Repeal the health care law. This one was in San Francisco. This is 90 minutes. Rep. Pelosi we gather here to save our health care. People are gathering all over the country, and democratic districts, under the leadership of democratic members and republican districts, with outside mobilization weighing in. A day of action to preserve our care. This is absolutely essential, because this is again, and is absolutely essential, because this is again, and assault on one of the most important rights, the right to good health. Reverend Martin Luther king said, of all the forms of inequality, the injustice in health care is one of the most inhuman. Inhuman. We know that. Inequality, the injustice in health care is one of the most we know that, and we will talk more about that. We know this is a very important value to our country, to be respectful of meeting the needs of the American People. We will talk in the course of the morning on the republican plan and how that is really so out of the question. We want to see them come up with something thats not diminished what our goals were in the Affordable Care act. Those goals were to expand many people as possible in our country, to improve benefits for everyone, and to lower the cost. So its not just about the 20 Million People. Million, its 20 400,000 people today you have Health Insurance who would not have had it before. Its also about the 155 Million People who get their benefits through the workplace, and extended benefits that they noe, whether its preexisting condition being a barrier to insurance, whether its no lifetime or annual limits on the coverage they receive, whether its their children being able to stay on their policy until 26 years old, woman is no being a longer a preexisting medical condition. [applause] however, its interesting that Health Insurance companies spend 80 of the money theycondition. [applause] receive on the health care of their policyholders and not on advertising and ceo pay. In terms of Community Health centers, and essential part of all of this. It would be overturned the repeal of the Affordable Care act. The new number i want you all to 27 . With you and use is at this conference yesterday, families usa in washington, i heard a doctor make this presentation. 27 of people under the age of will be uninsurable because they have preexisting medical conditions. Costs will be so astronomical that it wont be able to happen. Thats not what our country is about. Flat out, i say, republicans want to make america sick again. And we will not let that happen. So what can we do about it . Everybody sees the urgency. Many of you want to take responsibility as you see that urgency. We have this opportunity to have people take another look at the Affordable Care act, to dispel what they have heard, the misrepresentations they have heard before. To that end, im very honored guests tove 2 special talk about from their experience. The secretary is the California Health and human services, secretary appointed by governor jerry brown. She served governor jerry brown in his first terms and has been involved in the private sector, the nonprofit sector. She knows the health issue from every angle. Subject,speaks on the everyone listens. She is an expert, and california has led the way covered california has led the way in being an example to the country. Thank you, secretary dooley, for being with us. [applause] before i bring her up, i want you to know who else is with us. Dr. Susan ehrlich is the ceo of the zuckerman San Francisco general hospital. On so many occasions, she has hosted us there for us to make presentations, hear stories, and the rest. She is on the front line of providing health care in our community. She has been a tremendous leader. Her background serves us all well. Were all here, again, to make sure that health care is viewed as a right for all americans, not just for the privileged few. Dr. Ehrlich has dedicated her life to that. Dooleyring up secretary with our respects to governor brown, who appointed her in the years, and now all these later, her experience is vast, longterm, and we are delighted to have her with us today. Secretary dooley. [applause] sec. Dooley thank you. We are also lucky to have leader policy. For her entire career, but never more than now. Thank you so much. [applause] i do feel very humbled to be with you today at this really important time, through the leadership of the pc people of california, we have been at the forefront of making the Affordable Care act real for californians, and showing the rest of the country what can happen when we put aside partisan differences. California has understood for many years that we have challenges in the Delivery System and while the coverage expansion has been the primary ,ocus of the work we have done and im certainly proud of the work covered california has done, to add nearly 1 million and a half people to coverage who would not have had this, but also to our medicaid asked tension, were almost 4 Million People who cannot get coverage before are now covered across california. This has happened because we have worked very hard for many to do this, and it was enacted in california with the leadership of the congress, but with a republican governor, and we locked arms and we made it work in california with people like dr. Ehrlich and our hospitals in our communities with our county eligibility rkers, and our community clinics. The way we have changed health care in california is really nothing short of miraculous. The Brookings Institute just last week did a survey of the states that had embraced to some degree the Affordable Care act, and said california was leading the nation. Dont get me wrong, i do not have a Mission Accomplished sign above us here. There is a lot of work to do, and we all know there are access withems and challenges relationships between primary care and Specialty Care and hospital care and outpatient care. And i think what the obamacare and the rhetoric around this problems into health care that it not have anything to do with the Affordable Care act. The Affordable Care act is to address those problems and solve those problems. And we have. We have done it in so many ways. In the employersponsored care, the premium cost is lower than it has been in 15 years. Ae trend before the aca was. 5 premium increases. Since the Affordable Care act, those him him increases have held at 4. 5 over the same period. 