WASHINGTON, D.C. - Sen. Tom Harkin (D-IA) today made the following comments on the Senate floor about the importance of health reform and the consequences of repealing the law. The Senate is expected to vote on a Republican amendment that would repeal the Affordable Care Act, the health reform bill that was signed into law last year. Repeal would deprive millions of Americans of important protections against insurance companies, raise health costs, cut funding to rural hospitals in Iowa, and, according to the non-partisan Congressional Budget Office, increase the federal deficit by $230 billion by 2021. Harkin's remarks, as prepared for delivery, are below. Harkin is Chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, as well as the Appropriations subcommittee that funds the Department of Health and Human Services.
"Mr. President, if there is one clear message that voters sent in the past election, it is that they want Democrats and Republicans in Congress to cut out the bickering and partisanship, and to focus like a laser beam on boosting the economy, creating jobs, and reducing the deficit.
"So I find it absolutely astonishing that the Republicans' No. 1 priority - their obsession - in these opening weeks of the new Congress is to launch bitter new partisan attacks on the new health reform law, and to attempt to repeal it - something that would cost hundreds of thousands of jobs and add $240 billion to the deficit over the next decade.
"It would be sufficient to oppose this reckless amendment strictly on budgetary grounds. As I said, it would add $240 billion to the deficit in the first decade, and nearly $1 trillion in the second decade. The sponsors of the amendment have proposed no offsets whatsoever. So for all the Republicans' crocodile tears over big budget deficits, their first action in the new Congress is to propose adding nearly a quarter trillion to the deficits over the next 10 years!
"The Congressional Budget Office is our only objective, nonpartisan referee when it comes to budget projections. CBO has told us, in no uncertain terms, that the McConnell amendment will add $240 billion to the deficit.
"The Republicans' lame response is to attack the credibility of CBO and to claim that the hundreds of billions in budget savings thanks to the new health reform law are supposedly based on "gimmicks." That is complete nonsense. The budget savings in this new law are real. If anything, CBO has underestimated the savings that will come about as a result of the robust wellness and prevention provisions in the new law - provisions that will keep Americans healthy and out of the hospital in the first place.
"I would simply add that if the savings in the new law were based on gimmicks, then those gimmicks would certainly show up by the second decade of the law's implementation. That's the nature of gimmicks - they eventually get exposed. But the savings in the new law actually skyrocket in the second decade to nearly $1 trillion. So to wildly assert that the savings are based on gimmicks is flat wrong; it is irresponsible.
"Let's be clear, the Republicans' obsession with repealing the new health reform law is not based on budgetary considerations. It is based strictly on ideology. They oppose the law's crackdown on abuses by health insurance companies. And they oppose any serious effort by the federal government to secure health insurance coverage for tens of millions of Americans who currently have none.
"We all remember William Buckley's conservative motto. He said that the role of conservatives is "to stand athwart history yelling stop!"
"In 1935, Franklin Roosevelt passed Social Security, providing basic retirement security for every American. Republicans fought it bitterly. And 75 years later, they are still trying to undo it!
"In 1965, Lyndon Johnson passed Medicare, ensuring seniors' access to decent health care. Republicans fought it bitterly. And 45 years later, they are still trying to undo it!
"Well, here they go again!
"By the way, notice that the Republicans are no longer even pretending to offer a realistic, comprehensive alternative. They used to talk about "repeal and replace." Now their focus is mostly on "repeal."
"As always, the Republican approach to health reform can be summed up in five words: Pray you don't get sick!
"So make no mistake: The fight to provide access to quality, affordable health care for all Americans has only just begun.
"The same ideologues who came up with the Big Lies about "death panels" and "pulling the plug on grandma" are rolling out their latest campaign of misinformation.
"The good news is that, this time around, the dynamics of the debate have shifted.
"Just as I long predicted, as people learn more about the great things in the Affordable Care Act - benefits and protections that are now guaranteed by law - support for health care reform is growing steadily.
"A year ago, we were bogged down in the messy, frustrating politics of passing the bill. This time around, the law is the law, and what's at stake is crystal clear:
"Are we going to put the health insurance companies back in the driver's seat - once again free to discriminate based on preexisting conditions, free to cancel your policy when you get sick, free to cut off payments?
"Are we going to revoke access to health insurance for more than 30 million Americans?
"Are we going to add hundreds of billions of dollars - and, eventually, trillions of dollars - to the deficit by wiping out all of the savings in the Affordable Care Act?
"Are we going to impose higher taxes on up to four million small businesses that are eligible for health care tax credits thanks to the new law?
"Mr. President, I also want to rebut the extreme, ideological attacks on the "individual mandate" in the new law. Republicans claim that this is somehow an "assault on freedom." Well, it is certainly an assault on the freedom to go without insurance, show up at the emergency room, and stick other Americans with your health care bills!
"The individual mandate is just common sense - that's why so many Republicans supported it in the past.
"Senator John Chafee's reform bill in the early 1990s included an individual mandate; it was supported by Republican Senators Grassley, Hatch, and Lugar.
"More recently, the original Wyden-Bennett bill, including an individual mandate, was supported by Senators Alexander, Crapo, Corker, Graham, and Grassley.
"And, as we all know, the individual mandate was a critical piece of Republican Governor Mitt Romney's health reform in Massachusetts.
"As I said, it's just common sense. By eliminating free riders and putting everyone in the risk pool, we keep rates down for everyone. And it's the only way that people with preexisting conditions are not left out in the cold.
"When we join together, we have more freedom.
