King v. Burwell Decision

Floor Speech

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Mr. DURBIN. Mr. President, this morning the Supreme Court of the United States came down with its decision in King v. Burwell. I think it will probably be a decision that is remembered for a long time, certainly by Members of Congress. We were watching carefully, closely, wondering what the Supreme Court was going to say about the Affordable Care Act, otherwise known as ObamaCare. We passed it 5 years ago, and it was about the issue of health insurance--how many Americans who were uninsured would be insured under the Affordable Care Act and how much it would help health insurance cost.

Controversial, as the Senator from Utah just noted--it was passed on a partisan roll call. There was an effort to write a bipartisan bill, and it failed. There was no sentiment shared by both sides of the aisle to create the Affordable Care Act or anything like it.

How important is this decision, King v. Burwell, a decision which basically sustained the Affordable Care Act and said that the tax credits--which are part of the act--given to families in lower income situations were legal and constitutional? I think it is one of the most important decisions because I think health insurance is one of the most important things in our lives.

If you have ever been in the position as a father with a sick child, a seriously ill child without health insurance, you will never forget it. I know. I have been there. As a law student, my wife and I got married and had a little baby. She had some challenges, and we had no health insurance. Every time we took her to the hospital, every time we saw a doctor, I wondered if she was getting the best that she could get because we didn't have health insurance. It meant waiting in big waiting rooms with a lot of other people without health insurance and hoping that whoever walked through that door, that doctor would be just what my daughter needed. I will never forget it. When it comes to a time when people are debating about health insurance and how important it is, it sure is important to me. It was even when I didn't have it, as I realized how insecure and uncertain I was.

About 5 years ago, I was down in southern Illinois, Marion, IL, which is a great little town. I stayed there in deep southern Illinois at a local motel, and in the morning I would go up and go in. They had a little breakfast buffet there. There was a sweet lady named Judy. She was always there; ``Senator, what can I do for you?'' and all that. She couldn't have been nicer. I got to know Judy over the times we stayed there, and we talked about her life.

Judy was 60 years old. She was working part time in this motel--kind of in the world of hospitality--and she took care of guests when they went to the breakfast buffet in the morning. We talked about her life. She had grown up in southern Illinois. She had worked all the way through her life, job after job after job. I knew she was a hard-working lady and a good person.

One day she said to me: Senator, I have heard about this debate in Washington about the Affordable Care Act, and I am scared.

I said: Why?

She said: I don't think I can afford it, and they won't let me pick my own doctor.

I said: Well, Judy, I don't want to get personal, but I need to ask you a few questions. Do you have health insurance?

No. No, Senator. I have never had health insurance in my life. I have never had a job that offered health insurance.

She was 60 years old.

I said: Now I am going to get real personal. Can you give me an idea how much money you make? If you want to, can you tell me?

Sure.

She told me.

I said: Judy, when it is all over, you are going to be covered by Medicaid. You won't be paying for this. For the first time in your life, you are going to have health insurance. You are going to be able to go to the hospital and not be a charity case.

She said: It won't cost me?

No. Your income is so low that you qualify for this tax credit and this treatment under Medicaid. You don't have to pay out of pocket.

The next time I went back there after the law passed and we knew she had Medicaid coverage, Judy didn't look the same. She was obviously sick.

I said: What is wrong?

She said: Well, I just got diagnosed with diabetes.

I said: Well, at least you have Medicaid.

She said: I sure do. And I have a doctor. I like him, and he is helping me. And I have a hospital that I can go to if I need to.

There she was, for the first time in her life at the age of 60, with diabetes, and with health insurance. From my point of view, that is what this decision and this debate is all about.

What we set out to do with the passage of the Affordable Care Act was to make sure health insurance was there for that young couple getting started with a baby who otherwise wouldn't have had health insurance or that 60-year-old woman who was working a job that didn't provide health insurance benefits who was facing diabetes.

Well, it has helped a lot of people. When we started the debate on the Affordable Care Act, there were 50 million Americans--out of over 320 million, 50 million--who had no health insurance. Because of this law, the Affordable Care Act, almost one-third of them--16 million--now have health insurance. I think that is a good thing. Most Americans would celebrate that we have reduced the rolls of the uninsured by one-third. It means they have peace of mind having coverage.

Roy Romanowski, in Chicago--I sat next to Roy at a community health clinic in a neighborhood. I go to those clinics all the time because I think they are one of the best places on Earth to meet some great medical professionals who are doing a wonderful service for a lot of people who live in a neighborhood and who wouldn't have a place to go.

Roy Romanowski, a big, barrel-chested Polish guy from Chicago, is a musician. He plays a guitar. He never had a solid 40-hour-a-week job in his life and never had health insurance. He has it now. The Affordable Care Act gave Roy health insurance coverage for the first time--health insurance coverage he can afford.

That is what the decision in this court case was about today--whether people like Roy and Judy would have health insurance. And it does something else: It moves us along the path we want to be on--and not only that more and more people have health insurance. Here is good news for everybody: The rate of growth in health care costs is going down. Oh, it is not a dramatic plunge. We didn't expect it to be. But even as it starts to level off a little bit, it has a dramatic impact. It means even if you don't have your health insurance plan through the Affordable Care Act, if you have it through your employer, the health insurance premiums your employer faces are less than they would have been. So it is starting to flatten out this growth and the cost of health care.