7 have had an average of increases, even in the covered california exchange, and the last it was under 5 , until our oneyear blip this year. We are changing the way health care is delivered, we are improving the efficiency and the quality, the transparency. We have essential benefits across all of the products that people can understand. Believe me, its hard to bite with understanding how to get the care we need, and we have more work to do. But we certainly cant go backwards as the repeal, and even the replace language. Right now to just keep my people running the programs that they have, because if we get distracted, analyzing every tweet and every possibility that is out there, you are completely irreconcilable. If you feel confused when you read the news every day, its for good reason. You cant reconcile what they say about wanting to have better care and lower cost and more health. That is what the Affordable Care act is. It is sort of sad that the people who are getting it right we the comedians, who say have that. Its called the Affordable Care act in this country. In the six years i have spent making it work, believe me, this is a team sport. ; it has involved a lot of people across a lot of sectors in this. Not the mostis radical plan that alive democrats wanted. Many democrats wanted. Many of us are were singlepayer advocates, and many of us still are. But we have a plan that is theing, and we cant let perfect be the enemy of the good. This plan was romney care in massachusetts as fortunate your care and schwarzenegger care in california. The iron the having it be opposed by the people who of havingt irony it be opposed by the people who designed it is beyond me. My job is to follow the law. Land, it isw of the working in california, and it will continue to work if people all across this country and national day of action will get through the rhetoric to the reality, because what israel is people are getting what is real is people are getting the care that people have talked about wanting great if they can make it better, i will be there every day to make it better. But what i have seen so far will not make it better, and we need the kind of action that you represent here and across this country. I was born and raised in the San Joaquin Valley of california. I know how disadvantaged communities live and work. I had no Health Insurance myself until i had a job after college. The Central Valley of california has benefited perhaps more than any other region of california, and yet we have elected leaders in that part of our state that arent acknowledging the benefits to their people. We need to help our friends and colleagues and neighbors across the state and across this thetry understand what Affordable Care act really is, not what it has been represented to be. I cannotr pelosi, thank you enough, and i am here to your partner to do everything we can to keep to be a partner to do everything we can to keep making it work. [applause] thank you, madam secretary. Thank you for your leadership and your history. One important thing to remember about the Affordable Care act, medicare, medicaid, and the Affordable Care act are wedded. In the Affordable Care act we prolong the life of medicare, closing beyond closing the doughnut hole of the cost of prescription drugs. The whole bill is about prevention and wellness straight its about a healthy america, not Just Health Care in america. But wellness. And the medicaid piece of that is very central. Thoughtdicated medicated to be for poor children and their families and a large portion of the beneficiaries are children, a much smaller percentage of the money is spent on children. 50 of the funds spent in on seniors in Nursing Homes comes from medicaid. Comes from medicaid. And, a lot of the long term care, whether its in a nursing home or day care for seniors, etc. , comes from medicaid. The governor of ohio, republican john kasich, he said thank god for medicaid. That is going to help me fight the opioid epidemic. Addiction, opioids, and the rest of that. We do have some republican governors who are helping us who have expanded medicaid in their states, are helping us to protect medicaid. Because they are really out to get medicaid with a tax, with block granting, and the rest. And they are out to get medicare. They have a provision in their budget to voucherize medicare, remove the guaranty of medicare. Edicare is a guaranty remove the guarantee, you have something else. I think the California Alliance for retired americans for going to the republican district to make these points as well. Thank you for that. [applause] its now my pleasure to bring up dr. Ehrlich, and to say one word about her and the work she does. Its about respect. Its about respect for the sees, its about treating them as if they are the most privileged person in america. And you know what, her care for those people makes the privileged person in america healthier because including everyone in the loop, we learn so much. We care so much. It teaches us a lot about how to keep people healthy. Thats what they do. Zuckerberg San Francisco general, thank you, dr. Ehrlich, for your leadership. Thank you, leader pelosi. Leadershipiate your on this critical issue. Everybody. G, im susan ehrlich, ceo of zuckerberg San Francisco general hospital. Im so privileged to work with 5500 people every everybody. Day who work for the department of Public Health and the university of california San Francisco to take care of the more than 100,000 patients that we see every year at zuckerberg San Francisco general. Im honored to address this issue of critical concern to everyone, especially our organization. What happens to our patients and our Public Hospital if the Affordable Care act is repealed . We all know theres a lot of uncertainty right now. We dont know what the outcome will be, but we know there will be change. Leadera dooley and pelosi said, the benefits of the aca have been felt by our nation, state, entire community in San Francisco. In california the expansion of medicaid under the Affordable Care act has created a pathway for an additional 4 million californias lowest income residents to have access to Health Insurance. 4 Million People. Here in San Francisco, an additional 95,000 people have been enrolled in medicaid since the passage of the Affordable Care act. [applause] that brings the total membership to 200,000 people. Meaning that here, 1 4 of San Francisco and sock covered by the medical program. That brings the total membership to1 4 of our citizens straight e are a healthier city as a result. Fewer san franciscans are delaying needed care, now that they can have a primary care doctor, like me. Access to Preventative Care and San Franciscos highquality providers and hospitals. More san franciscans now rate their health care as good or better. We made such great progress, and that is why we are so concerned about this effort to repeal. What are the effects of repeal for our patients . The urban institute and Robert Wood JohnsonFoundation Report the number of uninsured people in the u. S. Would rise by 24 million. 2021, an increase of 81 . There would be 14 1 3 million fewer people with medicaid coverage in that same year. These people, newly frozen out of the comprehensive benefits they have today, would unnecessarily get sicker, they would not go to seek medical care until they are truly ill. They would find medical attention through our emergency department, which is already full and requires more wait time, less effective for chronic conditions, less efficient, and costlier. Why would we want to do this . No congressional proposals to replace the aca will improve our Health Care System if they threaten to have our most vulnerable citizens revert to going without insurance, and doing without routine care to pay for food, housing, and other basic needs. That is an unfair and undue burden for our patients. Aca will also put a strain on all hospitals and particularly, our Public Safety net throughout the country and in california. Tsudies that hospitals could face a net negative impact of 165. 