Washington, D.C.–(ENEWSPF)–March 24, 2010. What follows is the Senate floor speech given today by Senator Carl Levin (D-Mich.).
“Mr. President, the debate which comes to a close this week has, in one sense, been going on for more than a year. But in another sense, it has been going on for a century. In 1912, Theodore Roosevelt campaigned on the promise of a national health insurance program. Workers, Roosevelt said, are entitled to a basic standard of protection from injury and illness. “Wherever such standards are not met by given establishments, by given industries, are unprovided for by a Legislature, or are balked by unenlightened courts, the workers are in jeopardy, the progressive employer is penalized, and the community pays a heavy cost in lessened efficiency and in misery.” Presidents and members of Congress from both parties, seeing the same costs that Theodore Roosevelt saw in the failure to assure health care for all, have grappled with this issue ever since.
Yet these attempts at reform have largely fallen short. They have foundered for many reasons: The subject is personal and complex. The timing has been wrong, the politics have been difficult, leaders on all sides have failed to find the compromises that would have enabled them to move forward. But the recurring theme is that time and again, reformers have failed to overcome the enormous obstacles that those who profit from the status quo have been able to erect. And because we have fallen short in the past, Americans today face a health care system that costs too much and too often delivers too little.
In the United States today, mothers and fathers wonder what else they can cut from the family budget to afford yet another increase in their health care premiums. Parents file for bankruptcy because their insurance fell thousands of dollars short of providing for a child’s life-saving treatment; nearly two thirds of the bankruptcies in this country involve medical costs, and more than half of those involve people who had insurance. Small-business owners eliminate health coverage for employees because they can’t afford another year of massive cost increases. And thousands of Americans who woke up this morning with health insurance will go to bed tonight without it.
Despite these tragic facts, entrenched interests have sought again to prevent reform, to consign our nation to an utterly unsustainable status quo, because what’s good for the American people might not necessarily profit some company. The health insurance industry has dominated health care decisions in this country for too long. How often have our constituents come to us with stories of insurance companies that deny them coverage of necessary treatments? How often have they told us of insurance companies that deny coverage because of pre-existing conditions or canceled coverage because of minor inaccuracies that the company conveniently discovered just after diagnosis of a serious and costly illness? It is time to end the unhealthy dominance of the health insurance industry. I will cast my vote again against those entrenched interests and for health care reform, and encourage my colleagues to do the same.
It is worth remembering, Mr. President, that in opposing the specific measure right before us, our Republican colleagues cannot block health care reform. Reform is already the law of the land. What Republicans are now opposing is a bill that would improve the bill we passed in December and was just signed by the President. The bill before us in fact makes some of the changes our Republican colleagues called for so loudly during that December debate. The logic of this opposition will surely elude many of our constituents. It is, I suppose, consistent with the “automatically oppose everything at all costs” approach they have taken throughout this debate.
But we have the opportunity to finish the task of overcoming the entrenched opposition, to do what so many presidents and so many members of this body have fought for decades to accomplish.
These months of debate have been difficult. They have too often been filled with too much heat and too little light, with exaggeration, half-truth, untruth and innuendo designed to obscure rather than to inform. That’s no different in many ways from some previous debates on major reforms. When Congress approved Social Security in 1935, one Republican senator warned it would “end the progress of a great country.” When Medicare was debated in 1965, one critic charged that cooperating with the plan would be “complicity in evil.”
That these scare tactics of the past proved absurd is demonstrated by the fact that, today, as we debate this legislation, our Republican colleagues continue to claim that their opposition is in part a defense of Medicare. Not too long ago Ronald Reagan declared Medicare a threat to our very freedom. He did so in a recording distributed by the American Medical Association, which opposed Medicare. Today, the AMA endorses our health care plan. So do AARP, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Hospital Association. Perhaps these groups have all suddenly become exponents of a government take-over of health care. No, in fact, the claims that this bill represents a government take-over of health care are just another round of the scare tactics we have seen so often before.
Scare tactics have derailed real health care reform in the past. Scare tactics aren’t working this time. The American people have expressed their disapproval of wild, inaccurate claims in many ways, including personal conversations with many of us.
It is true that because health care is so complex, because changes must be phased in and transition periods are often necessary, many of the benefits of this bill will not take effect for some time. But improvements in health care for millions of Americans will take place almost immediately. Immediately after President Obama signed this bill into law, small businesses got a tax cut to help defray the costs of providing insurance to their employees.
Within three months of signing, the bill will allow people with pre-existing conditions to access a special fund to help cover the gap until insurance exchanges where they can obtain coverage become operational. And retiree health plans will qualify for a reinsurance program to help lower costs.
