than $1,000 in additional premium costs each year to cover the cost of uncompensated care.
Every minute, 8 people are denied coverage, charged a higher rate, or otherwise discriminated against because of a pre-existing condition.
THE COST OF INACTION — WITHOUT REFORM
Family premiums are projected to increase an average of $1,800 each year.
The average family premium is projected to be $23,842 in 2020.
The number of the uninsured would reach 62.5 million by 2020, with the middle class becoming uninsured at a faster pace than other income levels
With employers unable to afford rising health care costs, our country could see an additional 3.5 million people unemployed and without benefits in the next 4 years.
Workers pay for the rising cost of health insurance through lower wages.
HEALTH CARE & BUSINESS
WHY WE NEED REFORM
American businesses are losing their ability to compete in the global marketplace due to rising health care costs. The burden is particularly heavy on small businesses.
Small business premiums have risen 129% since 2000.
28 million uninsured Americans are small business owners, employees, and their families – 60% of our nation's entire uninsured population.
In 2008, 38% of small companies offered health coverage, compared with 41% in 2007 and 61% in 1993.
On average, small businesses pay up to 18 percent more than large firms for the same health insurance policy.
An employee of a small business is 50 percent more likely to lose job-based coverage than an employee of a large business.
THE COST OF INACTION — WITHOUT REFORM
By 2016, average health insurance premiums for an individual policy in a firm with less than 50 employees will be approximately $6,700.
Small businesses would lose $52.1 billion in profits to high health care costs over the next ten years.
Employer health care spending would increase by 90.8 percent between 2010 and 2020, increasing from $430 billion in 2010 to $820 billion.
About 10% of small companies are considering ending their employee health coverage plans over the next year, compared with 3% of small businesses in 2005.
Firms with less than 50 employees would see offers of health insurance drop from 41.1 % in 2010 to 33.4 % in 2020.
28% of employers plan to use spousal surcharges next year, up from 21% this year.
HEALTH CARE & THE ECONOMY
WHY WE NEED REFORM
The United States spent approximately $2.5 trillion on health care in 2009, or $8,093 per person. This comes to 17.3% of GDP, nearly twice the average of other developed nations
Since the recession began, an estimated 4 million additional Americans have lost their health insurance.
The economic consequences of uninsurance are enormous, with an estimated lost productivity of roughly $76 to $152 billion in a year.
Waste and inefficiencies in our health care system cost us $800 billion per year.
In 2009, the cost of uncompensated care was $62.1 billion.
THE COST OF INACTION — WITHOUT REFORM
By 2019, national health care expenditures are expected to reach $4.5 trillion–more than double 2007 spending.
By 2025, one in every four dollars in our nation's economy will be spent on health care.
The proportion of spending attributable to Medicare and Medicaid in the health system is expected to rise from 4.1 percent of GDP in 2007 to 6 percent of GDP in 2020, making it the principle driving force behind rising federal spending in the decades to come.
Between 2009 and 2019, the average increase in national health expenditures is expected to be 6.1 percent per year, increasing faster than the projected GDP growth of 4.4 percent per year.
Without reform the cost of uncompensated care would rise to $141.4 billion.
We have an obligation to care for and honor America's servicemen and women, their families, and our veterans for their bravery and sacrifice. Some health insurance reform opponents continue to spread myths, including saying that reform will undermine the health care that veterans and military families have now. The health reform legislation the House is considering today fulfills Democrats' commitment to ensure choice for veterans, service members, and their families. Here are the facts about health reform and veterans and military families:
TRICARE, TRICARE for Life, and Veterans' Health Care all meet the requirements of the health reform legislation that calls for every American to be insured with at least a minimum quality of coverage. Enrollees in these programs can rest assured that this reform has no negative impacts for them.
Indeed, the legislation being considered today actually explicitly states that the TRICARE for Life is not affected by the individual responsibility requirement.
While TRICARE also meets the individual responsibility requirement, this was not explicitly stated in the legislation. Out of an abundance of caution, the House yesterday passed the TRICARE Affirmation Act to further clarify that all those serving in the military and their families, and military retirees and their families under age 65, have health care that meets the minimum benefit standard in the reform bill.
The Vietnam Veterans of America issued a press release applauding yesterday’s passage of the TRICARE Affirmation Act and encourages the rejection of “fear-mongering”:
“We thank and applaud passage of H.R. 4887 yesterday in the House of Representative, by a vote of 403-0. Passage of this bill ensures that health care programs for veterans, active duty military, retired military, and their families/survivors will not be affected negatively by the pending health care reform legislation.” said John Rowan, National President of Vietnam Veterans of America (VVA).