8 billion dollars. The scale of this loss would and inny hospitals, particular, make in particular, make many Public Safety net hospitals like ours unsustainable. The losses would mean cutting services, and in particular, make in particular, make many Public Safety net shortening hours, and ultimately, seeing fewer patients. Americas essential hospitals, the organization that represents hospitals throughout the country, says the loss of the aca coverage would result in costs, 154. 2 care billion dollars over a 10year period. Bese losses are going to devastating to all hospitals, all Public Hospitals, especially those with fewer resources or local investment in care, like those in the Central Valley or southern part of the state. Thing that is really clear is that at zuckerberg San Francisco general, our mission has not changed. Our mission is to provide our patients and our Community Health care with compassion and respect, regardless of income or insurance, or immigration status. Religion, oration, national origin. And that is our enduring commitment, keep those services going. Thank you. [applause] californiaour successful experience here. Yesterday and leading up to the day of action and the events happening across the country, many of them in the bay califora successful experience here. Area, Mike Thompson and Jared Huffman are having a combined event in their areas. Yesterday we were on the phone with some of the members are having events across the country, and many from early areas. What dr. Ehrlich said about this hospital, especially in these , they ares unsustainable without this legislation. And how that relates to the economy of the region, because people want to attract new investment in their communities, in rural areas. Governor mcauliffe said to me, that she could not get Medicaid Expansion because theres a republican legislature. Insaid, i tell these people these areas, i want to bring the jobs i am bringing to virginia to your area. They are not going to an area that doesnt have a functional hospital. These rural areas suffer economically. Our members from rural areas spoke to that yesterday on the phone. So, many of you have said, what is it that we can do . For being here. But you have to talk to your friends in republican districts to tell them to call their member of congress. The stories are the most persuasive, the most persuasive. I want you to hear the stories of what a difference the Affordable Care act has made in the lives of some of our guests. Hes a medical, medicaid and troy, willient you share your story with us, please . [applause] excuse me, guys. Representative, thank you so much great thank you so much for doing this and making this happen for everyone. Im a little nervous, excuse me. Patient. All, i am a thank you for everything you guys are doing at zuckerberg general hospital. [applause] this is a little weird, i want to make sure you can hear me. I am 51 years old, i am hivpositive for the last 23 years. Ive had fullblown aids for the 17 of those years. I am a representative of the aarp today. I want to make sure we are all on the same page, Going Forward and getting the things done that we want. Thank you also much for being here today. That being said, at one point in time, i never thought i would be standing on stage, when i went into the hospital. I had pneumonia and a week later i went into a coma. I spent about three and a half months into the hospital, it to me about one year to recover and get all of my functions back, i had to learn how to write and walk again. I had to learn how to be busy again. They got me volunteering around the city. I then developed i have had issues with my back, i found out i have deterioration of the bone. That was due to the medication they had too keep me breathing. I had to have my hips replaced. Then i had a second, third, fourth, and fifth. It has been an interesting journey, trust me. I have had my knee replaced, both shoulders, i have had to neck surgeries. It has been an extremely exhausting journey. I have made it through that. Because of these agencies that have been able to give us this needed support, i have been able to take care of these bills. It works. Here i am today, standing here. [applause] it has been a long journey, it really has. I have been through it. I also want to say that i am here to support the aca. I want to make sure we can support everything that is needed also, one in four Medicare Beneficiaries has an income below 14000. That stops them from paying their bills and taking their medication to survive. It is going to be very difficult for that to happen. This proposal goes directly against President Trump stated, to protect medicaid, to protect medicare, and everything there too. Thank you. [applause] rep. Pelosi when he talks about what they want to do to cut back on medicaid and medical here in california, remember that enable them to get a tax cut to the 400 wealthiest families in america. They would get a tax cut of 7 million. A year. That is in their dna, tax cuts for the rich, wherever the money has to come from. That is not what our country is about. Thank you, troy, for sharing your story. [applause] now we are going to hear from stephen, a aca recipient. [applause] hi my aca story is a little bit different than what you may think of when you hear the Affordable Care act. You may think about the implication of losing coverage and what it would do to your physical health. The aca has played a different role in my life. I am here to tell you about Mental Health and addiction. 12117 was my sober anniversary, something i didnt think that was possible but due to the Affordable Care act it was. At 23 i was unemployed and was having a relapse of alcohol on new years eve. I felt so desperate that i was at the point of killing myself. I decided i was going to try my hardest to get sober one last time. Because of the aca i was still covered by my parents insurance. Before that i would not have been. I could afford a copayment on treatment. As well as multiple psychiatric sessions. My doctor was ready to dismiss me, and said i was able to stay as long as i could. It did, i was in treatment for a total of 73 days and i have been sober since 2010. [applause] during my seven years of sobriety, i have been Program Director of a nonprofit, my masters of social work, worked serving minority communities, serving clients with hiv aids. As well as working at a nonprofit that has worked with youth departments. We helped organize the womens march in San Francisco. Now, i feel politics is where i can have my voice heard more strongly. [applause] so if anyone in this room has a tip how to make the transition, i would love to talk to you. [applause] [laughter] basically 73 days of care have translated into seven years of being a productive member of society. The aca is also meaningful because my uncle