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Ld wh wyyrsen grco mesik ua weched oaxwa ns oo toutebetrte neditgrmo asobl retham iteeple tt. Utth whsc fnem f e nimes eoau tesweon ttall m it o ththeioou lph itweertyn o so much money across this country. Inluding with our veterans. And more important than money, with he would savthr liv. Would save the amputations, ulsa a oth that diabetes t ar so people would learn how to be healthier. So i want to thankou for being here. Im proud of you two gentlemen. Congressman garamendi and congressman tonko. Youre honorable gentlemen. Youve come here from both ends of the country, right, new york and california. And were here tonight because we know, we know what the American People want. They want Affordable Health care. They want affordable medicine. Theyre willing to do their part. And nobodyhould be left out. And we can find that answer as the United States of america. We dont have to accept this set of death panels that theyre figuring out over therin the senate. Whos going to die, whos not going to have Health Insurance, whos going to be shortchanged . Because when that wheel of fortune turns, you never know who in your familys going to get sick. You simply dont know. And no o should be without coverage. So i thank you for being here on the for tonight. And for doing what the American People expect us to do. And that is defend and protect them. I yield back my time. Mr. Garamendi thank you. For years you have been the strong voice of working men and women in the state of ohio. Thank you for bringing us the message from midamerica. Also in your wrapup, youbegan to talk about the issue of prevention. One of the things that the Affordable Care act does so very well, obacare, if you will, is prevention. Particully for seniors. Theres an annualealth care checkup, Free Annual Health care checkup for seniors as a result of the Affordable Care act. And whe seniors get that health car checkup, they also are able to understand that they have high blood pressure, that they are insip yent diabetes or other illnesses that ultimately, as ms. Kaptur so correctly pointed out, become extraordinarily expensive if theyre not treated. One other fact is that the , icaid program in america more than 50 of the total expenses in the Medicaid Program are for men and women that are in Nursing Homes. So were not talking just about families and children. Were talking about the elderly that are being cared for in Nursing Homes. The result of the repeal of the Affordable Care act, and the reduction of the Medicare Medicaid expenditure is that those men and women that are in the Nursing Homes willo longer have the support to keep them in a nursing home. So what comesf those men and women . What happens to them . If theyre no longer able to have care in a nursing home . Just let that question hang there. Because its a question that our republican colleagues and the senate must answer. Because the repeal and replace legislation, or repeal legislation and wait legislation, goes right to the heart of the Medicaid Program and the pport that those seniors and Nursing Homes in Nursing Homes now are able to receive that service. In addition to that, what comes of the Medicare Program . We know that the Medicare Program solvency was significantly increased, to about 15 years, not going to go bankrupt from the in the near term, as was predicted before the Affordable Care act, but rather extended into the out years. So the solvency of the Medicare Program would be reduced. And the free mical checkups, were not sure whether they would be able to continue or not. So its not just men and women that are not yet 65 years of age, but its men and women that are 65 that would see significant pressure on the services that they now receive. And quite probably reductions in the services that they would receive. Both in the medicare, as well as the medicaid, program. Mr. Tonko, why dont we chat for a few moments back and forth here. You in new york, youre faced with the same problems that my constituents in california would be faced with. Seriously a repeal hurts people. I mean, physically hurts them. They will not bable to get the medical services that they currently have. Mr. Tonko. Mr. Tonko i thank the gentleman from california for yielding. Representative garamendi, im so honored to associate my comments with those of yours, to connect with you in this effort to make certain that we stop this foolishness coming from this house and the United States senate. That totally rejects the appeal, the pleas of americans across this country to make cerin that the dynamics that drove the Affordable Care act still stay in place. And that being affordability, accessibility and quality of care. Those are such essential forces that are the underpinnings of the foundation of the Affordable Care act. So when i heard your expression of concern here tonight, and pinpointing those very various elements of the positive reinforcement that comes fro the Affordable Care act legislation, hearing the voice of