“It is unfortunate that some continue to raise what is now is even more clearly a false alarm that is apparently meant to frighten veterans and their families in order to prompt them to oppose the pending legislation. While there is legitimate debate as to whether or not the pending health care measures should become law, VVA does not appreciate spreading rumors that are not accurate by any political partisan from any point of the political spectrum” continued Rowan.
“Last summer there was a similar incident, also involving partisans in the health care reform debate,that VVA soundly condemned. We said then: “It is our hope that sane minds reject fear-mongering, and that veterans recognize these scare tactics for what they are,” Rowan said.
Rowan concluded by saying: “VVA has always worked hard for justice for veterans of all generations, and their families. We have always, and will continue to, work with public officials representing all political parties and points of view. Issues affecting veterans and their families are not, should not, and must not become partisan footballs to bat around. VVA decries any effort, by anyone, that would do just that.”
The Obama Administration has also been very clear that the health care programs for both the military and our veterans will not be undermined or compromised in any way by this health care reform legislation. Earlier in the week Tammy Duckworth, the Assistant Secretary of Public and Intergovernmental Affairs for the Department of Veterans Affairs, addressed concerns:
As Assistant Secretary of the Department of Veterans Affairs, a constant concern for me is having our Veterans dragged into partisan politics. Unfortunately the debate over health reform has seen that happen far too many times, and at the VA we often have to correct misinformation and assure Veterans that the care they rely on will not be taken away from them.
One of the concerns we are hearing the most now is whether health reform will affect the care Veterans receive under the VA system.
Let me be unambiguous: The healthcare that Veterans receive through the VA system, including dependents of certain veterans enrolled in the CHAMPVA program, will be safe and sound under health reform. The Secretary of Veterans Affairs would continue to maintain sole authority over the system and for enhancing the quality and access for all eligible Veterans.
Matt Flavin, who completed deployments to Bosnia, Afghanistan and Iraq and serves as Director of Veterans and Wounded Warrior Policy, blogged on WhiteHouse.gov today:
As a proud VFW member, I want to underscore that the health reform legislation being voted on today will not adversely impact our nation's veterans. In fact, during his time in office, President Obama has provided an historic increase in benefits for our veterans and has upheld every pledge to protect the benefits our veterans have earned in service to our nation. He will continue to stand firm in his commitment to veterans.
This afternoon, VA Secretary Eric Shinseki issued a statement further clarifying:
As Secretary of Veterans Affairs, I accepted the solemn responsibility to uphold our sacred trust with our nation's Veterans. Fears that Veterans health care and TRICARE will be undermined by the health reform legislation are unfounded. I am confident that the legislation being voted on today will provide the protections afforded our nation's Veterans and the health care they have earned through their service. The President and I stand firm in our commitment to those who serve and have served in our armed forces. We pledge to continue to provide the men and women in uniform and our Veterans the high quality health care they have earned.
President Obama has strongly supported Veterans and their needs, specifically health care needs, on every major issue for these past 14 months — advance appropriations, new GI Bill implementation, new Agent Orange presumptions for three additional diseases, new Gulf War Illness presumptions for nine additional diseases, and a 16% budget increase in 2010 for the Department of Veterans Affairs, that is the largest in over 30 years, and which has been followed by a 2011 VA budget request that increases that record budget by an additional 7.6%.
To give our Veterans further assurance that health reform legislation will not affect their health care systems, the Chairmen of five House committees, including Veterans Affairs Chairman Bob Filner and Armed Services Chairman Ike Skelton, have just issued a joint letter reaffirming that the health reform legislation as written would protect those receiving care through all TRICARE and Department of Veterans Affairs programs.
Here is the letter Secretary Shinseki references:
March 21, 2010
The Honorable Louise Slaughter
Committee on Rules
H-312 The Capitol
Washington, DC 20515Dear Chairwoman Slaughter:
The House Democratic leadership asked our committees to review HR 3590 and HR 4872 to assess the impact of the bills on the health care provided by the Department of Defense and the Department of Veterans Affairs. Our reviews of HR 3590 and HR 4872 lead us to believe that the intent of the bills was never to undermine or change the Department of Defense and Department of Veterans Affairs operation of their health care programs or interfere with the care that our service members receive under TRICARE. However, we commit to look into this issue further to ensure that no unintended consequences may arise and to take any legislative action that may be necessary.