helped write it. He was president of the American Medical Association when it passed he sent me an email last night saying he remembers working with him fondly. Today, i am speaking about his legacy and the legacy of the Obama Administration to fight for me and for everyone. [applause] rep. Pelosi thank you very much. This issue of addiction and alcoholism is a very much a part of when we passed the Mental Health parity bill. To be treated with health issues. On the drug side, not as a criminal justice issue. [applause] in her case we had a meeting of 100 representatives of different groups a few weeks ago. When we talked about Mental Health and when we talked about our veterans, the bullet disabilities, we came together in a way that is not just about the aca it is about the Mental Health parity act. It is about Social Security, it is about medicare and medicaid. The connection of all of that, that our veterans are very much a part of. I thought it was an unwise decision to have been in some of those military actions. [applause] as i said too many of the women who marched, it did not dampen anyones spirits. [applause] i said to them, one of those was to protect our health care. Women have marched for progress and must run for office. [applause] now we have a team, medical and aca recipient. Thank you for your time. [applause] good morning everybody. Thank you, thank you for inviting me to speak. Thank you for your work. I was born in peru. That was 29 years ago when i came here. I come from a family emphasis, i have worked in families for 20 years. I am a mother of two. He is 11 years old, my other is 18. In 2010, my son who was five years old was diagnosed with a severe asthma case. At the same time, i lost my job. As a result of that, my children and i lost our Health Insurance. What i learned was because of his preexisting condition he was not able to get insurance or it would be extremely expensive. I was so worried, i could not sleep at night. I was thinking about the high cost of medication prescriptions for medications. All of that. I was able to get insurance for my family despite his asthma thanks to the Affordable Care act. [applause] thank you my friend who encouraged me to apply. I was giving up. I did it. His extensive medication, they were all taken care of. Seeing my son fighting for his own life has been more tolerable knowing that he at least has Health Insurance. In 2014, i was able to buy insurance for my whole family undercover california. My family is covered under medicaid, william had a project two years ago. It was about who has had the most positive impact on your life. He said president obama. [laughter] [applause] obama saved my life, he said that. Republicans want to repeal this, my son, my family, millions of people will not be able to afford treatment and medication. It will be devastating for the country, i want to thank you for your leadership. Thank you. [applause] rep. Pelosi that, children learning, has been something that happened all of that. That is very much a connection to parents. I will tell the president what you said. That would be president obama. [laughter] [applause] some of you sent in comments and questions that you wanted us to be aware of. You all know dan from our staff. [applause] we will take a few comments and questions. Yes . Hi, nice to meet everybody. I am a constituent, the Affordable Care act saved my life. My husband and i are both over 50 and have preexisting conditions. We are basically uninsurable. We have been turned down even if we could get health care, it would be so expensive we could not afford it. We were thrilled when covered california came into being. We signed up right away. Two years ago, i had an abnormal mammogram. I would not have been able to get one with out the aca. My doctor arranged several mammograms and a needle biopsy. I had a few really long days and then radiology told me i have cancer. I was able to get care, i have written some things down, let me see. There were seven sites of the cancer, it was small, but there were seven. They were growing. If i had to wait even another year, i am not sure what would have happened. Anyway, i had a full health cares plan with the facilities. Costs totaled 250,000, without insurance we wouldve had to declare bankruptcy. We could not afford the medication, but most importantly my cancer was caught in time. The aca saved my life. What can we do to prevent repeal . And thank you. [applause] rep pelosi we will get to that. That goes back to that 27 . 27 of American People under the aca these are people under 65 will be uninsurable if they repeal the Affordable Care act. A mammogram just one year earlier saved her life and improved her health. That is what we should be doing, making people healthier. We will talk in a little bit about people sharing the stories with republican members because they have to to hear and expel all representation and characterization that others have put out. Thank you for your story. We are not going to hear from april. Good morning, everyone. I am here representing the learning program. We bring mobile Health Services to low income preschoolers in the bay area. We have a family to tell the story about how we touched their life. Before i turn the mic over, health care is the foundation of everything. If a child cannot see well in preschool, they do not develop as fully as they could with children that have asthma, they will not develop fast. These are all issues of productivity and being able to live full lives. These will help outcomes for everyone. In terms of what people have went through with the aca, there are incredible stories. I am going to turn it over to carl. [applause] hi, i am a father. Come up here. I want everyone to give miss nancy a round of applause. [applause] she has to come up here while he tells the story. All right. As much as i did not want to her glasses, aprils program came to her school. They were doing basic outreach, they noticed my daughter has astigmatism. The aca helped us with her glasses. They help the color and shape, they were able to give her real comfort and getting her eyes checked. I just want to say i appreciate this program and for miss nancy. I just wanted to stand here and say thank you for everything that is happening. [applause] rep pelosi thank you. Thank you. Thank you for with that association does for so many children. [applause] sasha, is going to tell her story about medicare and medicaid now. [indiscernible] i can live in my home in the community. If the aca is repealed, it would be like the death of me. I am very active, i campaigned with hillary. It would be [applause] rep pelosi thank you so much for your comments and reminding us that there are nearly 400,000 people in california who are looked able to live in their homes with the inhouse live service. This is a part of what we are fighting for. We are trying to live independently and live in our own homes. Thank you. [applause] what i talked about earlier with the funding, there is an important thing to note that it also funds the ability for people to have senior care and daycare. Thank you so much