Nancy Pelosi, House Democrats Hold Press Conference on Patient Protection and Affordable Care Enhancement Act

Nancy Pelosi: (00:01) It's not only about their health, but it's about their financial health. And when we ran in 2018, we said that we would do three things for the people. We would lower the cost of healthcare by lowering the cost of prescription drugs and preserving the preexisting condition. We would have lower healthcare costs, bigger paychecks by building the infrastructure of America in a green way and cleaner government with H.R. 1, which would make the first two possible by reducing the role of big dark money in politics, preventing us from accomplishing other goals in the public interest, rather than the special interests. Nancy Pelosi: (00:44) On the subject of healthcare, this was a reiteration of what we had run on in 2006, six for '06. One of that six was to give the Secretary the authority to negotiate for lower prices. We knew then, right Frank? And we knew now that that was the only way we could take down these prices. Of those six for '06, five of them became law, one did not. And that was giving the Secretary the authority to negotiate for lower prices. That is the heart of H.R. 3, which is very much a part of the legislation you'll hear very much about today. Nancy Pelosi: (01:28) I'm honored that we're here with Richard Neal by video. Mr. Pallone, whose committee has so much jurisdiction in terms of of healthcare. Mr. Chairman of the Education and Labor Committee, Bobby Scott. These three committees were there from the start developing the Affordable Care Act. All of them were very much a part of shaping that. Now, we want to enhance it. And so, the leadership of these three committees are here today to do that. Let me just say that, we didn't envision when we were doing H.R. 3 in December that we would be in the middle of a pandemic now, but we are. All the more reason for us to remove all doubt of the affordability of healthcare. This is about the lives and the livelihood of the American people. Nancy Pelosi: (02:26) And I always like to quote Mr. Clyburn, who always likes to quote Martin Luther King, would said, "Of all the forms of inequality, injustice and health is the most shocking and the most inhuman because it often results in physical death." Well, that is true, generally speaking. It is also true at the center of this pandemic, where there is a disproportionate number of deaths in communities of color because of inequality of access to healthcare. That's what we're here to talk about. I could say a lot about each of the people who are here, on [inaudible 00:03:05] Colin Allred, [Andy Kim 00:00:03:06], [Angie Crape 00:03:07], part of our freshmen class, who from day one and that's ... Where is he? From day one have taken the lead on this. Nancy Pelosi: (03:16) And in terms of asserting Congress's right to fight in court against the President's repeal of the Affordable Care Act, repeal of preexisting condition benefit, repeal of so many opportunities for people from day one. And they'll talk about their roles in all of that as they join our distinguished chairman. In between it all, Mr. [Ruiz 00:00:03:45], a physician, many degrees in public health and medicine, as well as a member of Congress will speak to us about that juxtaposition of policy and good health in our country. And with that, I'm very pleased to start out with how we started this congressional session a year and a half ago with Mr. Allred taking the lead. And I yield to the distinguished gentlemen from Texas, Colin Allred. Colin Allred: (04:21) Thank you, [crosstalk 00:04:15]. Well, thank you, Madam Speaker. And I want to thank all of my colleagues for joining me here today and for fighting for this critically important legislation. As the Co-President of the freshman class, I can say that our diverse and talented colleagues were elected to deliver results like protecting Americans' healthcare and to stop the sabotage of our healthcare system. And that starts with stopping the Trump administration's lawsuit to end the Affordable Care Act in its entirety. This pandemic has made clear the deep inequities and failures in our healthcare system. Colin Allred: (04:56) This is especially true in my home of Dallas County, where one in four folks don't have health insurance. In the state with the highest uninsured rate in the country, Texas has still not expanded Medicaid, leaving more than one million Texans without healthcare coverage. These problems were clear before the pandemic, and yet this administration is still dead set on achieving through the courts, what they could not do in Congress. While we all fight for this common sense legislation that will improve the ACA, as we speak, the Trump administration is engaging in a cynical attempt in federal court to tear it down and rip away healthcare from millions of Americans. Colin Allred: (05:35) Families like the Rose family in Rowlett, Texas, in my district, who I met at the opening of a veteran center. Rob and Debbie Rose have been able to get plans on the exchange as they waited for their Medicare coverage to kick in after Rob lost his job and the healthcare that came with it. This is a story that's far too common in our country, and this is why we can't go backwards. That's why on day in Congress, I led the charge to fight the administration's lawsuit with my colleagues. This is a fight that we need to win in order to preserve