Date: 2010-03-21
Speaker: LINDA T. SANCHEZ (democrat)
Chamber: H
State: California

Mr. Speaker. whether all Americans should have access to quality health care at a reasonable price is a question a century old. First raised by Teddy Roosevelt in 1912. then repeated by FDR. Harry Truman. and later presidents. the question almost answers itself. No nation can be strong whose citizens are sick and poor. To improve our economy. to care for our people. to fix our expensive and broken healthcare system. the time is now. Truman argued that the principal reason why people could not receive the care they needed in 1946 was that they could not afford to pay for it. At the time. the cost of health care accounted for 4 percent of the nations income. Today. the reason people dont receive care most likely remains its unaffordability. but the aggregate cost of health care has since risen to 16 percent of the nations income. Having grown up in a working family of seven kids. I know how important health insurance is. My parents couldnt predict which of us might break a leg. need our tonsils out. or worse. but they could predict that without insurance. they couldnt pay to get us the care we needed. There is no reason that hard working Americans should be priced out of needed healthcare. Without doubt. this is not a perfect bill. It does not contain strong employer responsibility provisions or a public plan to provide real competition to private insurers. It cuts DSH payments for hospitals too much. It benefits states that have left some of their poorest citizens out of Medicaid without rewarding states like California that have been doing the right thing all along. It contains an Independent Payment Advisory Board. which would severely limit Congressional oversight of the Medicare program and place authority within the executive branch. without Congressional oversight. judicial review. or state or community input. It also does something no bill has ever done beforeprohibits undocumented immigrants from spending their own money to buy private health insurance within an insurance exchange or marketplace. But the bills strengththat it makes health insurance accessible and affordable for more than 30 million Americans who currently lack insuranceis so much more important than its weaknesses. After fifteen months of hearings. meetings. debates. and ideas. the time has come for Congress to act to make healthcare better for all Americans. I take this vote after much thought and consideration. not for any politician. but for my constituents who are anxious about whether they will be able to afford care for themselves and their children when they need it. For a nation as wealthy as America to have tens of millions of people without health insurance is shameful. Even those who have insurance fear losing their jobs. and with it their insurance. Some are concerned that they will reach their annual or lifetime caps on coverage. Others are anxious that their insurance companies will simply drop them as soon as they get sick. This bill. which my constituents have told me this Nation desperately needs. will address a number of shortcomings in our current system. In our current system. those who have insurance pay more to subsidize care for those who dont have insurance. This bill changes that by requiring everyone to have basic health coverage. Everyone has a stake in improving public health. Currently. the uninsured dont get preventive care. and once theyre sick. they wind up in the most expensive place to get treatmentthe emergency room. The large number of uninsured distorts our system. acting as a hidden tax on the insured. This bill repeals that hidden tax. In our current system. those with preexisting conditions are discriminated against. No child asks to be born with muscular dystrophy. juvenile diabetes. asthma. or Down Syndrome. Yet current law allows insurance companies to deny or limit their coverage. This bill fixes that injustice. protecting our children. and ensuring they can access coverage for life. In our current system. some women pay twice as much as men for insurance simply because they are women. This bill will change that so insurance companies will treat all people equally. In our current system. Americans who work just as long and just as hard as their fellow citizens often lack insurance simply because they work for a small company instead of a large one. This bill addresses that too. by creating generous tax credits to small businesses to make insurance more affordable. and by creating affordability credits to help selfemployed folks buy insurance at an affordable price in an insurance marketplace. In our current system. healthcare costs are skyrocketing out of control. This bill will help rein in costs by paying doctors for quality. not quantity. and actually reduces the budget deficit. making our Nation more fiscally stable. Oh. and one more thing. in our current system. millions of Americans like their doctors and insurance companies. This bill allows you to keep them. Millions of Americans will see no change in this bill except for the added peace of mind that occurs when you are no longer at the mercy of an insurance company that can drop or deny coverage at the drop of a hat. And I havent even mentioned the improvements to Medicare: closing the donut hole. eliminating copayments on preventive tests. and reducing fraud and waste to extend the life of the Medicare Trust Fund. Yes. anyone who looks at this bill can find something wrong with it. But I cant remember the last time I voted on a perfect bill here in Congress. Just about every bill can be improved in one way or another. On balance. this bill does what I came to Washington to do: to give a voice to average working people. whose voices are too often drowned out by the voices of moneyed interests. Because I believe this bill would make America a stronger. more stable. healthier. fairer. and more just Nation. I vote yes.