for being with us, i know later this week you are going to talk about the ban and the raids. Now, from california retired lives. I want to thank you for that call out. We represent over one Million People, seniors people with disabilities, we look forward to representing two or 3 million to join us. Considering the alternative that is a good idea. [laughter] really, my question is a question you can already answer. I am pleased to live in california because california [applause] california gives a dam. We were worried about were raising the age for medicare. The only program that allows people to age, if they need to go to assisted living, it allows them to go. There is a way for them to live in dignity. We took people there. We took 1000 people to bakersfield. They had asked for a meeting in mccarthy, they turned up the off the lights and locked the door. We went there to show the people of bakersfield that they need to know this. That a percentage of them are on medicare and medicaid. He wants to voucherizing do block rates. We went up the Central Valley, going all over the state and going to republicans about what they need to do to represent their constituents. [applause] not the 400 richest people. I have no question for you. [laughter] i just want to thank this wonderful hospital that helped, i want to thank planned parenthood for doing a great job. [applause] i am so dam happy that i am on medicare. It has helped me live. We can take back the house then. Just say you know the organization, she wanted you young folks to aspire to join is the California Alliance of retired americans. But you are giving good advice to the question many have asked. What can we do . The most effective use of everyones time is to communicate with constituents in republican districts. Again, i say nothing is more eloquent to a member of congress than the voice of his or her own constituents. They have to hear from their own constituents and organizations in their districts. They have constituents in every single republican district. Rep. Pelosi and their voices must he heard, their stories told. Let me go to a point here. Medicare has made, between Social Security and medicare, seniors have been lifted up out of poverty remarkably. Not everybody and not completely. But it has been in a transformative way. Medicare being so essential to the health and financial security. When medicare was debated in the johnson administration, republicans did not support it, just as i may have a moment between differentiation between party at republicans, some of them eventually voted at the end, but they supported every amendment to block, to block, to block. In the 1990s, they gained control of the house, the congress, and Newt Gingrichs motto was medicare should weather on the vine. Now that is their attitude medicare should wither on the vine. That is their attitude. This time when they take back the congress and in the ryan budget, they put in a provision to take away the guarantee of medicare and to voucherize it. Remove the guarantee, which is to do away with medicare. In terms of the subject, that is a fight that we will make and that the public is with us on. And i have said too many times, president lincoln said public sentiment is everything. With it, you can accomplish almost anything. Without it, almost nothing. And he had some pretty big, heavy lifts to do in his day when he said that it you heard during the Affordable Care act, when republicans were misrepresenting what it was about, they said, government, keep your hands off my medicare. Well, it is a government program. [laughter] rep. Pelosi but now, these same people who opposed the Affordable Care act, have to know that it will undermine its solvency and benefits, but not only that. Coupled with that is the ryan budget, which they all voted for, including i do not know if pence was there at that time, but he was there to vote to privatize Social Security, which is your other point. On the Social Security part, we just have to fight that tooth and nail. We want to improve the benefits of Social Security. We will need your help with all of that, as well. [applause] rep. Pelosi brenda is going to share her story, Mission Neighborhood health center. The Health Centers have been such an important part of all of this. Thank you, leader pelosi, for being a champion for Community Health for so many years. As you know, the Affordable Care act really brought a lot of additional dollars to Community Health centers. And hearing this story today, one of the things it brought was actually dollars so that we could integrate Mental Health services into primary care. Do many Community Health centers were able to add that. [applause] you were a champion for us years ago in being able to extend that funding that was attached to the Affordable Care act, and that is fur to expire that is due to expire this fiscal year. My question to you is, would you be able to expand that funding again for Community Health centers . Rep. Pelosi thank you it yes, we were able to put that into the bill, to put the funding in. That was a big thing. The Community Health centers were a very essential part of what we were doing in the Affordable Care act. If we do not have a health system, or starting from scratch, you could taper the country, carpet the country with Community Health centers, and that would be the first line of defense, and it would be a very positive contribution to the health and wellbeing of the American People. So thank you for what you do. In the Affordable Care act, we did two things, not only increase money for programming, but we put money in for bricks and mortar so that we could have more Community Health centers, more places. We were able to do what we did to bob years ago in two years ago in a bipartisan way because we had some leverage. What they wanted was helpful, not something we wanted, too, but we were able to do that. Big we have good bipartisan support for i think we have good bipartisan support for doing well, we did it. This is a new congress and president , so the leverage is gone, and who knows what whats his name is [laughter] rep. Pelosi and i use this next term loosely, thinking, but it is very important, and there are enough republicans, i think. But public sentiment, they have hear from the Community Health centers in their area. Another blessing of the Affordable Care act is that some of these republicans ignored or did not recognized but would be very much effective if we repealed the afford will care act, but we do need the funding. So thank you for your question. I do not know if there are any other questions that we heard before. Yes, maam . Hi, how are you . Good morning, everybody. My question is, the fight, we know, is on. In less than a month, we have all been assaulted. The next step is going to measure the next four use for all of us in this room and the as a leaders, we are here with you. Were looking to you to tell us the streets and the action on the streets is working. Besides knocking down the stores on the republicans in our districts, what else do we need to prepare ourselves for . On the immigration