the protections for preexisting conditions and all the other protections and rights in the ACA. Colin Allred: (06:09) This really shouldn't be a political issue. It's time for the administration to drop this lawsuit and join us in our efforts to expand coverage and lower costs. Americans need more access to healthcare, not less. This bill is a big first step towards fixing our healthcare system and I'm proud to be joining in this fight. And with that, I'll yield on video to our Chairman of the Ways and Means Committee, Richard Neal. Richard Neal: (06:36) Thanks, Colin. And thanks to you, Madam Speaker, and thanks to colleagues. I think that Frank, and Bobby, and myself, along with the Speaker would take particular satisfaction in this moment. We helped to write the Affordable Care Act and overwhelmingly it has been successful. A compelling statistic, even as we assemble, 100% of the children in Massachusetts today have health insurance and almost 98% of the adults in Massachusetts at have health insurance because of our efforts. As Dr. Fauci reminded us yesterday, we're very much in the midst of this pandemic. There is no better time than to increase access to high quality healthcare, while lowering healthcare costs then right now. Richard Neal: (07:15) Especially as Republicans continue their efforts to dismantle our healthcare system and eliminate protections for millions of Americans with pre-existing conditions. In response to the devastating challenges Americans are facing due to COVID-19, the Ways and Means Committee contributed provisions in this legislation to expand tax credits that lower premiums on the marketplace. In the first time in history, the AC ... No person will pay more than 8.5% of their income with Silver Plan secured in the marketplace. We also recognize the need of newly unemployed Americans who will now be looking for health coverage through the marketplace, and made sure they now qualify for subsidy. Richard Neal: (08:04) For earning $40,000 a year would save nearly $1,600 in premiums this year. An adult earning about $19,000 ... And American's have ... [inaudible 00:08:16] family that only earn $19,000 would see premiums cut to zero, saving $800 a year. And a 64 year old earning $57,000 a year would save more than $8,700 in premiums each year. These are significant savings that would make a big difference for Americans during this crisis. The wellbeing and financial security of the American family and the workers of our nation are at stake. We must act quickly. The pass is urgently needed legislation. Nancy Pelosi: (08:55) Effective from the start, a healthcare professional herself, Congresswoman, Lauren Underwood. Speaker 1: (09:00) Lauren Underwood of Illinois. [inaudible 00:09:01] Lauren Underwood: (09:06) Thank you Madam Speaker, and thank you Chairman Neal. Thank you for the opportunity to be a part of today's historic unveiling of the Patient Protection and Affordable Care Enhancement Act. For Americans who remain uninsured or underinsured, we know affordability is the biggest barrier to coverage. COVID-19 makes affordable care and reliable insurance coverage an even more pressing need for the nearly 27 million Americans who can lose their insurance during the pandemic. Now more than ever, it's imperative that we act boldly to lower the cost of premiums and bring healthcare within reach for every American. That's why the Patient Protection and Affordable Car Enhancement Act is so important. This package includes legislation that I introduced to make insurance premium tax credits more generous and available to more Americans. Currently there is an income cap on who qualifies for the tax credits. This legislation would ensure anyone who buys insurance on their own could buy it for 8.5% of their income or less. Lauren Underwood: (10:14) Let me share an example of what that can mean for families in my district. A 60-year-old couple making $70,000.00 a year currently spends more than a third of their income on health insurance. Under the Patient Protection and Affordable Care Enhancement Act, their premiums would drop by nearly 80%, saving the couple over $1,500.00 a month. A typical family of four in my district would see their monthly premiums drop by nearly half. The bill also extends Medicaid coverage for pregnant people, from 60 days after delivery to one full year, so that moms can receive the care that they need and deserve in the full post-partum period. We know that this policy will greatly reduce the racial disparities and maternal health outcomes, an urgent focus of our Black Maternal Health Caucus that I co-chair and it will save lives. At least nine million more uninsured Americans could gain coverage and another 10 million or more would see their premiums reduce with this bill. The millions of Americans who lay awake at night wondering if they are one illness away from medical bankruptcy will finally know the economic security of health insurance coverage. Lauren Underwood: (11:27) The Patient Protection and Affordable Care Enhancement Act delivers on a promise to the people and for the people, insuring every American citizen has access to quality affordable healthcare. Thank you and it's now my honor to introduce the Chairman of the Energy and Commerce Committee, The Honorable Frank Pallone. Frank Pallone: (11:49) Thank you Lauren. Let me just say that I think this bill which I call the Enhancement Act is a win-win all around and I say