Washington, D.C. - Speaker Nancy Pelosi, Majority Leader Steny Hoyer, Majority Whip James E. Clyburn, and Democratic Caucus Chairman John Larson held a press conference today in the Capitol with Americans who represent the struggles many have with our current health care system and how they will benefit from much-needed health insurance reform. Below is a transcript of the press conference:
Speaker Pelosi. Good afternoon. They say a picture is worth a thousand words. Well, a number is worth a lot, too. I love numbers, and today the number from the Congressional Budget Office that this health insurance reform legislation will save $138 billion in the first 10 years and $1.2 trillion in the second 10 years speaks very eloquently to the deficit reduction that is in our package. That also strengthens Medicare. We will talk more about some other provisions in the bill, and a little bit later today it will be online.
Also speaking eloquently to the need for this legislation in terms of the health of America are the guests who are with us today. I am very pleased that we are joined by Ed Morris, Kim Moldofsky, Stella Johnson, and Carolyn Comeau. Their personal stories tell the eloquent stories of why health care is needed--to make America healthier, to lower cost for America's families' budget while we lower the cost to the federal budget.
We always said there were two reasons to do health care reform. One, it was about the health of the American people, to improve quality, to lower cost, to expand coverage and to do so in a way that held the insurance companies accountable. Second reason, of course, was to reduce the deficit. The President has said that “health care reform is entitlement reform.” There is no way that we could continue on the course that we are on. It is unsustainable in terms of the mountains of debt that will be heaped onto future generations unless we intervene with this legislation.
Again, let me yield to one our guests today, Ed Morris. Ed is from North Carolina and I want him to tell his own personal story. Ed, thank you for joining us today.
Ed Morris. Thank you so much. My name is Dr. Ed Morris. My wife and I own a small business, Franklin Health and Fitness Center, in the little town of Franklin in western North Carolina. As you probably know, more than half of small businesses no longer provide health insurance at all to their employees. Well, why is that? Well, our premiums for our business over the last 10 years tripled. This is a huge cost for our business every year to pay these health insurance premiums. Well, why are our premiums so high? Well, we as a small business are in such a pool that we cannot spread these costs around. One of our employees had cardiac bypass surgery about eight years ago. Well, the next year when the insurance company got these legitimate medical bills, our premiums went out the roof the next year. So to keep offering the coverage to our employees, we had to do two things. First of all, we had to raise our deductibles from $250 to $3,000 for an individual. And secondly, we used to pay 100 percent of the premiums for our employees but in order to continue to have coverage, we now require the employees to pay up to 40 percent of their own premiums. And many of them simply can't afford that.
Well, what will this bill do to help us? First of all, we will be in a big pool so our cost will be much lower. And secondly, it will prohibit insurance companies from raising our premiums if an employee gets ill and actually has to use the insurance. And third, and probably most importantly for me as a small business owner, beginning this year, I will receive tax credits of up to 35 percent to help cover the cost of these premiums. This will help me continue to provide health insurance for my employees and possibly to hire some new employees to grow my business.
Our congressional district has one of the highest rates of uninsured of anywhere in the country--23 percent are uninsured in our district. We have over 700 bankruptcies every year just in our congressional district. Every year, hundreds of my friends and neighbors suffer because of lack of adequate health insurance and these hundred of medically related bankruptcies, and this huge burden that us small businesses have, businesses just like mine in our little mountains of North Carolina.
So I am here as a small business owner to urge my Congressman, Congressman Heath Shuler, and really all the Members of Congress, both Democrats and Republicans, to do the right thing to help us small business owners, to do the right thing for our employees, to do the right thing for our local economies, and to do the right thing to reduce our national deficit. So I am urging Congress to say yes to this health care bill this week and now I will turn it over to Leader Hoyer.
Leader Hoyer. Thank you very much. I should've kept that because if I just repeated it, I think it is right on message. I think Dr. Morris was excellent, and he made all the points. I am going to make them again because they bear repeating.
First of all, as the Speaker pointed out, we know that in trying to stabilize this economy, grow jobs, and get our country back to work, we've had to incur deficits. We know that the fiscal soundness that we had in the 90s was dissipated in the last 10 years. We need to get back to balance. This bill is the biggest deficit reduction bill that any Member of Congress is going to have the opportunity to votes on--$138 billion in the first 10 years and over the next 20 years $2.2 trillion dollars plus reduction in the deficit. Excuse me, $1.2, $1.4 trillion dollar reduction in the deficit.
