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September 25, 2013
WASHINGTON – U.S. Senator Barbara A. Mikulski (D-Md.), Chairwoman of the Senate Appropriations Committee and Dean of the Senate women, today spoke on the Senate floor in support of the Affordable Care Act, a law providing access to health care coverage for millions of Americans.
"We are having a national debate on the Senate floor about should we provide access to healthcare to all Americans, and be able to do it in a way that is fiscally prudent and in a way that modernizes the way we deliver health care to emphasize value healthcare over volume healthcare. And we are having this debate even though we passed the legislation in 2010. Now I thought when you passed a bill and it was signed into law, that it was the law of the land," Senator Mikulski said. "I want to get rid of the theatrical politics and get into the real business of helping govern America in a way that provides jobs, economic opportunity and ensures our national security."
Repealing the Affordable Care Act would take away basic coverage for women as a result of the Mikulski Women's Preventive Health Amendment to the Affordable Care Act. The Mikulski Amendment guarantees that women will receive, at no cost, an annual women's health exam to screen for the leading causes of death among women. It also requires all health plans to cover comprehensive women's preventive care and screenings, including mammograms, with no copayments. In addition, thanks to health care reform, women will no longer be charged more than men for the same coverage, and C-sections and domestic violence will no longer be considered pre-existing conditions.
Health care reform also ensures that young adults can stay on their parents insurance until age 26. And it closed the prescription drug 'doughnut' hole, saving seniors an average of $700 dollars a year.
Republicans have voted 41 times to repeal or defund the Affordable Care Act. Republicans have now threatened to shut down the government if healthcare reform, which was enacted nearly four years ago and upheld by the Supreme Court, is not defunded or repealed.
Senator Mikulski's remarks on the Senate floor, as delivered, follow:
"Mr. President, here we are. We are having a national debate on the Senate floor about should we provide access to healthcare to all Americans, and be able to do it in a way that is fiscally prudent and in a way that modernizes the way we deliver health care to emphasize value healthcare over volume healthcare. And we are having this debate even though we passed the legislation in 2010. Now I thought when you passed a bill and it was signed into law, that it was the law of the land. But no, no – here we go again. We're trying to take legislation that was passed and undo it by defunding it.
"I don't know what we're doing here. You know, first, there was the attempt to delegitimize President Obama. Well he's won two elections. The American people have said we want Barack Obama to be our President. When he ran the second time, we had passed the healthcare initiative. So that was another affirmation that there was public support for that bill.
"Now here we are, on the eve of funding for fiscal year 2013 expiring, that there is a manufactured crisis bringing the government to the brink of a shutdown because the other party and a few in it are sore losers. They lost the election. They lost the battle to get the votes when they had the opportunity to vote and amend and change the Affordable Care Act. So now here we are. And I think it is an outrageous use of the Senate's time, and we need to be able to move on with the serious business governing our country.
"I worry about unemployment in our country. I worry about the fact that our children are no longer achieving the best in the world. I worry about my small to mid-sized businesses having access to capital. I know that many here call this bill a job killer. But you know what's a job killer? Our actions here in the Senate. This gridlock, deadlock, hammerlock on the United States Senate means that we cannot do the business of the country in an orderly and predictable way. Therefor when businesses want to plan what are going to be the rules of the game coming out of the United States government, they're not going to know. So if they're planning what they should do about their business – should they expand? What should they do? They need certainty. As long as we play brinkmanship politics, you cannot have certainty.
"One thing is certain, though – that we definitely should keep Obamacare. I'm happy to call it Obamacare, because I think Obama does care. And I think all of us here that are Democrats, certainly, in the Senate, and many on the other side of the aisle, also support the fact that we want to increase universal access. So let's go to what the legislation meant.
"When we passed the Affordable Care Act, number one, it provided more access for people to healthcare. When we passed that bill, 42 million Americans did not have access to health care. So that means, here in the United States of America, if you needed a doctor, that doesn't mean that you would have one. If you needed a prescription drug, it doesn't mean that you could afford to buy one. In many instances, this brought hardship on many families.
"What also the Affordable Care Act did was end abuses of health insurance companies. When we passed that legislation, people we denied healthcare on the basis of a pre-existing condition. That often meant that for children in the United States of America, if they had juvenile diabetes, if they had cerebral palsy, their families couldn't get health care insurance because these children had a pre-existing condition.