front, we are being assaulted. Muslims are being assaulted. Our health care is being taken from us. And they do not seem to give a damn. The president is not acting like the president , and we are all looking to you. And i know that is a lot of weight on your shoulders, but we are all looking to you which direction to go in. There is no longer left, no longer right, only survival, and that is the there is no longer left, no longer right, only survival, and that is the mode we are all in. We represent the janitors here in San Francisco, and for us, that health care literally is to live or die. Rep. Pelosi thank you. Thank you very much. Thank you. [applause] rep. Pelosi shall we take a couple questions, and then i will respond . Hi, good morning. I am a psychiatrist, and i have the great honor to be a psychiatrist at haightashbury free clinic. [cheers and applause] which is part of a beautiful nonprofit organization, which includes all the walden house programs, which do so much in this city and throughout california for people who are dealing with Substance Abuse issues, addiction issues, Mental Health issues, formerly incarcerated individuals. And i just wanted to mention the large percentage of our patients who are homeless or who have very severe housing insecurity, as well as a large number of our patients who were previously incarcerated and are in very tenuous situations. I am interested in our patients who have serious Mental Illness as a psychiatrist. I wonder if you can talk about what you for c in terms of parity what you are seeing in terms of parity for Mental Health diagnoses and Substance Abuse diagnoses moving forward . Did you speak specifically to that, please . Rep. Pelosi really appreciate it. Two different questions. I will take them both. Thank you for your question. Here is the thing, you know, what can we do . As you said so clearly, this is it. This is it. They have pushed everything to the limit. There is a sense that we do not even have shared values, and i hate to say it that way. Now i have always granted people there position. I respect you. You are this place on the political spectrum, i am this place. How can we Work Together to get something done for the American People . By the way, as out of a question that this person who occupies the white house on occasion, from one day or another, the question is he is no different from the republicans in congress. There is not anything that he has said or done that they have not done the sooner, whether it is antiimmigrant, antigun safety, a womans right to choose, denial about climate change, lgbt in some cases, he might even be better. God forbid. He has not made his statement about lgbt yet. They make a statement every day. Make sure you understand that when people say to make, how long it is it going to take a republicans in congress to just say we have had it with trump . I say, why would they say that . He is the enabler of everything let me say before i go on with that, perhaps our special guest would not like to be here during this part. [laughter] rep. Pelosi let me move to the second question, and then we can give you your ability to stay or go because of the organization. Ok, on your own time. The Mental Health parity act, which we passed when we had the majority, was very important. We did it in a bipartisan way. Republicans who worked with us said, when they, the republicans, had the majority, they cannot even get a hearing on Mental Health parity, whether it was Mental Health or other manifestations, addiction, alcohol, they cannot get a hearing. Joe patrick kennedy, springing from his own experience, senator kennedy in the senate, the two of them were very instrumental in shaping the bill. I would have done more. Anytime you our comrades in the senate, it is more diminished than where we are, which is really the roughandtumble. Anyway, we carry that over into the Affordable Care act. But more has to be done. It is definitely under siege when they go after the Affordable Care act. When we had the 100 groups, there was a coming together in terms of veterans, people with mental challenges one way or another, people with disabilities, cost of prescription drugs there is a consistency, a connection, there that we have to recognize. Suffice to say that it is important. Let me say this one thing that somebody said the other day, and i thought it was so good. She had alcoholism and her family, and she said my father was in alcoholic in this or that, and it caused great damage to our family. But if they saw my father going into a bar, nobody would say to go arrest him because he is an alcoholic going into a bar. But if another Family Member had his own edition or her own addiction, which might be drug addiction, including opioids, which spring from overuse of prescription drugs, they see people using drugs and want to arrest them. And it is just the complete opposite of what we should be doing. So it is about issues that are in the bill, the health bills, in our authorization bill, but it is also in terms of issues we relate to in the criminal Justice System and the rest. Treatment ondemand, prevention, and the rest, what we are doing would have been the exact opposite if we treat people who use drugs as criminals rather than people with an illness, an addiction. That is part of that thinking. [applause] rep. Pelosi ok, another question, but let me just say, theres nothing that we have seen people say, well, we have a responsibility to find Common Ground where we can cooperate, let as engage, confront, this is part of resistance recess. This recess is a resistance recess. We may not come here in that spirit, but this is carved out, this kind of action. Because they have nothing that i have put forward, and we could go into specifics about the ban and the rest of that if you wish. Hi, nancy. Im robin. I am going to ask a question that was asked by republican senator during watergate. What did the president know, and when did he know it . [laughter] i really am very concerned. It is not health care, it is my Mental Health, many of our Mental Health, about what transpired during the election, campaign, what the connection was to trump and his cronies and the russians. So i think this is something that really needs to look to be looked into. Rep. Pelosi first, let me thank olga at sciu and our friends in the Labor Movement for the actions, and thank you to ashley, as well. As far as the Labor Movement is concerned, nothing less is at stake but collective bargaining, osha, nlrb, National Labor relations board, any of the kinds of things raising minimum wage. Imagine if somebody at the head of the Labor Department did not support raising minimum wage in our country. Let me tell you something, if we did one thing, and that is from the chairman of the San FranciscoLabor Council here, thank you there are a few one things we could do, but if we could just pay people a living wage, a living wage, it would do more to lift up our economy, instead of putting billionaires in office. Sue the epa so many times, in denial about climate. A woman over the department of education who does not believe