Now, Dr. Morris, of course, spoke to that issue as it relates to him because every American that is watching us with health care says: ‘What does it do for me? How does it impact me and my family and my security and my availability of health care?'
First of all, let me talk about small business. America has the highest health care cost in the world. And that is not just harmful to America's families who see their premiums rise year after year. As Dr. Morris pointed out, it is harmful to our job-creating small businesses who see mounting competition from foreign companies with lower health care costs, who face the painful choice between laying off employees and dropping their health care coverage. Health insurance reform helps relieve that burden. It creates an insurance exchange, a marketplace where private insurance companies will compete to attract customers. That's what Dr. Morris said. He'll be in a big group not a little group, and we know that bigger groups are cheaper and more reliable.
Health insurance reform helps relieve that burden, where individuals and the small businesses will be able to pool together for the same purchasing power and lower rates that have only been available to the biggest businesses. Small businesses will also see a $40 billion dollars in tax credits. Dr. Morris spoke to that as well, which will help him provide health insurance for his employees. That's good for Dr. Morris, but by the way it is very good for his employees and their families. If we pass health insurance reform, as we will on Sunday, those tax credits will begin to kick in immediately, but if reform fails the trend of shrinking coverage will continue. According to the Robert Woods Johnson Foundation, the number of small business employees who can buy plans through work will be cut nearly in half by 2020. From 41 percent today to 23 percent in 10 years, now what does that speak to? People who say: “Look, I've got insurance now, why am I concerned about this bill?” They are concerned about the bill because they are losing it at a rapid rate because the businesses for whom they work can't keep it. And if they can keep it, they have to lower benefits very substantially, increase co-pays and premiums very substantially and people are being priced out of the marketplace.
So I am very pleased to be here with Dr. Morris, but I am also pleased to be here with Kim Moldofsky, who is going to be speaking to us--Moldofsky, I am sorry-- from Morton Grove, Illinois. Kim, thank you very much for joining us to give us your perspective.
Kim Moldofsky. Thank you, Leader Hoyer. Hi. I am Kim Moldofsky from Morton Grove, Illinois. Agliophobia is a fear of pain; iatrophobia is a fear of doctors, but I have yet to find a word that defines my biggest fear--a fear of pre-existing conditions. My fear of pre-existing conditions began years ago when I was diagnosed with Sjogren's Syndrome, an auto-immune disease that causes dry eye and dry mouth. My illness seemed more of nuisance than a health crisis, so I was shocked when after my husband's employer went bankrupt and we lost our medical coverage, I was repeatedly told that I was uninsurable due to this condition. That was back in 2001, when I was 33 years old.
Eventually, my husband found a job with benefits. After a period of time, my faulty immune system was covered in full, which was helpful because by then I had developed rheumatoid arthritis. Still, once it was diagnosed, and I found the right combination of medicines to combat my symptoms, life continued at a normal pace. We were happy to have medical insurance, but we didn't have a great policy. We had a $5,000 deductible for our family, and with two young children under foot, we often met that deductible. At one point, I realized our high cost, high deductible actually penalized us for using the plan. For example, using the mail-order pharmacy aligned with our plan, it cost me over $2,000 a year for certain medication, a certain arthritis drug. On my doctor's recommendation, I checked the prices at the local Costco. It turned out that the same drug cost me less than $300 without my insurance at Costco.
In the fall of 2008, my husband lost his job and eventually his benefits. This time, I felt fortunate to find a private insurance, a private insurer saving me the expense of the state plan. However, like many policies, it does not provide coverage on the issues that matter most to my family, even my 9-year-old son has a pre-existing condition that is not covered. And of course, my arthritis, well they accepted me into a plan, into the plan with a special deductible for arthritis-related treatment. Knowing that this typically only involves a couple thousand dollars of treatment a year, we felt okay with that. However, it wasn't until after we had signed on the dotted line, the only dotted line that was available to cover my entire family, that we learned this deductible which I assumed was $5,000 or $10,000 was actually a $65,000 deductible--a $65,000 deductible for the most pressing medical condition in my family.