HR 3590, as drafted, does not specifically mention that TRICARE coverage meets the individual responsibility requirement, but such coverage would satisfy the requirements of this bill. To affirm that this is the case, the U.S. House of Representatives unanimously passed HR 4887, the TRICARE Affirmation Act, which provides assurances to the American people that care provided to those in the military and their families, as well as military retirees under age 65 and their families, would indeed meet the requirement for coverage.
The members of our nation's military sacrifice much to defend us all. We commit to these dedicated service members and their families as well as our veterans that we will protect the quality healthcare they receive.
Sincerely,
BOB FILNER
Chairman
Committee on Veterans' AffairsIKE SKELTON
Chairman
Committee on Armed ServicesGEORGE MILLER
Chairman
Committee on Education and LaborSANDER LEVIN
Chairman
Committee on Ways and MeansHENRY WAXMAN
Chairman
Committee on Energy and Commerce
This afternoon, the House will begin debate on comprehensive health insurance reform legislation. Critics continue to spread misinformation about how reform will impact American workers, their families and small businesses–below we debunk the five biggest myths Republicans are spreading about health insurance reform.
MYTH #1: Health insurance reform is a “government takeover.”
FACT: The health insurance reform legislation expands private health insurance in America, and is based on increasing choice and competition — providing for new marketplaces (called “Insurance Exchanges”) where the uninsured, small business employees, and the self-employed will be able to choose among a variety of private insurance plans.
As President Obama explained in St. Louis on March 10:
There’s no government takeover, unless you consider reining in insurance companies a government takeover…
MYTH #2: Health insurance reform slashes Medicare and hurts seniors.
FACT: Nothing in the health insurance reform reduces Medicare benefits for seniors. The reform achieves savings by cracking down on inefficiency, fraud and waste in Medicare — targeted at private insurance companies and providers, not beneficiaries. These savings include cutting large and unnecessary overpayments to private insurance companies that offer Medicare Advantage plans.
Rather than undermining Medicare, this bill strengthens Medicare. Much of the cost savings achieved are reinvested into Medicare — improving benefits. In fact, the legislation lowers prescription drug costs for seniors by closing the prescription drug donut hole, ensures free preventive care, and extends the life of the Medicare Trust Fund by nine years.
MYTH #3: Health insurance reform will cost businesses too much.
FACT: The status quo is unsustainable for the small business community — 60 percent of America's uninsured, or 28 million people — are small business owners, workers, and their families. Insurance costs for small businesses have increased 129% since 2000.
The health insurance reform legislation before Congress provides $40 billion in tax credits for small businesses to help them offer coverage to their employees and exempts 96 percent of all businesses from the shared responsibility requirement.
MYTH #4: Health insurance reform is bad for the economy.
FACT: The nonpartisan Congressional Budget Office (CBO) says the legislation will dramatically reduce the deficit — by $143 billion in the first 10 years and $1.2 trillion in the second ten years — reins in costs for most Americans, and is fully paid for.
If health care cost increases slow down, then businesses will find it more profitable to expand employment, and workers will more readily move into those new jobs.
Moreover, 41 of the nation's leading economists — including three winners of the Nobel Prize — signed a letter urging the swift passage of comprehensive health reform before Congress to slow 'unsustainable' health care spending facing our country:
…Without effective reform of the way we pay for health care, growth of health care spending will create unsustainable fiscal burdens, eat into cash compensation, perpetuate waste, and undermine the prospects for universal access to needed care…
…these measures are a serious, multi-faceted initiative to improve the quality and efficiency of American medical care, rein in the fastest growing portion of government and private budgets and provide a valuable platform for future cost-control efforts. If this nation is committed to cost containment and deficit reduction we must pass health care reform. If this legislation fails, the chances of reducing the growth of health care spending in the future will be greatly reduced.
MYTH #5: Health insurance reform includes a marriage penalty which will mean higher costs for those who get married.
FACT: This myth has nothing to do with health insurance reform – it is a new criticism of how the federal poverty level has been calculated for decades — under Republican and Democratic leadership alike.
Under all federal income-related assistance programs, total assistance provided to two single people is greater than the total assistance provided to a married couple for the simple fact that two people living together have lower expenses than two people living separately. (And the federal government assumes that single people are living separately and a married couple is living together.) It is considered good stewardship of tax dollars to reflect actual costs.