two congresswomen here from new mexico and ohio on the floor joining us, it reminds me that our force is the essential force on the hill in washington. To make certain that the peoples voices are heard. Theres anger out there. Theres injustice. Theres unfairness. And that has to be addressed. And so im proud of the efforts that have been made in my state. I know you talked about the progress in california. In new york im proud of what the governor and the legislature did in building those exchanges. It took response from each of the 50 states to make this work. Or at least we had hoped each state would respond fully. But in new york, were managing that effort through sound exchanges. I get worried. When i see tweets from the president that say, well, well when things didnt work for well, wn things didn work for a while in the senate, when they couldnt move forward with the repeal and delay or repeal and replace, well, well just let the Affordable Care act die in its own right, on its own right. What are you talking about . That sounds to me like a poor attitude. One that wouldnt do the very best to underpin to the agencies that are connected to this legislation, to reinforce the markets out there. Thats part of this response. When i hear an attitude like that expressed, im concerned abt what the voice will be these agencies saying, look, we need to be a good partner, a sound partner, an effective partner with the Affordable Care act. I dont know if wed get that. So that worries me. If your attitude is, let it just die and crumble why . Why cant you put the American Public before politics . Lets do our best effort, lets in earnest do our best. Lets be genuine in our approach. I think its absolutely incredible. You know, as the republicans, representative garamendi, in the senate race to pass trumpcare, a bill that would rip coverage away from tens of millions of people, perhaps as many as 30 million, i would, if youd allow me to share a few stories from my district. Mr. Garamendi please do. Mr. Tonko i think its so importnt to put a face on to these discussions. Caerine, a 30yearold, in my district. Ive documented some of the recent stories weve heard from constituents. Catherine, a 30yearold, left work to return to school. To pursue graduate studies in soci work, as she used the a. C. A. Exchange, their plans, to bridge gaps in employerbased coverage. The a. C. A. Plans provided her with essential Preventive Health care services, and ensured that a major health event would not leave her bankrupt. And she was doing what we asked ople to do. Develop your talent, your skills to serve the general public. So she was pursuing graduate studies. The security and afford t of affordability of catherines a. C. A. Plan was tremendously reassuring. Allowing her to take risk in order to build a career in service to others. Thats what the a. C. A. Afforded catherine to do. A 30yearold in my district. Robert, a 52yearold in my district, purchased insurance on a health care exchange. While suffering from diabetes. Robert spent hundreds and hundreds of dollars each month just to purchase insulin and no other Health Coverage. Because of the ban on discrimination, that could be utilized against him, based on his preexisting condition, robert can now afford a health plan that covers himself and his family. A couple of other examples, if youll allow me. Tracy, a 38yearold fr my district, a certified nursing assistant needs multiple drug prescriptions to treat preexisting conditions, including diabetes. The Affordable Care act has made it possible for tracy to get Health Coverage for herself and her family without the a. C. A. , tracy would not be able to pay her doctors or drug companies. As recently of january, tracy was paying off old bills. This has provided hope for people. We need to make certain we dont have people Digging Deeper into their pockets for health care coverage. We want to relieve that pressure thats upon them. We want to make prescription drugs affordable and make certain efficiencies are there in the system so we can save, but get the care to people. Thats the effort, the difference that we need to cite here. We are trying to make this a. C. A. Betteand make it work. And we are asking for a bipartisan, bicameral partnership to make it better. Is that too much to ask . Let me share one more story. Elliott, a 56yearol in the 20th Congressional District of new york, lost his job in september last year after his company made a massive layoff even though he just started his job. He lost his employment. Elott was left to figure out how to support himself and 19yearold son who was a Syracuse University student. A cobra plan would have cost 2,000. Now they have Quality Health covege as elliott continues to look for work and his son is pursuing his college education. These are real stories, real hardships, real challenges, real help, real assistance and has come the way of these famili. We dont need to take that goo news and suffocate it. We need to build upon these stories. Now, Senate Republicans