It is not creaking bones that keep me awake at night--it's the fear of developing a condition related to my arthritis that could send us tumbling into bankruptcy. Although I have some coverage, I have a fear of unexpected news, odd test results, a new diagnosis. I have a fear of a new pre-existing condition, a phobia without a name. Although we pay several hundred dollars a month for access to quality care, I am afraid to use it. I often ignore minor aches and pains. I have held off on some scheduled blood tests and exam, and I worry that my attempt to save a few dollars now could cost me dearly in the future if minor problems spiral into larger ones, but ironically, as long as people with pre-existing conditions can be denied coverage, spending money on doctor visits and tests to solve problems early on could actually cost more dearly in the future.
I will now turn it over to Whip Clyburn.
Whip Clyburn. Thank you very much, Ms. Moldofsky. A few months ago, I participated in a radio call down in South Carolina. A gentleman called in and said he liked his insurance, and he didn't want us to change the system. The next caller was a woman who said that she had recently been diagnosed with breast cancer, and for me she crystallized what this debate is all about. She said: “I thought I liked my insurance too, until I tried to use it.” And she went on to talk about receiving an awful letter cancelling her coverage at her second treatment. People like that woman in South Carolina and Kim who are struggling with serious illnesses suffer in the current unfair practices of insurance companies.
It is time to bring an end to discrimination based on pre-existing conditions. It is time to bring an end to rescissions or dropping coverage when a person gets a catastrophic illness. And it is time to bring an attend to the fear that many Americans have that if they lose their job, or they change jobs, they cannot get health coverage. It is time to do what generations before us could not accomplish. It is time to pass health insurance reform.
Stella Johnson. Good afternoon. My name is Stella Johnson, and I am a retired school teacher for Washington, D.C. I am also a member of the Alliance for Retired Americans. Like many seniors, I must take prescriptions every day to manage my high blood pressure and high cholesterol. But unfortunately, along with over 3 million other seniors, I am in what is known as the Medicare “donut hole.”
For several months of the year, I have to pay full price for my prescriptions, even though I am still paying my Medicare premiums. In other words, I pay the money but get nothing in return. For an example, in 2008, I received a letter from my insurance company stating that I would not receive any money for my medicine during the month of December. No you know how that is, that is supposed to be a very joyful month. However, I found myself, during that time, quite desperate for I would not receive any money until the new year for my insurance began. I had to use my utility bill money in order to buy my medicine. And then, in order to catch up these bills, I had to even go to borrow money from my food money. I became quite desperate, and I didn't know what to do. Because in times like this, it is very hard for me to make ends meet. I have to chose between taking the medicines I need and paying my monthly bills. Because my prescription costs so much, I fall behind on some of these bills. When I get hit with late penalties, things even get worse.
The health care bill will help seniors like me, who struggle every day to afford the prescriptions they must have. Retirees all across the country desperately need this bill to pass right away.
Thank you. Now I would like to turn it over to Chairman Larson.
Chairman Larson. Thank you. Stella said it eloquently, as have all of our guests this afternoon. All of our guests this afternoon understand that this very important vote before us is, in so many respects: whose side are you on? And the vote this week will demonstrate clearly which side Democrats are on in the United States Congress. We hope that our colleagues on the other side, when hearing the same compelling stories that we know all of their districts hear, will join us.
Stella points out very clearly, what happens to those who find themselves in the dreaded “donut hole.” We are going to end that process, beginning to correct it and solving it completely. We are going to extend solvency of Medicare--a program that this great party of ours is so proud of. We will not privatize Social Security or voucher Medicare. We are going to continue to make it solvent. We are going to improve the quality of senior care, with better coordination amongst doctors, coordinated care--I just left a group of hospitals--is the most important thing with the innovation and science that we have is our ability to make sure that they don't experience the senior shuffle, that they actually get the care and attention in the coordinated manner that they need, that they won't have to any longer co-pay, or pay for a very simple preventive procedures, whether they be a physical check-up or important screenings that the elderly need. And expand home and community-based services to keep seniors in their homes, instead of nursing homes.
And that's why we're so proud of this legislation. The Speaker spoke at Yale with Rosa DeLauro about two weeks ago -- about the importance and significance and the impact of this legislation on women. And we're going to hear from Carolyn Comeau who will further explain that.