What about Medicare? Medicare is important for over 40 million Americans. Here is the great news on Medicare--two things. No. 1, because the overall cost of health care is coming down just a little, in 5 years, the projected solvency of Medicare has been--they have added 13 years to it, 13 more years of solvency for a program critically important to seniors and disabled people. So Medicare has benefited from it as well.

There is a second part. If you are under Medicare and you have prescription Part D, which covers your prescriptions under Medicare, we closed the doughnut hole. The doughnut hole used to be that point in the cost of your prescription drugs when Medicare no longer paid for it and you had to pay for it out of pocket. That was a crazy idea in the law, and it cost seniors thousands of dollars. And then, of course, after they paid out of pocket, Medicare came in to cover the additional expenses. We got rid of that craziness. We eliminated that doughnut hole. So for seniors wanting to take the medicines the doctor has prescribed so they can feel good, be strong, be independent, stay on their own, this Affordable Care Act helped them pay. In Illinois, it was about $1,000 per Medicare recipient per year in prescription drug costs taken care of by the Affordable Care Act.

Let me tell you a couple other things this law did and does. Do you have any children in your family who are going to college? Are you worried about when they graduate from college, whether they have a job and health insurance? I was. My wife and I were worried about our daughter.

I remember calling her.

Jennifer, you just got out of school. Do you have health insurance?

Dad, I don't need it. I am healthy as can be.

That is not what a father wants to hear.

The Affordable Care Act says that your son or daughter can stay under your family plan until they reach the age of 26. I think that is a good thing. As a parent who had a college grad looking for a job, I had the peace of mind of knowing she was under the family health insurance plan.

So the people who want to repeal the Affordable Care Act--do they really want to repeal that provision?

And here is another one that is important. How many of us can say with certainty that in our homes, in our households, there isn't someone with a preexisting condition, someone who--perhaps a child--has had diabetes, a spouse who has had good luck in beating breast cancer or prostate cancer? Someone there is a history of mental illness. In the old days before the Affordable Care Act, what I just described to you were grounds for denying health insurance coverage or charging through the roof. Well, that was changed by the Affordable Care Act. Preexisting conditions no longer disqualify you from health insurance in America.

The President said this morning, after the Supreme Court decision: We will have to explain to our grandkids there was a time when you couldn't get health insurance if you were sick.

Thank goodness that time has passed and the Affordable Care Act protects people. Overall, this act in the last 5 years has made real progress for America. For 16 million Americans, it has given many of them health insurance for the first time in their lives, health insurance they can afford and a tax credit to help them pay for it that was protected today by this Supreme Court decision.

In all of the time since the Affordable Care Act has been the law, we have heard from the other party that they want to repeal it. But in that same period of time, we have never ever heard what they would replace it with. They don't have a better idea. Here is what I hope we will do. I hope we will put behind us this whole effort of let's file another lawsuit, let's vote another time to abolish the Affordable Care Act. I hope instead that there will be a constructive dialogue between Democrats and Republicans to make the Affordable Care Act better.

I voted for it and am proud of it. It is one of the most important votes I ever cast in Congress. But it is not perfect. I tell my town meetings in Illinois that the only perfect law was brought down the side of a mountain by Senator Moses on clay tablets. Ever since then, we have done our best to write laws but know that we have to be ready to improve them and to react to changing circumstances.

We should do the same with the Affordable Care Act. I think there are things we can do to make it stronger, and on a bipartisan basis we should. Until this moment in time of this Supreme Court decision, it has been politically impossible to have that conversation.

The Restaurant Association came to see me. They are worried. They said: Wait a minute. We have a lot of part-time employees and a lot of them don't want health insurance. Their spouses have health insurance. We are looking at the law. We want some clarity here about what our obligation will be under the Affordable Care Act.

They deserve that clarity. I will tell you as I stand here today, I am willing to sit down with any Republican Senator and work out changes and provisions in the law to make sure we treat these employees fairly and we give them coverage and do it in a fashion that is fair to their employer as well as individual employees. These are things we can and should do.

For the longest time, there were people who opposed Social Security--going way back in time 70 or 80 years when it,was created. They said that it will never last; it will never stay. Eventually, public sentiment changed and people realized Social Security was critically important for America.

The same thing was true for Medicare. There were those who said: Socialized medicine, you have to get rid of it. Now, 60 years later, 50 years later, they understand it is part of America. For millions of Americans, it is critically important. Medicaid, the same thing.

I hope today will be that turning point on the Affordable Care Act, where we decide on a bipartisan basis that this is part of our future, providing health insurance for uninsured Americans, doing it in a fair way, and particularly for those in lower income situations.

This was a historic decision, King v. Burwell, at the Supreme Court--6 to 3. A decisive majority opinion said the Affordable Care Act is legal and constitutional and should move forward. I hope that message makes it across the street over to the Halls of Congress.

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