"When everyone is covered and no one is left out, we enhance liberty.
"Health reform is all about freedom - freedom from the fear that if you get sick, you won't be able to afford a doctor . . . freedom from the fear that a major illness will lead to financial ruin. These are the practical freedoms that really matter to Americans.
"Mr. President, I can't tell you how many people have come up to me to thank me and other sponsors for passing the Affordable Care Act. They tell me how it has personally affected their families in profoundly positive ways.
"Let me tell you about Sarah Posekany of Cedar Falls, Iowa. She was diagnosed with Crohn's disease when she was 15 years old. During her first year of college, she ran into complications from Crohn's, which forced her to drop her classes in order to heal after multiple surgeries. Because she was no longer a full-time student, her parents' private health insurance company terminated her coverage. Four years later, she found herself $180,000 in debt, and was forced to file for bankruptcy. Sarah was able to complete one semester at Hawkeye Community College, but could not afford to continue. Because of her earlier bankruptcy, every bank she has applied to for student loans turned her down. With the new health law, people like Sarah are able to stay on their parents' health insurance plan until they are 26.
"And consider the case of Eleanor Pierce, also of Cedar Falls, Iowa. When her job with a local company was eliminated, she lost her health insurance. She had the option of purchasing COBRA insurance, but it was completely unaffordable. So she searched for coverage on the private, individual market, but was almost universally denied access because of her pre-existing condition of high blood pressure. The only plans that would cover her came with premiums she could never hope to afford without an income.
"So Eleanor - at age 62, suffering from high blood pressure - had no choice but to go without insurance, and hope for the best. But, Mr. President, "hope for the best" is no substitute for regular medical care. One year later, Eleanor suffered a massive heart attack. And, when all was said and done, she had racked up $60,000 in medical debt.
"Mr. President, we need to get beyond ideological obsessions and listen to these ordinary Americans - victims of the old, broken health care system. Americans have a clear message: The new law has important new benefits and protections. Don't take these protections away!
"Nearly half of non-elderly Americans have some type of preexisting condition, like high blood pressure, arthritis or heart disease. The new law outlaws the denial of coverage based on preexisting conditions. The McConnell amendment sweeps that away.
"The largest health insurer in California used technicalities to cancel the policies of women who got breast cancer. The new law outlaws the practice of canceling policies when people get sick. The McConnell amendment fully restores the right of health insurers to return to that despicable practice.
"The new law prohibits insurers from imposing lifetime limits on benefits. The McConnell amendment takes that away.
"The law allows parents to keep adult children on their policies until age 26. The McConnell amendment takes that away.
"Mr. President, I want to briefly mention the destructive impacts the McConnell amendment would have on my State of Iowa:
- It would raise taxes on more than 260,000 Iowans by taking away tax credits to help them purchase health care coverage.
- More than 8,300 young adults in Iowa would lose their insurance coverage through their parents' health plans.
- Tens of thousands of Iowa seniors would face significantly higher prescription drug prices, and, once again, would have to pay a co-pay for preventive services such as colonoscopies and mammograms.
- And, of course, the 1.9 million Iowans with private coverage would, once again, be vulnerable to the whole range of abuses and discriminatory practices by health insurance.
"In addition, Mr. President, I want to mention that the new health reform law dramatically remedies the discrimination against Iowa and some other states in terms of Medicare reimbursement. Under a complicated Medicare formula, doctors in Iowa and a number of states were paid less for their services than their colleagues elsewhere. Under the formula, for example, Iowa physicians are reimbursed less than doctors in Louisiana.
"As part of the new health reform bill, I joined with Reps. Bruce Braley, Leonard Boswell and Dave Loebsack to negotiate a compromise that provides an immediate $800 million to address geographic disparities for both doctors and hospitals, as well as written guarantees from Health and Human Services Secretary Kathleen Sebelius for further action to reform Medicare reimbursement rates. This great achievement is wiped out if the McConnell amendment passes.
"In addition, thanks to the new law, mid-sized hospitals in Iowa - the so-called "tweeners" - will see a greater Medicare reimbursement. The two-year fix will cover Fiscal Years 2011 and 2012 and will aid low-volume hospitals, some of which have struggled to keep their doors open. The fix was included in the new health reform law - the Affordable Care Act.
"At the heart of the reform mission was an effort to decrease the number of uninsured and increase access to affordable care. The law does just that and will ensure every Iowan access to quality healthcare, which these community hospitals. This, too, goes away if the McConnell amendment prevails.
"Finally, Mr. President, I want to mention the many millions of Americans who will be denied health coverage if the McConnell amendment passes. The Republicans, apparently, reckon that middle class Americans who already have health insurance don't care about those who are not so fortunate. I couldn't disagree more strongly!
"Americans do care about the uninsured. And they are well aware of the devastating human cost of repeal. Nearly 45,000 Americans die each year, in part, because they don't have health insurance.
"With this landmark law, we are ensuring - at long last - that every member of our American family has access to quality, affordable health care as a right, not a privilege!
"So mark my words: The American people are not going to allow the Republicans to take away this great humanitarian achievement.
"Mr. President, I urge my colleagues to oppose the McConnell amendment. It blows a huge hole in the budget deficit. It destroys hundreds of thousands of jobs. It repeals the Patient's Bill of Rights - allowing health insurers to return to the same old abusive and discriminatory practices. It revokes health insurance coverage for tens of millions of Americans.
"Instead, let us listen to the American people.
"Let us move forward to build a reformed health care system that works not only for the healthy and the wealthy, but for all Americans."