in public education. These are not people who share our values, plain and simple. But there are a very specific things they have in mind to do, and we have some specific things we would like to see. If you want to grow the economy, trickledown is a proven failed system. Tax breaks to the rich, it trickles down, maybe creates jobs. If it does, good. If it doesnt, so be it. That is the free market. They have their hands in their pockets for every tax break they can get. I do not know what his freemarket about that. Second, the small Child Tax Credit would do more to put money in the pockets of families that need to spend, inject demand into the economy, and the rest. We could use the tax code to help working families in our country become middleclass families and the rest. But if you do not increase the purchasing power and the Consumer Confidence of working families, you are never going to have the growth in the economy except a bigger differential between the rich and the poor in our country, undermining the middle class. There is a lot at stake. Understand this about them, it is in their dna, tax cuts for the rich. My motivation when i wake up in the morning, one in 25 children in america lives in poverty i cannot stand up. They wake up and say that we need more tax cuts for the rich. Two different places. What i love about the house democrats, we have shared values. We are there for working families in our country, and we know that this is a fight. So this is not about i respect the office of the president. I do not know that the current occupant respects the office of the president. I do not know if he does. Ok, so on the subject of what did whats his name know and i do not know that the current occupant respects the office of the president. I do not know if he does. Ok, so on the subject of what did whats his name know and when did he know it [laughter] rep. Pelosi this is a question we have been asking, and maybe this is a good time to say this to you. All of our members in their capacity, whether it is the ways and Means Committee going after show us your tax returns, show us your tax returns. [cheers and applause] rep. Pelosi it is only to abide the law, which is part of how nixon came down. In the law, it says one prison, two people, but it requires one of them, the chairman of the finance committee or the ways and Means Committee in the house can ask the secretary of the treasury for the tax returns of the president. They can ask, and that would be brady and the house or hatch in the senate. Brady is also the chair of the joint tax committee, and that person can do it, but he is the same person. Chair of the joint tax, overly that person would do it. Then it takes a majority of the members of that committee to make the tax returns public. There are only six members on the committee, four republicans, two democrats. So we need just two republicans, and that is one of the actions taking place in the districts of those republicans. Show us the tax returns. Between now and april 15, every week you will see on the floor this week we are out for president s week, but following that, every week you will see that this issue has been worked on for a very long time. There are members making sure this is in front of their constituents. Your member of congress is standing in the way of our seeing his tax returns. Why are they important . Well, because it is tradition and he should do it out of respect for the people who elected him. But it is also important because it is an answer to some of the questions that you asked. This is the president here we have been calling everyday. This takes us to other committees. The ways and Means Committee, show us your returns. Elijah cummings, he has been asking for investigation of comey and what he did on the election. [applause] rep. Pelosi and supposedly that is taking place, but nobody can know or whatever. And the Inspector General supposedly is investigating what comey did. That is a little bit off the subject here, but it still takes us to the question, what do the russians have on president i cannot say those two words in a row on the president . What do they have on him . We want an investigation, an accelerated investigation, of the personal, the financial, and the political connection of trump to the russians. So that is what is happening on that front. On the Intelligence Committee, i think you have seen adam schiff of california, who has been magnificent, putting the questions out there in the committee. They are in a little better place now to investigate the russian connection. There is a member of the Intelligence Committee who is from our region, who has a future forum of millennials, listening to their concerns, but he has a bill calling for an outside, independent commission to investigate all of them. 100 of the democrats signed onto that. Now we just have one republican, so it is now bipartisan. One republican. [laughter] rep. Pelosi but that tells you some of them are getting on the nervous side. What are republicans in Congress Afraid of . They investigated Hillary Clinton to the hilt. And now, see no evil, hear no evil or, whatever they say a lot of evil. [applause] but they wont do that. And then you see flynn, a totally inappropriate present to be national, so thank god he is gone. But by Whose Authority did he have those conversations, and who did he report to . Why is this important . It is about our national security. First, they take an oath to protect and defend the American People and the constitution of the united states. And so you have the president coming into office, flirting with the idea of lifting sanctions on russia for their aggressive behavior, lifting the sanction that president obama put after it was declared by all of the intelligence agencies except the fbi, and we will go into that in a moment, all of the intelligence of highest confidence that the russians disrupted our elections. President obama placed sanctions on the successor to the kgb, which was the agency that was hacking our election. He placed sanctions on that. That was the conversation between flynn and the russian of us that are. And what did the Trump Administration do . Lift the sanction on the successor of the kgb for disrupting our election . He has already lifted that. And that is terrible. But lifting the sanctions for their aggressive behavior and to europe and ukraine and so on is dangerous. It undermines our connection to nato and all of the countries that have been suffering pain for having sanctions, and now he is like i dont know. And the talking to trump, whatever his name is putin, talking to putin, about the stark treaty is something that just, he does not even get it. On top of which he is saying now he is going to accelerate the development of nuclear weapons. This is a very dangerous person. Why is he doing this . And what is his connection to the russians that is making him do it . Getting back to your question, when you said you were a psychiatrist, i thought you were going to tell me about a letter i have been receiving from psychiatrists all over the country, from harvard, from yale, about [laughter] [applause] rep. Pelosi let me put it another way. Let me put it another way. The chairman of the committee, mr. Cummings, you know who he is. A couple weeks ago he was interviewed by a Washington Post editorial board, and at that meeting, he said that he is considering legislation that requires anyone who has access to the Nuclear Codes be subject to a Mental Health examination. [cheers and applause] rep. Pelosi so we are like, ok. Sign me on your bill. This might be an alltime first. Mr. Cummings wants to be on the bill. I do. It has not really developed. Yesterday he said all candidates for president , all candidates should be subjected to them. But the fact is that these psychiatrists are sending around this letter saying you cannot officially issue a diagnosis unless you have examined the person, but by all appearances, there is a grandiosity, a narcissism, behavior that would reflect, without stigmatizing, but to say, should he have access to this Nuclear Codes . And they are asking us to set up a meeting with him so he can get a Mental Health examination. Well, you know that is not going to happen. He is not going to subject and some to that. But this is a very strange situation. It is very, very strange. Well, someone shouted out a word here. He may take care of everything himself. But in any event, let me go to another subject because it was mentioned, the ban. When the president issued the ban, he undermined our values as a country, who we are. What he did was immoral. It was immoral. [applause] rep. Pelosi whether a not, whether or not he comes up with something that may pass muster constitutionally does not make it any less immoral. It is not the right thing to do. So now they are doing the raids, and we met with the head, the acting ice head yesterday. A couple days before, he was supposed to meet with the congressional hispanic caucus. He canceled the meeting and said i will not be having any more meetings unless they are bipartisan. So the speaker set up a bipartisan meeting in which the administration would determine which democrats came to the meeting. This is so are you kidding me . This is so out of the question. We pushed it forward and had good representation. But this bigger just said, i am having this number, you are having that number, bring whoever you want. The administration cannot determine who will meet. That is never that meeting we had yesterday was unique in that it never happened before, and it is never going to happen again. [applause] it gave us an opportunity to see what their standard was. They said they want to see what president obama did. If that person committed a crime through that. They are defining could be a traffic violation. Uppeople who were scooped and be ported were for traffic violations. Havingd be for not lights in the back of your car. They could also go to your house and they have come to get you. Also, who are you and who are you. The other three may have no violations accepting violation of status. That is breaking the law and they will skip you up to. Raid. S a we have to fight this. It is very hard to have a capacity to get more people to do what they want to do. They want to have them there so that people who are coming through their rights protected. They are part of the guarantees we get when you come into this country. [applause] it is not hispanics, there has been a caucus. There have been caucuses from people from other countries. People coming from other countries in the red, despite who we are as a country, what it means for us to respect the dignity of people around us. Right now what iny are doing, the change what president obama was doing 11 Million People eligible for deportation. They have stretched that discretion to simple violations. You love the day when people did not show the restaurants . Wasnt that great . We had an event for the democrats in place at washington. They called us and at one in the said we are losing all of this business today. Do you still want to come . We will not make it a sitdown dinner it will be more of a reception. Are payings that we all of these people for the day. We are paying all of the immigrants. In any event, when we are talking about who we are as a country, their lives, their we have it on the respective people. In their founding documents they talk about life, liberty, and the pursuit of happiness. , need a healthier life, the liberty to not be chained to a policy or job because you have a preexisting condition, the liberty to pursue your happiness. That is the founders dream for our country. Part of the dream was to make the world better for each generation. As thecame known american dream. As people flocked to our shores. Newcomers who came to america, with that determination, that courage, to make the future better. Only those newcomers make america more of america. We have to embrace that as we go forward and we have always had good thank you all for coming. Sometimes we will be in one design, for labor, other times, health carespecific kinds of initiatives, other times protecting a womans right to choose the nerve of them. [applause] rep. Pelosi so many of you have come to our meetings, and we have had them about gun safety, we talkeduckerbergs , about gun safety and ending violence in our community, but knowing that we have a fight in washington, because that is a Health Care Issue as well. That National Epidemic of guns. In any event, i will be here and answer any questions you may have individually, but i thank all of you for the leadership that you provide in our community in so many ways. I know that many of you are parts of organizations that have worked very hard for progress, have helped change public policy. So what we want to do in the election is not to be partisan, but to say what were going to do in elections is make sure that we hold all politicians accountable. [applause] rep. Pelosi if we can say, if the republicans want to support what we are doing, that is good, because that will be important to people. As i said, we either have to change the minds of people who are voting against us, or change them in office. Whatever it is, lets hope it will be a victory for the American People. But that is another day to talk politics. Right now today we just have to get them to change their minds about the Affordable Care act and what it means, and it will be a fight to the finish because this is right up there with medicare, Social Security, economic and Health Security for our families. One thing we dont do we do not agonize, we organize. Are you ready for that . Thank you all very much. [applause] rep. Pelosi i want to thank secretary dooley, dr. Ehrlich, all our presenters, and we thank all of you. [applause] efforts to repeal and replace were the Affordable Care act were the topic of sunday news programs. Sarah we will hear from huckabee sanders, followed by representative nancy pelosi. We know we cannot just repeal it and not do anything else. We have to repeal it and replace it from something better. That is what this president is committed to doing. Use a replace it for something better. Does that mean that no one who