WASHINGTON, D.C. – In remarks on the Senate floor today, U.S. Senator Tim Kaine discussed the positive impacts of the Affordable Care Act, Medicare and Medicaid in Virginia, and why it is critical that Congress defend these landmark health care programs going into the next administration. Repealing the Affordable Care Act, Kaine argued, would inject needless uncertainty into the economy and have a painful impact on American families. He instead urged his colleagues to meet for bipartisan discussions on how to make improvements to the law.
“A repeal [of the Affordable Care Act] without a replacement would be malpractice to the health of millions of Americans, but also malpractice to the American economy,” Kaine said. “The percentage in the nation of people who were uninsured when the Affordable Care Act was passed was 16 percent - one in six Americans was uninsured. Now, it’s 8.6 percent…327,000 more Virginians have health insurance in 2015 than in 2010.”
“If you tell the entire American economy that, ‘we are going to go into the largest sector of the economy and we’re going to repeal it,’…you will inject uncertainty into an economy by a degree that has never been done by this body. I think it would have catastrophic consequences, even beyond healthcare,” Kaine continued. “If this body goes down the path of repealing this important law that provides important protections to millions… it will be one of the low moments in the history of the United States Senate.”
Kaine also discussed his visit to a community health center in Alexandria, Virginia on Monday where he heard directly from patients and providers about the importance of access to quality and affordable health care.
Full transcript of Kaine’s remarks:
I rise to discuss the Affordable Care Act and want to make the case that its repeal without a replacement being known would be malpractice to the health care of millions of Americans but also malpractice to the American economy. Before I talk about why I just want to tell two stories.
Monday, I visited Neighborhood Health which is a community health center in northern Virginia that serves 14,000 patients. It's not a walk-in clinic. They're sort of a medical home for 14,000 low-income northern Virginians, mostly working people. Community health centers in Virginia, West Virginia, every state, are a critical part of the health care safety net in Virginia. They serve about 300,000 patients, millions nationally. They are medicine with a mission. They don't deny anybody primary health care services because of inability to pay and residents have equal access regardless of where they live, their culture, their gender, their race or resources.
Many centers, including the one that I visited just twenty minutes from here, were centers that were able to build or expand because of the Affordable Care Act. The facilities have gotten better in communities across the country because of the Affordable Care Act. That visit really made powerfully clear to me how much every zip code in this country has been affected by the Affordable Care Act because of these centers and other services that are provided.
The second story is a story from my recently completed 105-day unsuccessful venture as part of a national ticket. I was at the Iowa State Fair. A grandfather was carrying a little boy who looked to be about 3 and a half years old. I said tell me this youngster's name. The grandfather said, “This is Jude.” Of course I said, “Hey Jude!” I said, “Tell me about Jude.” The grandfather, now the father, walked over and started to talk to me.
What they said was Jude is 3 and a half years old and has already had five open heart operations at the Omaha Children's Hospital which is just across the river western Iowa in Nebraska. They looked at me and they said he couldn’t have had these operations had it not been for the Affordable Care Act. Had it not been for the Affordable Care Act he now would have exceeded the lifetime limit of any policy he could ever get, and he also would have a preexisting condition because of his heart condition that would render him unable to get insurance for the rest of his life.
They looked at me, and the father is a pretty big guy. They said, will you do all you can, will you do all you can to make sure that this Act is not repealed? You can strengthen it. You can improve it, but will you do all you can to make sure it's not repealed. I looked at them and I said, because I believed this even before they asked me the question, I’ll do anything to my last breath to make sure that we improve this but that we don't get rid of it. That's why I stand on the floor today.
Since the Affordable Care Act was passed in March 2010, 20 million Americans have health insurance and many of them for the first time in their life. That's, I think, the combined population of about 14 or 15 states. Having health insurance for the first time in your life.
Now, when you have health insurance, it's not only that you can get care for an illness or an accident. Even when you're healthy, you can go to bed at night with the knowledge that if something happens to my wife tomorrow, if something happens to me tomorrow, if something happens to my child tomorrow, they will be able to receive care.
The percentage in the nation of people who were uninsured when the Affordable Care Act was passed was 16 percent, one in six Americans was uninsured. Now it's down to 8.6 percent. That's the lowest level of uninsured that we've had probably since we've measured that. In Virginia the drop has been from 13 percent. We were a little better than the national average, and we've dropped down to 9.1 percent uninsured. We're a little higher than the national average now because my state has not accepted Medicaid expansion, but the difference in six years is 327,000 more Virginians have health insurance in 2015 than had in 2010. That's a powerful, powerful thing.