that because we're trying to increase access and at the same time deal with affordability so that people can afford their health insurance and their prescription drugs. As the speaker said, when we drafted the Affordable Care Act a few years ago now, those were the goals, but the one thing that was absent was the ability to bring down the costs of prescription drugs which more and more is a big part of affordability and whether people can afford healthcare. Frank Pallone: (12:29) So what do we do? In the ACA, the two ways to expand access that were crucial were one, to provide a level of tax credit or subsidy for people to pay their premiums on the individual market, and the other one was to expand Medicaid. We knew that if we expanded Medicaid, got more people, and if we had a major subsidy or tax credit, tens of millions more people would be able to get coverage. That's what we're doing with this enhancement act because we know that with COVID, prices of health insurance are probably going to go up and we know that many states have not expanded Medicaid and now because they're not at 100% match anymore, they may have less of an incentive to do so. So we basically address both of those things. We say that we're going to increase the level of the tax credit or premium. It's estimated by CBO that premiums would be 10% lower because of this bill. So we give a greater subsidy to pay your premium and we also increase the level of income at which you are eligible for a subsidy and essentially there is no cap anymore so almost everyone gets some kind of help. Frank Pallone: (13:47) With regard to Medicaid, we know that if we go back to the 100% match, that creates an incentive for those states that haven't expanded Medicaid to do so, so CBO basically said this morning that four million more people would be covered under this Enhancement Act, 2.3 under Medicaid and significantly more because they would buy individual insurance and it would cost them less, but the win-win is also the fact that we put in the negotiated price legislation that was part of H.R. 3 as the speaker said. Why in the world should our country, all the other developed countries in the world, prices are half, 25%, sometimes they're 10 times the cost here of what they are in other countries and that's simply not fair. Then what do we do? We take those savings, the savings from those negotiated prices, and it's used to pay for the additional subsidies and for the 100% match for Medicaid. So it's a win-win all around and it's part of the effort by House Democrats again to get more people have health insurance coverage and also increase affordability for both prescription drugs and for their premiums with the goal constantly of trying to get as close as we can to universal health insurance. With that, I'd like to introduce another one of our ... I don't like to say new members anymore, relatively new members who has been very active on this issue, Angie Craig. Angie Craig: (15:32) Thank you so much Chairman Pallone. I think at this point the freshman class is pretty darn experienced after this 116th Congress. My name is Angie Craig and I represent Minnesota's 2nd Congressional District. This bill today is immensely personal to me. See, I grew up for a portion of my childhood without access to health insurance. I still remember the box of bills that piled up on the kitchen table that my mom couldn't pay. I also spent more than 20 years working in two healthcare manufacturing firms and I also had responsibility for healthcare for 18,000 Americans at a major U.S. company. For the 51% of non-elderly, with pre-existing conditions in my congressional district, the ACA was a lifeline. I ran for Congress because Americans don't just need us to address the cost of health insurance. They need us to address the cost of healthcare. This is a moment that requires us to come together as Americans and stop playing politics with healthcare. The Patient Protection and Affordable Care Enhancement Act strengthens the important progress we have made under the ACA. I am proud that the base of the bill, H.R. 1425, a bipartisan bill, the State Healthcare Premium Reduction Act, is my bill and it was the first healthcare legislation that I filed as a member of Congress. Angie Craig: (17:08) See, Les and his family is ... They're farming in my district, and they currently pay over $20,000.00 a year in premiums with a $12,000.00 deductible in the individual marketplace. Another farmer farms by flashlight and works during the day, just for the family health insurance. This bill will allow states to lower the cost of premiums in the individual marketplace and to expand access to healthcare to more Americans. These examples show the heart of the problem. If healthcare isn't affordable, it isn't accessible. I am also pleased that this package includes the transformational drug pricing negotiation mechanism from the Elijah E. Cummings Lower Drug Cost Now Act, which finally takes on the high cost of prescription drugs. It's long past time to stop trying to tear down and throw out the ACA. Angie Craig: (18:03) ... To stop trying to tear down and throw out the ACA. It's time to work together to build the healthcare system Americans need and deserve. Thank you. I'd now like to turn it over to my colleague and friend, Congressman Andy Kim. Congressman Andy Kim: (18:16) Good morning, everyone. My name is Congressman Andy Kim from New Jersey. I believe that it