Carolyn Comeau. Thank you. I'm Carolyn Comeau. I live in Ashville, North Carolina. I was diagnosed with breast cancer three years ago at age 45. I got the diagnosis call as my husband was on an important job interview for a position that would allow us to have good, high-quality benefits. Thank heaven he got those benefits in that job. However, seven months later, he was laid off. He works in the construction industry, which was hard hit in our state -- and laid off in the middle of my treatment. We had no choice but to get -- then get benefits through COBRA and that was $1,058 a month for 18 months. We looked to the individual market for private-insurance, we did not qualify for Medicaid, and had a disastrous meeting with a representative from a company who quoted us $2,000-plus a month for me only. You feel, in a sense, tainted. Being a woman should not be a pre-existing condition.
It's hard to describe the stress of going through a catastrophic illness and the side-effects of the treatment that you receive and worrying about the insurance mess at the same time and how you are going to make it through as a family. The light on the horizon that we thought we had was the North Carolina high-risk pool. I currently pay into that $400 a month. I have a $5,000 deductible. However, my oncologist's office does -- is not a member, is not affiliated with that program. And the latest update is that I just got word that there is an exclusionary policy with the high-risk pool for the genetic testing that my doctors want me to have, which would possibly impact my treatment and my future course as well as the futures of my children.
And the final highlight is that recently my husband and I did our taxes. And as we sat down and saw everything in black and white, we saw that very nearly half our income went to health-related costs. And that is just for me. My children are on the North Carolina CHIP program and my husband is uninsured.
So, the bottom line is -- the reality: if you're healthy, you get insurance. If you get sick, there's no option -- you then have a pre-existing condition, there is no place to turn. Insurance should help everyone, including those who need it. There's no real option in a private market for people with pre-existing conditions. So I urge and urge strongly that Congress make the humane choice for our country and pass this health care reform bill. Plain and simple: It's a broken system and it continues to leave a trail of families whose finances have been decimated by the system.
I'll turn it over to Speaker Pelosi.
Speaker Pelosi. Mr. Hoyer has to go away on business. Thank you very much Carolyn for sharing your personal story with us. Thank you, Ed Morris. Thank you, Kim Moldofsky. Thank you, Stella Johnson -- for your eloquence in speaking for many people in our country.
We talk about reduction of the deficit -- putting money in the bank. There are many stories, millions of stories in the story bank that talk about how people have been denied coverage, had coverage cancelled, had coverage rescinded, when they're practically in the gurney on the way into the operating room.
Well, Carolyn was speaking about women. I want to say something about that as well, and what this legislation is about. In the beginning of her remarks, she said to the effect that being a woman is a pre-existing condition. I will go further than that and just say: if you're of child-bearing age and you've had children as I did, I had five children in six years, they told me I was a poor risk -- I thought I was showing my strength -- off the policy. [Laughter.] If you can't have children, you have a pre-existing condition. If you have a C-section, you have a pre-existing condition. If you are a victim of domestic abuse, you have a pre-existing condition.
This legislation ends that. And it ends discrimination based on gender as well as pre-existing conditions. Women are charged now, nearly 50 percent more than men, for the same coverage. With reform in place, it will be illegal for insurance companies to use gender ratings. No one will denied coverage or charge higher premiums because of a pre-existing condition and that includes having a c-section or being a victim of domestic violence.
This legislation ensures the coverage, treatment, and care women need, ensures that that is affordable and accessible. Fewer than half of women can obtain affordable insurance through a job. Fewer than half of women can obtain affordable coverage--insurance through a job. More than half of women report delaying needed care due to high-cost, compared with 39 percent of men. This eliminates co-pays and deductibles in many cases for recommended preventive services. And that's an important part of this.
So, here we are. We believe that the best initiative that we can take to reduce the deficit, is to pass health care reform. The best initiative that we can take to strengthen Medicare and improve care and benefits for our seniors, closing the donut hole, is to pass health care reform. We believe that the best initiative we can take to create jobs, strengthen our economy security, is health care reform. The best initiative we can take to keep America competitive, to have our economy energized by people following their aspirations, taking risk, being entrepreneurial, but not hampered, by not having health insurance, is to pass health care reform.
For the health and well-being of American people, for the fiscal soundness of America's budget, for seniors, for our young people, for women, for small businesses, for competitiveness -- we will make history and we will progress by passing this legislation.