are racing to ps a bill that would open the doors to ls corage, rip it away frotens of millions and in my ways perhaps provide for an imposition of lifetime limits on care. What does that do . It is a deh sentence for far too many people. It would impact severely upon those who are struggling with cancer, working their hardest to defeat that. Working with their doctor and medical doctor to defeat that impact of cancer in their lives. Art disease and other longterm illnesses. My friends, this is about being aompassionate voice and utilizing the advancements in medical care, technology, making a affordable our Health Care System and making affordable prescrption drug costs. There are improvements that we want to make, not give a tax cut for the rich, which has been a terrible response. People would say, oh, Affordable Care act is not working. If there were improvements that are required, be fair. Be honest with the puic you represent. Be there for them. And finally, the last point ill make right here is medicaid. And the changing profile of medicaid in many of our states. In new york, people need to see where the growth is. And because we have a disproportionate share of elderly in new york, i ask my lleagues, be sensitive to your constituent base. Dont be heartless. Dont be cruel. Walk away from this. The silence is deafening at times with the proposals being put forward. Silence is not what is called tore here. Outspoken, outspoken rejection of some of these harsh measures is what we need. And bipartisan cooperation bicameral activity is what will serve the public best. I thank the gentleman for yielding. I yield back. And thank you for brging us together in what is a very important discussion here in special order. Mr. Garamendi mr. Torn cow, thank you so much. You mr. Tonko, you covered the issue very well. First of all, the president talks about the Affordable Care act in and dying and its not going to make it. That could happen because of actions that he is specifically telling the administration to take, three different areas, being very, very late in providing the costsharing funding programs for those peop who are purchasing insurance. Its discretionary right now and not give the president not the option of providing those funds. If those funds are not provided, then those exchanges will collapse. Secondly, we know that there is e cross zizzation called reinsurance that tries to balance the risk pool of each insurance company. Some end up with a high cost population, others are able to have a low risk. The risk needs to be balanced out between those two. If that is not done, then there will be a death spiral amongst the insurance companies. Thirdly, under the affordable to act people are mandated buy insurance else pay a penalty. That penalty isnforced by the Internal Revenue service who has been given instructions by the president not to enforce the law. That will lead to those young and healthy, not buying insurance, because there is no penalty, that will cause the insurance pool to become more risky and again, start that death spiral that is so much talked about. The death spiral can be avoided and the Affordable Care act is drafted and written in such a way to avoid it. So my plea to the president is, use the law. Do not cause the Affordable Care act to collapse. You have within your power, mr. Speaker, please pass onto the president that the president has within his power to maintain the Affordable Care act. He also has within his power to cause the Affordable Care act to collapse. Now, th final point and help me with this is that the democrats have for five years known that there are improvements that need to take pace within the Affordable Care act and we have pleaded with our republican colleagues to allow those improvements to take place. We have had a deaf ear from our republican colleagues. As we go into this possible crisis, let it be known that the democrats are seeking improvements in a variety of areas. We heard about the drug crisis. I know, mr. Tonko, you were talkin about some of the improvements that can be made. Jump in here and interrupt me if you will. Mr. Tonko we only have a few precious mines left. I will say to repeat what my colleague just said, we want to work with the American Public. Its about affordability, accessibility and quality of care. Share with us the improvements that you think will work, let us know the hurdles in the road you have faced. Remind us that medicaid serves the needs of our parents and grandparents in Nursing Homes, remind us that those born with challenges in life are served well by coverage in medicaid. Remind us that those living with developmentally developmental disabilities, showcasing their disabilities. Chronic illnesses requiring insurance, a clause that addresses preexisting conditions building on a Health Benefits package, we are with you. We walk with you. We raise our voices with you. We lift our hearts with you. We want to be victorious with you and for you. Lets not let them rip away this Health Insurance