"And if you were a woman, it was even worse. Maternity was considered a pre-existing condition. In some instances, if you'd had a premature birth or a C-section, you were denied coverage, because it was a pre-existing condition. In eight states, if you were a victim of domestic violence, that was counted as a pre-existing condition and you couldn't get access to healthcare. Now what is that? So in the Affordable Care Act, we changed that law and we created the opportunities that the punitive practices of the insurance companies would not be a barrier to being able to get health insurance.
"Then there was this other issue of lifetime caps. That means if you had a condition and hit a lifetime cap, tough luck for you. But what happens if you have a child with hemophilia? That's a hard, hard thing for that child to face the rest of his or her life, and for the family. Don't you think there should be no caps on a benefit? What happens if you are struggling with cancer and you hit a cap? It doesn't mean that your need for treatment ends. It just means that your insurance company won't pay for it. Well, we lifted the lifetime caps.
"And for we women, the double insult of paying more for health insurance simply because we were women was repealed. In the Affordable Care Act, there is no gender discrimination.
"We found in our hearings that women were paying two to 10 times as much for their health insurance as men of the same age and health status. We didn't think that was fair, and we changed it.
"We also improved health care for seniors. We added new Medicare benefits, including free cancer screenings. Early detection means better treatment and a better chance of surviving cancer. We also provided an annual free checkup where you could go and get an identification of those killers, those silent killers. So if you have high blood pressure, if you have high blood sugar, those could be detected before they turned into a deadly situation. We know that high blood pressure undetected can lead to a stroke or to death. So we helped get better health care and better value for our seniors.
"Then there is the prescription drug benefit called Part-D. And there was something in it called the 'doughnut hole.' The 'doughnut hole' was hard to swallow because it meant once a senior's drug costs exceeded a certain amount, they went into not a doughnut hole, but a dark hold, and they had to pay for the full cost until they reached a catastrophic threshold. For many people with chronic conditions, not only those dramatic things like cancer, but a chronic condition like diabetes, you can reach that 'doughnut hole' pretty quick. But that's exactly what enables you to manage your blood sugar. Working with your doctor, following a program of diet and exercise, you still need a medication to help control that. If you don't get that medication, you then could be heading for worse problems related to diabetic neuropathy, to vision loss, to the need for dialysis. You need to be in a program that you can follow and that you can afford. That's why closing the 'doughnut hole' was so important. It saves lives and it saves money.
"I could go on to other examples about what is in the Affordable Care Act. There were many advances in terms of women. There were many advances in terms of children.
"I want people to know, because I'm getting a lot of vitriolic tweets saying that Maryland isn't served.
"When I looked at the data from our own state's health commissioner, 48,000 young adults in Maryland were able to go on their parents plan and had health insurance while they looked for a job or finished their education.
"Also, 485,000 Marylanders on Medicare were able to get that annual checkup.
"In Maryland, 72,000 were able to participate in the eliminating of the 'doughnut hole,' that saved them on average $700 a year for a total savings of $51 million that was pumped back into the Maryland economy to do other things and create jobs for other people.
"So when they say they want to defund Obamacare, what is it that they then want to replace it with? Do they want to go back to big insurance and their punitive practices of denying coverage for a child with a preexisting condition? Let them call the parent of a juvenile diabetic or a child with cerebral palsy.
"Would they then want to defend the fact that young people can't stay on their parent's plan until their 26? Do they want to make that phone call and say we know you're working hard to find a job or working hard to finish your education, but too bad? No.
"Do they want to eliminate caps on benefits? Do they want to eliminate closing the 'doughnut hole?' No. They just say they want to eliminate it. Well, I would eliminate this provision from the C.R.
"Let me tell you where I come from as the Chair of the full Appropriations Committee. In a very short time, the Democratic Leader, the Majority Leader, will offer an amendment to the C.R. sent over by the House.
"I want to get rid of this brinksmanship, slamdown, slapdown, showdown politics. The amendment we will be offering will strike the provision to defund Obamacare. It will strike the provision that was put in on the debt ceiling, which the House sent over structured to pay China first and then put Americans at the end of the line.
"I want to have an amendment to strike out the defunding of Obamacare, strike the language on the debt limit, move the date for the Continuing Resolution from December 15 to November 15 so that we can get to a situation where we focus on completing our budget, getting an Omnibus and eliminating sequester for two years.
"I want to get rid of the theatrical politics and get into the real business of helping govern America in a way that provides jobs, economic opportunity and ensures our national security."