We'll be pleased to take any questions you may have.
Q: Madam Speaker, you have the largest Democratic majority in more than a generation. Why are you having such a hard time getting 216 votes? And if this is to show -- this vote's going to show whose side you're on, whose side are the Democrats who are voting “no?” Whose side are they on?
Speaker Pelosi. Well, let me say this. First of all, as I've said to you before, every vote around here is a heavy lift. How many times have you come -- whether it was the budget, whether it was energy -- whatever it is. Every vote is a heavy lift. We have great diversity in our Caucus. We don't have a rubber-stamp Congress or a rubber-stamp Caucus. So, we have our full airing of issues. Members want to see the figures, they want to see what the Senate will do. We like the dynamic in our Caucus.
But it does show also -- the second part. It also does show the impact of a campaign of misrepresentation, of fear, that is going out there. There is no limit to what the other side will do to protect the insurance companies. And that is what came out, I think, at the President's summit, when he said that -- he came out and said that: “The difference is -- you're for regulating the insurance companies, or you're for protecting the insurance companies.” We're for regulating them.
Q: Madam Speaker, it's over $900 billion. Could you tell us off the top of your head how this is going to be paid for--is this a surtax on the wealthy? Cadillac tax?
Speaker Pelosi. Well that will be up...
Q: …table tax? How's it going to be paid for? A few bullet points on that.
Speaker Pelosi. Well, what I want you to do is to go to the Web site in about an hour or so. Later today the report will be complete from the CBO -- an analysis of it -- and we will put it up on the Web site.
But, basically, most of the legislation, the biggest one -- one biggest covering of the cost comes from cutting waste, fraud, and abuse -- largely in Medicare. Over $500 billion comes from that.
The remainder of the money comes from a number of things. One of the victories that we have in the House is that our Members did not like the excise tax on insurance plans. We thought it hurt the middle-class. There was a debate about that. So the higher end of that is left in the plan. I call it the platinum Rolls-Royce piece of it. The rest will be covered by a Medicare fee on unearned income. Medicare fee on unearned income. A Medicare fee on unearned income -- whatever category that is.
The third piece of it is that there will be -- well, it's not a pay-for, it's about coverage. You'll have to look there, but that's the main thrust. Cut mainly from Medicare -- waste, fraud, and abuse. No cuts in benefits. No increase in premiums. Just cut -- waste, fraud, and abuse. This is essential in order to strengthen Medicare and in this legislation we will make it solvent for nine more years.
There's some other pieces to it that will be in there, but the main piece is the Medicare fee -- it's health for health. In our bill we had a surcharge at the high end. This is a health fee on unearned income. And some other features in there as well, but they're the two main ones.
Q: Madam Speaker, we've heard many times that one of the things that's most important to House Democrats was removing special interest that were in the Senate bill…
Speaker Pelosi. We do.
Q: …So did you remove, aside from the Nebraska issue, did you remove the money for Connecticut hospitals and did you remove extra money for some [inaudible]? Was everything removed altogether?
Speaker Pelosi. No. You will see. Okay, let me talk about what the bill is. Largely the difference between the House and Senate bills that have been corrected are the following:
We did not believe that the Senate bill had enough on affordability. So there's more affordability for the middle-class in the reconciliation package that we'll pass.
Secondly, we did not--we did not like the state inequities. It's a category. And this bill corrects the state inequities by making the Medicare--excuse me--Medicaid reimbursements more fair to all of the states. That also includes rewarding do-gooder states who had been out there before in advance of this bill, making changes to reward them for that.
The third in that Medicaid piece is funding for primary-care doctors who handle Medicaid cases. So that we're not adding more people to Medicaid without adding the opportunity for more doctors to provide services.
The next piece of it was to close to the donut hole. We talked about some of these things by way of our guests here today, but to close the donut hole. For those who are not seniors, as I am a senior, the donut hole was very important issue to us. And what it is is an undue burden on seniors in terms of their prescription drugs and Stella Johnson spoke eloquently to that. Thank you, Stella.
Another feature of this is that we did not think that the Senate bill went far enough in the insurance reforms. And that is something that we do in the bill.
So in terms of the affordability for the middle class, the reforms, accountability for the insurance companies, the access to many more people that we talked about in the equity for the states, changing the excise tax, which was, a main feature, a complaint, among many of our Members, to a different pay-for. Those are the major changes in the bill.