In October, the federal government will begin helping states set up agencies to help consumers choose new health plans or to challenge unfair decisions by their current insurance plan. Eventually, these agencies will help consumers enroll in the insurance exchanges that will help millions of people find dependable coverage that meets minimum quality standards at a price they are more likely to afford.
And within six months of the president’s signature, insurance reforms will begin to take hold. New health plans will be required to let women see an ob-gyn without seeking insurance company approval. They will be prohibited from denying coverage to children based on pre-existing conditions, and required to allow children to remain on their parents’ policies until age 26. They will have to provide preventive care without co-pays or deductibles, and they will be barred from setting lifetime coverage limits.
These are historic improvements in our health care system, and they will take place within the first six months after enactment of this legislation.
More sweeping changes will come with full implementation of this bill’s provisions. We will protect Americans of all ages from denial of coverage based on pre-existing conditions, from annual limits on treatment, from exorbitant out-of-pocket costs, and from confusing and opaque language that disguises the cost or scope of coverage. We’ll even require insurers to give their customers a rebate if they don’t spend enough of their revenue on patient care. And we will fill Medicare prescription drug “doughnut hole” that hurts so many seniors.
At its heart, Mr. President, this bill aims to tackle the central problems of our health care system: rising costs and the insecurity many Americans rightly feel about the lack of dependability of their insurance. The cost of health care already exceeds the ability of many American families to pay, will price more and more families out of the system if it continues to rise, and will present enormous problems for the federal budget if not contained. We can, and will, make the health insurance system work for those who already have coverage by holding down these unsustainable increases in premiums. In ways large and small, we attempt to tame this beast that threatens to swallow our family budgets and our federal budget.
How will we do so? We will bring real, transparent competition to a health insurance market that is now nearly impossible for consumers to navigate, forcing insurers to actually compete with one another on quality and cost. We will end wasteful subsidies to insurance companies using Medicare Advantage, and require Medicare Advantage plans to spend at least 85 percent of revenue on benefits for patients. We will encourage more prudent spending by taxing the most expensive insurance plans, those valued over $27,500, beginning in 2018. A panel of respected health care experts will recommend changes to deliver better Medicare coverage at lower costs. And we will explore the use of innovations such as “bundling” of Medicare payments, so that we pay health care providers not for the volume of services they provide, but for the quality of the care they provide.
It is important to keep in mind that even though health care experts believe these measures will help lower costs for families and the government, the Congressional Budget Office, being reasonably prudent, cannot tell us precisely how much money many of these steps will save. Even without counting those savings, the CBO estimates this legislation will reduce deficits by more than $140 billion over the first ten years and more than $1 trillion over the next decade, making it the most significant deficit-reduction legislation in years. Those numbers are a concrete demonstration of our commitment to fiscal responsibility. Even wise policies have costs, a fact too often ignored by Congress over the years. This legislation will be paid for responsibly, by those most able to afford it. For example, it will subject the investment income of the nation’s wealthiest, families with incomes over $250,000 a year, to the Medicare tax, and will impose a moderate Medicare tax increase on their earned income. It will crack down on artificial financial structures which have no economic substance and whose only purpose is to allow their users to avoid taxes. And it will impose fees on insurance providers, medical device makers, and brand-name pharmaceutical companies that stand to gain new patients through these legislative actions.
And Mr. President, we will take an enormous step toward reaching a goal sought by so many of the leaders of our country, sought by Franklin Roosevelt, by Harry Truman, by figures as different in ideology as Richard Nixon and Ted Kennedy. We will provide health insurance to millions of Americans who do not now have it. We will protect the workers who Theodore Roosevelt warned nearly 100 years ago were “in jeopardy,” and who remain so today.
Now, as has been the case over that century, the opponents of reform are vocal and strident. But I urge my colleagues to answer history’s call, to make real and lasting changes that will improve the lives of our citizens. And to those who continue to oppose reform, let me ask: Isn’t it long overdue to end discrimination based on pre-existing conditions? The American people believe we should, and so do I.
Isn’t it long overdue to end the insurance industry practice of “rescissions,” the denial of coverage to those who paid for it? The American people believe we should, and so do I.
Shouldn’t we do something about the thousands of Americans who are forced into bankruptcy because of health expenses, even though they have insurance they thought would protect them? The American people believe we should, and so do I.
Shouldn’t we take strong steps to rein in enormous, ever-growing health care expenses, expenses that threaten to put health care out of reach for more and more Americans, and to bankrupt our nation? The American people believe we should, and so do I.
And shouldn’t we clear the way for 32 million Americans who do not now have health insurance to obtain it? The American people believe we should, and so do I.
Mr. President, I ask my colleagues to join me in providing what so many before us have tried and failed to do, in reforming a system that leaves so many of our fellow citizens in jeopardy. I urge them to approve this bill as part of a package of historic legislation, and to finish the task of bringing landmark change to American health care.”