Affordable Care Act

Floor Speech

BREAK IN TRANSCRIPT

Mr. DURBIN. Mr. President, last week I had an opportunity to cross the street into the Supreme Court, and I witnessed the first oral argument I have ever seen. It was a historic moment for me and for our Nation because it was a moment for the Court to argue about the Affordable Care Act and the intention of Congress when it was creating this Affordable Care Act.

Having been here at the time it was debated and having voted for it, it was interesting to hear arguments made on the floor of the Supreme Court that suggested something we had never intended. The exchanges that were created under the Affordable Care Act are exchanges created by each State or Federal exchanges. There was never a distinction made in the debate nor any intention that the subsidy given to those who bought insurance in these exchanges would be different if the exchanges were State-created or federally created, and that is basically the argument before the Supreme Court.

One can only imagine what the final decision of the Supreme Court will be, but we know it is critically important to millions of Americans. In the past year alone, 10 million uninsured Americans finally have insurance because of the Affordable Care Act. In the private market, millions more now have access to expanded coverage for preventive health services, such as a mammogram or a flu shot, without any cost sharing. Because of the Affordable Care Act, a person no longer needs to stay in a job simply to carry health insurance or be denied coverage because of a preexisting condition--a situation which virtually every family faces. And because of this law, prescription drugs for seniors cost less.

Last week, when the Supreme Court heard arguments in King v. Burwell, the plaintiffs made an argument that those who were governed by Federal exchanges were supposed to be treated differently under this act. That was never the intention of those of us who were part of the creation and voting for this legislation.

A ruling in favor of King would change this provision as we intended it. It would mean 8 million Americans would no longer be able to afford health insurance.

According to the Urban Institute, premiums for people able to purchase insurance would increase by 35 percent. I can't imagine that even Senators who voted against this bill are cheering at the prospect that 8 million Americans would lose insurance and many others would face higher premiums.

Well, the Republicans have argued they have an alternative to the Affordable Care Act in the Senate. They put out a draft proposal last month. The chairman of the Ways and Means Committee in the House said he was going to release his own plan.

The Affordable Care Act puts families in charge of their care instead of insurance companies. It expands health care coverage and lowers health care costs, makes Medicare stronger, and lowers the deficit.

What part of that do my Republican colleagues disagree with?

Before the enactment of the Affordable Care Act, 50 million Americans lacked health insurance while health care costs for working families and small businesses were increasing by double digits. The Affordable Care Act changed all of that. Ten million people now have private health insurance, millions more are covered by Medicaid, and for the first time ever insurance companies have to live up to their promise of being there when you actually need them.

The Senate Republican proposal falls short. It would allow insurance companies once again to charge higher premiums to women, to decide that people with preexisting conditions will not get any coverage at all, and to decide that certain individuals will only get so much help for paying their bills. If Republicans have their way, insurance companies will get to decide again whether you can renew your health insurance policy as you become older. Worse yet, under the Republican proposal, 12 million people would lose their health insurance and taxes on working families would go up. That is not right.

The Supreme Court would put in jeopardy health insurance coverage for Ariana Jimenez. She lives in Chicago and works part time as a nursing assistant at a community health center. Ariana pays $52 a month for her health insurance premium. When asked what would happen to her coverage if the Supreme Court took away the tax credit, she simply said: ``I wouldn't be able to afford it.''

In Illinois over 800,000 people now have health insurance. Over 290,000 people purchased their plan through the Illinois marketplace, which is a Federal marketplace. An additional 530,000 people have enrolled in Medicaid, and 125,000 young adults in Illinois can still stay on their parents' health insurance plan.

Since September 2010, children under the age of 18 enrolled in the employer-based or marketplace plan have been eligible to receive vaccinations for diseases such as measles without any cost sharing.

A few years ago Domingo Carino found out he had a health condition that required medication he couldn't afford. Thanks to the Affordable Care Act and to some help from staff at the Asian Human Services Family Health Center in Chicago, Domingo found good health insurance that only costs him $11 a month. Domingo's plan not only allows him to afford the medication he desperately needs, but he is also able to keep his current primary care physician. According to Domingo, he can now live without worrying about how to afford his medication.

For Domingo and millions like him the tax credits provided by the Affordable Care Act are a lifesaver. If those who oppose the Affordable Care Act prevail in the Supreme Court, that tax subsidy, or tax credit, will not be available to Domingo.

Over 54 million people also benefit from Medicaid. Before the Affordable Care Act, two out of three people on Medicaid were pregnant women and children. That is 36 million vulnerable Americans. Medicaid also provides for people with disabilities.

Before the Affordable Care Act, almost 3 million people were covered by Medicaid in Illinois. More than half a million births were covered by Medicaid in Illinois, too. Since the Affordable Care Act was signed into law, another 290,000 people in Illinois are covered by Medicaid. That means these people finally get better from a condition they could not afford to treat. That is a success story.

The new Republican plan uses something else out of an old playbook. Republicans want to cap Medicaid spending for each beneficiary. This budget gimmick would hurt the most vulnerable people in America--low-income seniors, people with disabilities, children, and pregnant mothers. States would be forced to make harsh choices on what they would cover and what they would not cover.

Is that what America wants?

According to a recent Gallup poll, the uninsured rate dropped 3.5 points from 2013 to 2014. In Illinois the uninsured rate dropped 4.5 percent in the same period of time.

The Affordable Care Act includes changes meant to help slow the growth in health care costs, and they are working. We need to stick with the Affordable Care Act.

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