In addition to having health insurance, families are protected with insurance. They can't get turned away because of pre-existing conditions. They can't get turned away because they've reached lifetime limits in terms of their medical care as Jude would have reached by age 3 and a half. Children can stay on family policies till age 26. Women cannot be charged different health care premiums than men. Insurance companies are required to rebate excess premium payments back to consumers if they overcharge. It's not just about the millions who have health insurance who never had it before. There's also millions and millions more who receive protections that they've never had before. And these are important, important provisions.
There's been discussion that I’ve been reading and following here that what we need to do or what some want to do is just repeal the Affordable Care Act with a vague promise that something will happen down the line. Of course, those who want to repeal the Affordable Care Act who voted against it in March 2010 have had six or now nearly seven years to come up with what they think would be better. And there's been no consensus about what they think would be better. So the notion of we're going to repeal it and don't worry we will come up with a better alternative, that rings pretty hollow to a family like Jude’s parents and grandparents who have a 3 and a half-year-old boy who needs open-heart surgery, the notion that don't worry, we will find a replacement, we will find a fix, I think we can forgive somebody like Jude’s family for not having a lot of confidence in that. And if in fact we're serious about finding a fix, why don't we go to work finding a fix before we pass legislation to repeal the law.
I've said that I think it is malpractice, both health malpractice and economic malpractice. Let me start with the economic malpractice.
The worst thing Congress can do for the economy is to inject uncertainty into it. I've been a mayor and I’ve been a governor and I’m a certainty fanatic. What I’ve learned about the economy is that our strong and resilient business sector, if you give them certainty, they can plan. They may not like a policy, they might not like a budget number but if you tell them this is the way it's going to be, the ingenuity of our private sector is significant. They're going to be able to plan. They'll be able to make the best of it. They're going be able to figure it out. But if you don't tell people what you're going to do, that is very devastating.
I’m on the budget committee. I came onto the budget committee in the Senate and I told my colleagues on both sides of the aisle, I’m a certainty fanatic. We should be doing budgets, we shouldn't be doing a continuing resolution right now. We should be doing appropriations bills. Because when we tell our own planners, our own departments, and also the private economy, this is what it’s going to be for the next year, they can figure it out, they can adjust, and they can do well. But when we instead deliver a message that we don't know what we're going to do, oh, yeah there will be a fix but it will be a few years from now, we can't tell you what it is going to be now, and really we can't even promise we'll do it since we haven't come up with it for six years, you inject uncertainty into the economy, and that is the worst thing we could do.
I have made the argument that the recovery we've been on economically, which is not a robust recovery but it’s been a steady recovery, the principal reason it's been steady but not robust is because of uncertainty and the principal generator of uncertainty in the United States is this body: Congress.
Congress’ inability to do budgets in regular order.
Congress’ inability to tackle priorities.
Congress’ inability to work on big-picture fiscal issues generates uncertainty.
Now we're talking about a repeal of the Affordable Care Act, the single-largest sector of the economy. One-sixth of the GDP of this country is health care. If you tell the entire American economy we're going to go into the largest sector of the economy, we’re going to repeal it and don't worry we'll get to something down the road as a replacement, you will inject uncertainty into an economy in a degree that has never been done by this body that I think will have catastrophic economic consequences even beyond health care.
It is also malpractice in the health lives of Americans. The Urban Institute has come out with a study today, and it was an update of a study they did a year ago, because there was a proposal a year ago to repeal the Affordable Care Act that President Obama vetoed, but they did a study, “what would repeal mean?” This is what repeal means to the American public as we get ready to celebrate the holidays, a time when we are mindful of the needs of others.
The number of uninsured people in the United States, if the ACA is repealed, would rise from its current 28.9 million to 58.7 million, an increase of 29.8 million uninsured in this country. The share of non-elderly people without insurance would increase from 11 percent to 21 percent. Of the 29.8 million newly uninsured as a result of the repeal, 22.5 million will become uninsured as a result of eliminating premium tax credits, Medicaid expansion and the individual mandate, and the additional 7.3 million would become uninsured because of the near-collapse of the non-group insurance market.
82 percent of the new 29 million who will become uninsured are working families. 82 percent.
38 percent would be ages 18-34.
56 percent would be non-Hispanic whites.
80 percent of adults becoming uninsured are adults who do not have college degrees.