is insane that in the middle of a pandemic, our healthcare in our country is under attack. I dare anyone to look in the eyes of the people of New Jersey and tell them that we should be taking away healthcare from people who need it right now. My state that is on the verge of 13,000 deaths due to this virus. We stand here today to definitively and resoundingly say that the richest most powerful country in the world should commit itself to strengthening our healthcare. Not weakening it. I should not have to utter those words. Congressman Andy Kim: (19:05) It should be a given that in the middle of a pandemic and a crisis that has taken the lives of over 120,000 Americans that enhancing and improving our healthcare should be a top priority. Taking away healthcare from Americans in the middle of a pandemic is as absurd as saying that we should be slowing down testing of the coronavirus when thousands are dying. We are better than that. Americans deserve better than that. There are tangible ways to be able to improve our care and make sure that we are taking immediate steps, if only we just stop playing politics with people's lives. Congressman Andy Kim: (19:45) That is what people want. Their representatives developing concrete solutions, to be able to stop the partisan bickering and pass the healthcare that the American people deserve. One such idea is delivering funds for states who want to establish their own state-based exchanges. One of those states currently in the process of setting up an exchange is my own state of New Jersey. State-based exchanges work. They expand options and lower costs, and it has bipartisan support. It shouldn't be up for debate. It shouldn't be in doubt. It should be law. And I look forward to making that happen and working with my colleagues to bring this bill to the floor and be able to get this passed for the American people. Thank you. Congressman Andy Kim: (20:37) I'd like to introduce Chairman Scott. Chairman Scott: (20:48) Thank you, Congressman Kim. And thank you, Speaker Pelosi, and our Chairs for their work and our other members working to expand access to affordable healthcare, especially during this pandemic. As we continue to confront the most serious public health emergency in recent history, our first priority must be to protect the health and safety of the American people. Based on job losses in March and April alone, experts estimate that over 26 million people across the country have lost their job-based health insurance due to the COVID-19 pandemic. Many of these workers and families will turn to the Affordable Care Act marketplaces for healthcare during this pandemic. And so we must prioritize building on the progress we've made through the ACA to expand access to affordable coverage. This is exactly what the Affordable Care Enhancement legislation will achieve. As my colleagues have noted under this proposal, no person will pay more than 8.5% of income on benchmark silver plans through the marketplace. Chairman Scott: (21:53) Moreover, by fixing the family glitch, the bill would make coverage affordable for millions of working families. The legislation will also provide incentives to expand Medicaid so that low income workers and families will have coverage regardless of where they live. There's a lot of legislation also builds on existing patient protections by reversing the Trump administration's expansion of short-term or so-called junk plans, which discriminate against persons with preexisting conditions and are not required to cover essential benefits. Chairman Scott: (22:28) These junk plans also divert healthy people from the general insurance market, raising the cost for everybody else, and then abandoned patients when they get sick, when they actually need insurance. And finally, the bill will save money for workers and employers by cutting cost on prescriptive drugs and bringing them in line with costs that people pay in other countries. Unfortunately, the Trump administration has continued to aggressively pursue the Texas V. US lawsuit, and will file an opening brief this week. If this suit is successful, all of the benefits of the ACA will be lost. Chairman Scott: (23:06) For example, tens of millions of people will lose their insurance. People with preexisting conditions will lose their protections. Affordability credits will evaporate. Consumer protections will be lost. And this will all happen in the unprecedented public health emergency. This would be a major step backwards in our efforts to support quality healthcare within the reach of all Americans. By contrast, passing the Affordable Care Enhancement Act, we will strengthen the ACA and ensure that millions of Americans have access to affordable healthcare when they need it most. Thank you. And I now wish to call on the gentleman from California, Congressman Dr. Raul Ruiz. Dr. Raul Ruiz: (23:59) Thank you, Chairman Scott. Thank you to Speaker Pelosi for your leadership and your relentless determination to make true the words for the people. I'm Congressman Raul Ruiz and I represent California's 36th Congressional District where I practiced emergency medicine before being elected to Congress. As an emergency physician, I have seen the faces of failed healthcare policies. I have looked into the eyes of the suffering when they couldn't afford care. I have been at their bedside, resuscitating them after a severe illness took their life or their loved one's life, knowing