Q: But are the special deals still there?
Speaker Pelosi. Well, it's not a question of special deals. Whatever is in there can be subjected to many people competing for it -- they're capped--there's a comfort level with why they are in the legislation. We thought that Nebraska was indeed a special deal.
Q: On the second ten years, the CBO tends to be a little more cautious in calling the rough outlook. Are you comfortable with saying the $1.2 trillion is the savings or is the…
Speaker Pelosi. Yes. Yes. And let me say this. As you well know, the CBO is usually very conservative in its estimates. They gave us no credit for prevention, which we know will result in saving. In wellness initiatives and initiatives of that kind, which will make people healthier. They don't give us really any credit for earlier intervention so many more people can be attended to before their cost and more important than that, their situation--the health worsens.
So, we don't get any credit for some of the upside that we know is there. And I'm going to yield to Mr. Larson because he's going to talk about health IT and the savings that that will have as well.
Chairman Larson. Well, you know, if you look at any report that has come out recently -- whether it is the RAND Corporation or whether it's Reuters. Reuters predicted, back earlier this year, $700 billion annually that's available to us. In the RAND Report they said, just in health information IT, conservatively they guessed that there's around $500-$700 billion worth of savings that can be accrued here.
Part of the things that we discussed in the rollout today, was looking at hospitals and the ability of us to coordinate care. And by that, we mean everything from interoperability, to making sure that these cases are followed in a systematic manner with the most up to date technology. That's where the huge savings are going to be across the board and well into the future. And I dare say I think those are conservative estimates.
Q: Madam Speaker, Congressman Lynch, one of your whips, just came out and spoke [inaudible].
Speaker Pelosi. I'm sorry. I didn't hear what he said.
Q: Well, he said that it is disingenuous and he said that it really hurts the credibility of the House. This is one of your Whips. Do you have any response to that?
Speaker Pelosi. Well, I haven't heard that--you're telling me that but the fact is that what we're talking about here is the regular order that has been used hundreds of times in the House and it's really a non-issue. But, again, the poisoning of the well that you see is, again, the lengths to which the other side -- the insurance companies will go -- they will do anything to stop this legislation. And they have made such a fortune off of the misfortune of the American people. We have played on their turf for decades without even a -- being subjected to the anti-trust laws. And now they will be playing on the turf of the American people.
So what the American people should know is that this is what they're going to see -- a full menu of in the next few days -- misrepresentations, mischaracterizations--because, again, they are poisoning the well before Members even have a chance to see. There was no decision made about how we would proceed. We talked about various options. The options, the decision would spring from what the CBO report told us. And we--the urgency is even greater now for us because we know the opportunity it greater.
I'm pleased to yield.
Chairman Larson. Perhaps Mr. Lynch was referring to the more than 99 times that Mr. Gingrich used the process or the more than 106 times that Denny Hastert used it. But you know what our Members are concerned about? They're concerned about what our guests are, they're concerned about the process, which finds their policies being rescinded. They're concerned about the process that finds their policies cancelled because of pre-existing conditions. Stories that -- lying on a gurney heading into the hospital -- you have your policy revoked. That's what our Members are responding to and that's what Americans are responding to all across the country and why this is so important.
Speaker Pelosi. We feel very strong about where we are in terms of how we proceed. The CBO report that we have, that, again, speaks so eloquently. I love numbers, they are so precise. Speaks so eloquently to the savings that are there for the American people and our guests here today have spoken to eloquently to the needs that they have and have reflected the concerns that are shared around the kitchen table, the dining room table, of families across America.
So, we're going to go forward, share these numbers more fully with our colleagues as soon as we get just a few more charts, and then--and you will see it on the Internet shortly and get all of that. Then we'll meet again to see what other further questions you have. But in terms of our responsibility to the American people, to the taxpayer, to future generations, to making America not only have better health care, but to be healthier.
We are grateful to our chairmen. We are grateful to the President of the United States for getting us to this historic place, which will sit comfortably with Social Security and Medicare -- health care for all Americans as great progress. And the President has said, “We will measure our success by the progress being made by the American people.”
This is history and this is progress. Go to the Internet. We'll meet again soon.
Thank you all very much.