There will be 12.9 million fewer people with Medicaid or CHIP coverage in 2019 if the Affordable Care Act is repealed.
Nearly 9.5 million people who have received tax credits to help them purchase private non-group health coverage in 2019 will no longer receive that assistance.
This is catastrophic to tens of millions of Americans.
I’ll tell you a third story that's a story about me. I have to have the healthiest family in the United States. My wife and I and our three children. The only hospitalizations we've ever had until my wife recently broke a bone was for three childbirths. Our kids are 27, 24, and 21. We are the healthiest family in the United States. I was required once to go out right after the Affordable Care Act passed to buy health insurance on the open market. I didn't have an employer who could cover it, and two insurers turned me down because they said we can't write a policy for your whole family because of a preexisting condition, and one insurer turned me down because of something about me and one insurer turned me down because of something about one of my children. And, again, we are the healthiest family there is.
We were able to say, wait a minute, the Affordable Care Act just passed. You are not legally allowed to do that now. You have to write a policy for the whole family. And the insurance agent that dealt with us on the phone said, let me talk to my supervisor, then called back and said you're right. We have to write you a policy. This is a law that not only provides health insurance to 20 million people who never had it before but for even healthy families like mine provides benefits to protect against some of the worst and most predacious behaviors of insurance companies. And if the Act is repealed, this all goes away.
Americans agree repeal is not the answer. A Kaiser Foundation poll that was done in the last two weeks showed that only 26 percent of Americans support a repeal of the Affordable Care Act. Of the other 75 percent, some think it should stay the same. Some think it should be tweaked backwards a little bit. Some think it should be advanced. But only one in four Americans believe we should repeal this law. Overwhelmingly, what the American public is telling us is we should improve the law. And that's what we should be about in this body.
When I was the governor of Virginia, I noticed at the end of every legislative session there would be 1,100 bills on my desk for me to review, sign, veto, or amend. And of the 1,100 bills, pretty much every year, 200 or 300 would be new, but 800 would be improvements to existing law. The job of a legislator is more about taking existing laws and reforming and improving it than repealing or doing something brand new. And that's what puzzles me. Why aren't we doing that?
Clearly there's no rush. There's no rush because the discussions are, we would repeal the Affordable Care Act with a promise that we'll find a replacement in two or three years. So if the notion is, we're going to work for two or three years to find a replacement, there's no rush. And if there's no rush, why aren’t we sitting down right now instead of repealing the law? Why aren't we sitting down right now, let's sit down around the table, let’s talk about what we don't like, let's talk about what we do like, let's talk about what it means to have 20 million people in this country with health insurance, many for the first time in their lives, what they might think. Let's get the perspectives of hospitals, of doctors, of insurers and other medical professionals. That's what we should be doing. What's the rush?
I fear that the rush is for one reason: a desire to do something before this President leaves office that can be a little bit of a poke in his eye. But it's a poke in his eye politically in a way that takes families like Jude’s family or the families that I saw at the neighborhood health center in Alexandria and puts deep fear and uncertainty in their lives, and also puts uncertainty into one-sixth of the American economy.
I know, madam president, that we'll be having this discussion in earnest. I suspect a little bit over the next couple of days, but more when the year begins just as we're going to be having discussions about Medicare and Medicaid. 1 .3 million Medicare enrollees in Virginia, as of 2015, the CHIP and Medicaid programs in Virginia have an additional 970,000 enrollees. I read about dramatic discussions about these programs as well, these basic safety net programs. And I’ll just conclude and say, there is no reason that we shouldn't be able to sit down around the table and talk about improvements. And what I might call a reform, somebody else could call a replace. And I don't care about the label. But what I do care about is repealing the law that provides millions of people the confidence that they have health care for the first time in their life.
Doing it and having the discussion during the holiday season. Doing it in a way that will hurt working people, will hurt working people who don't have high school degrees. Doing it that will hurt people that are already sick, who are already dealing with illnesses in their families.
I am a student of this body. I am not a historian. I am a student of this body. But my prediction would be this: if this body goes down the path of repealing this important law that provides important protections to millions, with no idea about what the replacement is, I think it will be a day that we will look back on and those who care about this body will look back on probably in the not-too-distant future and will say, this will be one of the low moments in the history of the United States Senate. And there's no need for it because there are people of goodwill in this body who are willing to sit down, and find solutions, and find improvements and find reforms. But nobody seems willing to have that discussion.
Let's have that discussion rather than the repeal discussion and we will serve our constituents better.
With that, madam chair, I yield the floor.