Chinese Trade Practices

Floor Speech

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Mr. MURPHY. Madam President, I want to tell my colleagues a story about Charlene Dill.

On March 21 Charlene Dill was supposed to bring her three children over to the South Orlando home of her best friend Kathleen. The two friends had cultivated a really close relationship since 2008. They shared every resource they had from debit card pins to transportation to babysitting to house keys. They helped one another out. They essentially had become each other's safety net.

As Kathleen described it, they hustled. They picked up short-term work. They went to every event they could get free tickets to for their kids. They lived the high life on the lowdown. They cleaned houses for friends just so they could afford the daily necessities of life. They were the quintessential working poor, and they existed in the shadows of this economic recovery that is yet to reach a lot of average people out there.

On March 21, when Dill never showed up with her three kids, who often came over to play with Kathleen's 9-year-old daughter, Kathleen was surprised she didn't even get a phone call from her friend Charlene. She shot her a text message--something along the lines of ``thanks for ditching me''--without knowing what had really happened.

Charlene, who was estranged from her husband, had been raising her 3 children alone--ages, 3, 7, and 9. She had picked up another odd job to try to pay the bills. She was selling vacuums on commission for Rainbow Vacuums.

On that day, in order to make enough money to survive and--as you will understand--keep herself alive, she made two last-minute appointments. At one of those appointments in Kissimmee, she collapsed and died on a stranger's floor.

Charlene had a documented heart condition for which she took medication, but she often could not afford the medication, and her friend Kathleen often had to turn to crowd-funding Web sites to help raise the money that her friend Charlene needed to pay for her heart medication. Charlene was the working poor, but she was also among the uninsured. After her death, her friend Kathleen used that same crowd-funding method that she used to occasionally pay for her friend's medication to pay for Charlene's funeral.

Florida has made the decision not to expand Medicaid coverage under the Affordable Care Act. They have made a decision--for political reasons--to keep hundreds of thousands of people such as Charlene among the ranks of the uninsured. The consequences are for many such as Charlene absolutely deadly.

Charlene died because she was on the outside of our health care system. Occasionally she would get to see a doctor and occasionally she would get the medication she needed for her condition--in part--because she had one good friend who went out of her way to try to help Charlene.

The reality is that there are 5.7 million people all across this country who have been denied the chance to get health care through Medicaid simply because their Governors or their State legislatures have decided to score a political point against a President whom they don't like by refusing Federal dollars in order to expand Medicaid, and that is what this is all about. This is not about good policy, this is not about health care, and this certainly is not about finances. This is just about a bunch of really angry Republicans that don't want to participate in a health care reform law passed by Democrats even though they are essentially giving away the money of their constituents.

The first reason you should do this is because it keeps people such as Charlene alive. A 2002 Harvard study of 3 States that expanded Medicaid--Arizona, Maine, and New York--showed that the expansion of Medicaid in those States was responsible for a 6-percent reduction in mortality as compared to other States. It found that for every 500,000 adults that gained Medicaid coverage, we prevent 3,000 deaths a year.

I am not really good with quick math, but that is 3,000 deaths prevented for 500,000 people covered by Medicaid. We are talking about 5.7 million adults that are being denied Medicaid because of these political decisions; that is a lot of people who are dying needlessly every year. That is the first reason you should do it, because it is the right and compassionate thing to do.

The second reason you should do it is because people in States such as Virginia or Texas--there are 1.2 million people in Texas alone. There are 1.2 million people who could have health care insurance but don't have health insurance in one State because the Governor and legislature don't like President Obama.

This is also about those constituents essentially giving their money away to other States. The message to people in States such as Florida, Virginia, and Texas is that you are funding people getting insurance in other States because the Federal Government is contributing almost the entire cost of this Medicaid expansion. Texas and Florida's dollars are going to Washington and being spent to subsidize the health care of somebody else. It does not make any sense from a health care standpoint and it certainly doesn't make any sense from a fiscal standpoint. It is not just the taxpayers and patients who are getting hurt, but it is all the health care providers as well.

An Urban Institute study found that hospitals across the country are being denied $294 billion because of this refusal to expand Medicaid. The Presiding Officer knows this because she has worked in and around health care policy her entire life. This idea that denying people health care insurance denies them health care is patently false. They get health care. They just don't get it until they are so sick they show up at the emergency room door and their condition is at a crisis point, and then that costs infinitely more. All of this money we are spending could be spent in a different place, such as on preventive care, instead of on crisis care.

With a new Secretary of HHS, there is an opportunity for these States to think differently. From the beginning, HHS has been incredibly willing to be flexible with Governors who are not quite sure of the politics of joining in the ACA but know it is the right thing to do. States such as Arkansas, Iowa, and Pennsylvania have come up with innovative programs in which they take the Medicaid expansion dollars and instead of using them to expand State-based Medicaid, they use those dollars to help people buy private coverage. It seems to make a lot of sense to me.

At her confirmation hearing, Ms. Burwell said she was willing to continue to be as flexible as she possibly could with States that want to explore these innovative methods. Hopefully, with a new Secretary coming through the doors at HHS, maybe this is a new moment for these States to take another look at Medicaid expansion because this is just a matter of conscience.

Madam President, 5.7 million people are going without health care and potentially dying, as Charlene Dill did, simply because of politics.

David from Virginia wrote:

I am the coverage gap. I am a single 41-year-old male. I save Medicaid thousands of dollars per month by caring for my 99-year-old grandmother at home without pay, rather than place her in a nursing home at Medicaid's expense. I do not qualify for Medicaid even though I have a zero income. I have to cross the state line, into Kentucky to receive potentially lifesaving cancer screenings and hopefully receive treatment if I get bad news. Virginia Republicans hate the president and governor so much, they are willing to let thousands of us die. It is high time that these delegates place human lives ahead of party politics and do what is right, for a change!

Eight million people have signed up through the exchanges. Despite these decisions by Governors and Republican State legislatures, 5 to 6 million more have been added to Medicaid, and 3 million young adults have coverage for the first time.

Prices to the Federal Government are falling. We are spending trillions less than we thought we would spend on health care because of the Affordable Care Act. Quality is increasing. The number of readmissions to hospitals and hospital-acquired infections are decreasing because we are starting to pay for outcomes instead of paying for performance.

People are figuring out that the Affordable Care Act works, and that is why there are fewer Republicans coming to the floor of the Senate and the House complaining about it, and that is why the Koch brothers and others have stopped running all of these ads about the Affordable Care Act.

The Affordable Care Act works, but it only works if leaders actually try to implement it. It doesn't work if you ignore it for political spite, and that is what is happening in State legislatures and Governors' mansions all across the country.

We have a new Secretary of HHS and a new willingness of a lot of Republican Governors, including Mike Pence in Indiana, to take a look at trying to reverse this reality for 5 1/2 million people who--if not for the political actions of their State leaders--could also figure out, as millions and millions of others are doing on a daily basis across the country, that the Affordable Care Act works.

I yield the floor and note the absence of a quorum.

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