it could have been prevented with routine care if they only had health insurance or affordable care. And even now, I have gone into hard to reach and high risk communities and personally conducted COVID-19 testing. Watching the health inequities and disparities play out in real time. Seeing disproportionately higher rates of transmissions and deaths in low income, uninsured, Latino farm workers and the homeless communities. Dr. Raul Ruiz: (25:24) And when I'm out there, their concern about the affordability of care in these low income communities and working poor communities that don't have adequate health insurance still, they're concerned of spreading it in their homes. You see, because the decisions that real working Americans right now are making are, do I get tested and maybe be positive? And then I can't go to work. Well, how am I going to go to work if I'm positive? They won't let me. Therefore, I won't get the income to be able to support my family. Dr. Raul Ruiz: (26:04) These are decisions that American families should not be making in the greatest country this world has ever seen. And as a physician and humanitarian, I find it repulsive that during a global pandemic, while millions are infected by COVID-19, millions gasping for air, millions anxious and depressed, because of their situation. And millions more are unemployed and struggling economically, that the Trump administration is actively trying to tear down the Affordable Care Act. What does that mean? Actively trying to eliminate protections for people with preexisting conditions. All those underlying- Dr. Raul Ruiz: (27:03) For people with preexisting conditions, all those underlying illnesses like cardiopulmonary diseases, diabetes, immune weaknesses that render someone more likely to die from COVID-19, taking away health insurance for millions of people, all those who for the first time in their lives was able to get health insurance through the Medicaid Expansion. You see, repealing the ACA would be another disaster leading to millions of families facing financial hardships and many, many, many more deaths from COVID-19. It is precisely during this time, it is precisely in our moment of history, it is precisely in the American families' agony that we must pass H.R. 1425, The Patient Protection and Affordable Care Enhancement Act. That we must act for the people and fight to make healthcare more affordable by stabilizing the markets, strengthening protections for preexisting condition, expanding even further incentivizing other states to expand the Medicaid program and lowering the cost of prescription drugs as H.R. 1425, The Patient Protection and Affordable Care Enhancement Act, would do. Dr. Raul Ruiz: (28:40) That is why we need this bill for those patients who are concerned they have COVID or for those family who will be infected by COVID and for those individuals and the families who are struggling to pay their bills. And that is why Democrats will keep fighting for the people. So thank you, and I'd like to turn it back over to Speaker Pelosi. Nancy Pelosi: (29:08) Thank you very much. Thank you very much, Dr. Ruiz, my colleague, Congressman Ruiz. Thank you to all of our members for their leadership. As Congressman Ruiz mentioned and it was alluded to also by Mr. Scott, tomorrow the Supreme Court will hear the brief from the Trump administration as to taking down The Affordable Care Act right in the heart of the time of the pandemic. It was wrong any time, now it's beyond stupid. Beyond stupid. Nancy Pelosi: (29:47) I thank our colleagues, our freshmen members, each of whom has a piece of legislation in here from their own entrepreneurial thinking, from their experience, whether it's the healthcare professional experience of New Jersey as a person who has your family experienced but also worked professionally with Councilman Craig. And, of course, Mr. Allred who started all of this on the very first day of the Congress. That's tomorrow. Nancy Pelosi: (30:16) Today, we will go to the Rules Committee to make this legislation in order. Tomorrow, they'll do their brief to take down The Affordable Care Act. And they will remove all even semblance of reality when they say, "Oh, well on her [inaudible 00:30:34] she said we're all for the benefit of a preexisting condition not being an obstacle to health insurance and health care. We're all for that." Oh, really? Then get off the case or tell the president to get off the case. But nonetheless, that's tomorrow. On Monday, this important legislation will come through the floor of the House. We hope it will get bipartisan support. It certainly meets the needs of Democrats, Republicans, Independents and Declined Estates, whatever they call themselves across the country because the issue of healthcare knows no party and the issue of a pandemic certainly does not as well. Nancy Pelosi: (31:20) We talked to Dr. King, I mentioned earlier, he said, "The fierce urgency of now." It isn't just a fierce urgency of now. It is the opportunity of now that we have to make this difference, as Mr. Ruiz said again and again, for the people. So I thank all of our colleagues and I thank a Chairman Bobby Scott, Chairman Frank Palone and Chairman Richie Neal for their leadership in bringing this bill to the floor on Monday. With that, I thank you all. Wash your hands, wear a mask, take care, keep your distance. Thank you all. Nancy Pelosi: (32:03) Thank you. Thank you all. Thank you.