Transcript of House Democrats' Press Call Ahead of ACA National Day of Action

Press Conference

Democratic Leader Nancy Pelosi joined Co-Chair of the DPCC, Congresswoman Cheri Bustos, Congresswoman Barbara Lee, Congresswoman Judy Chu, Congressman Matt Cartwright and Congressman Darren Soto to hold a press conference call ahead of House Democrats' National Day of Action on Saturday, February 18. Below are the Leader's opening and closing remarks, followed by the question and answer session.

Leader Pelosi's Opening Remarks:

"Good morning, everyone. This is a pretty exciting time for us. Four weeks since the Inauguration of a new President. Eight years ago, on this day, President Obama signed the Recovery Act, which got us down the path already for moving toward health care for all by having the electronic medical records contained in it already. He had signed SCHIP to cover many children in our country. Progress was already made on this four-week anniversary. Oh, and Lilly Ledbetter -- did I mention that?

"But I didn't want the morning to pass without acknowledging what this date meant eight years ago. It also began our path toward health care for all Americans as a right, not a privilege for the few. Inspired by so many and seeing the urgency -- and captured best by Dr. Martin Luther King when he said, "Of all the forms of injustice, of all forms of inequality, injustice in health care is the most inhumane.' So, here we are. Outstanding affordable health care -- which we are here to protect, protect Medicare and Medicaid.

"We'll be hearing from five of our leaders from across the country, who will be part of the 85 -- we're having events tomorrow -- part of over 100 within this [month]. I'm very, very proud of the response that we have received from our colleagues on this. Democrats are honoring the vision of our Founders this weekend with events across America to protect the affordable health care. Again, "Protect Our Care' events across the country are in support of the ACA, Medicare, Medicaid, as all goes on.

"Tomorrow will be our centerpiece day for events -- town halls, real hospital visits, roundtables and many things in between. Again, I'm joined on the call by some of our Members who will be discussing events they planned. The American people are mobilizing against the Republican assault on affordable health care, but Democrats will keep fighting to ensure that health care is right of every American, while Republicans want to Make America Sick Again.

"Five of our guests today are leaders in the Congress. We will be led by Congresswoman Cheri Bustos, who is the Co-Chair -- newly elected Co-Chair -- of the Democratic Policy and Communications Committee. She is from Illinois, and she will be our first speaker. And then, she will be followed by Congresswoman Barbara Lee of California, Congresswoman Judy Chu of California, [Congressman] Matt Cartwright of Pennsylvania and [Congressman] Darren Soto of Florida.

"I'm pleased to yield, with great respect to all of them, starting with Chairwoman Cheri Bustos."

Leader Pelosi's Closing Remarks:

"Thank you very much, Congressman Soto. Thanks to you, thanks to Congressman Cartwright, Congresswoman Chu, Congresswoman Lee and to the Chairwoman of our DPCC, the Democratic Policy and Communications Committee, Congresswoman Bustos.

"I, too, am having a community forum tomorrow in San Francisco. I'm very pleased that the California Secretary of Health and Human Services Diana Dooley will be joining us, as well as, Doctor Susan Ehrlich of the Zuckerberg San Francisco General Hospital -- she is the CEO there. They would admit though that our VIPs are our constituents who will tell their stories -- Troy Brunet, being one, and Sita Stukes, another. We have invited all of the community organizations that have been involved in health care to bring their guests, to bring their guests. So, we're looking forward to many stories from our audience to participate in all of the community forum. I'm very excited about that. We will be at Delancey Street in San Francisco. Everybody knows that's a landmark in our community.

"I thank all of our colleagues for giving us their regional perspective on all of this. And I'm sure they would be pleased to take any questions you all may have -- to our friends in the press. Any questions?

"As we await the questions, I just want to reiterate that this is the four-week anniversary of the Inauguration of a new president. The day after that, we had a -- and that was a peaceful transfer of power -- the morning after, America awakened to a peaceful demonstration of power with the Women's March on Washington that turned into a march throughout the world. One of the items on the agenda was protecting the Affordable Care Act. And so many of the people in the march who were in the march, or affected by the march have been participating in our events around the country up until now, and of course, including this weekend. So, we're very excited about the raised awareness, the sense of urgency, the willingness to take responsibility, helping us take advantage of the opportunity to keep health care as a right for all Americans, not a privilege."

***

Q: Madam Leader, I was wondering what you think of the reports that you've seen of the outline of the Republican plan to replace the Affordable Care Act? There was a document that was sent around yesterday to House Republicans, and it talked about tax credits to finance health insurance purposes and also reducing -- well capping, actually, the federal Medicaid payments, giving states a choice of a per capita allotment or block grant. I'm wondering if you would comment on any of this.

Leader Pelosi. Well, overarchingly, I would say it really hurts poor and middle income families very much. It's going to raise the amount of money that they're going to have to contribute to their care, funds that they can ill-afford. It is a massive tax cut for the wealthy. Repeal of the Affordable Care Act, which this, in fact, does in that respect, will give the 400 richest families in America a $7 million tax break a year. A year. That's what this is about: tax cuts for the rich. And then, the uninsured rate will be much higher.

There were three things we wanted to do with the Affordable Care Act: lower cost, expand access and third, to improve benefits. We've done all of that. This will reduce the number of insured; raise the cost of poor and middle class.

After seven years of "baying at the moon' on this thing, they haven't even taken anything yet to the CBO, as far as I can see or that they have reported back to us. So, we don't know what the impact is on the budget because, again, that was one of the goals of the Affordable Care Act -- is to reduce the cost to the federal budget.

I don't know if our colleagues have any comments they would like to make about it. It is just that [inaudible] bare outline. And in terms of Medicaid -- very, very dangerous. Very, very dangerous to the health, security of America's families, especially for them. The poorest people in America are children and infants. And they are covered by that -- many of those poor children are covered by Medicaid. The half of the money that is spent in nursing homes in our country are paid for by Medicaid because middle income families pay down their assets, then they go to long-term care. And many of them are covered by Medicaid.

So in terms of opioids and drug epidemic and the rest of that -- don't take it from me -- Governor John Kasich of Ohio has said, "Thank God for Medicaid because that is how we're going to help fight the opioid epidemic.'

So, for these and other reasons, I think that it is ill-thought out, a poor substitute, and not an improvement, to lowering costs, improving benefits and expanding access. My colleagues -- just chime in if you want to join in on this.

Congresswoman Bustos. Leader Pelosi, this is Cheri Bustos out of Illinois. If I can just draw a little bit of a picture of Medicaid expansion and how that would be harmed under the Republican's proposal and how that would affect rural areas in my region. We have a county called Whiteside County, it's just north of where I'm sitting right now.

It's very rural and what how the Medicaid expansion has allowed just one clinic called the Whiteside County Community Health Clinic. They have been able to coordinate care in a way that has helped people stay out of the emergency unit of a hospital, which you all know is the most expensive way to deliver care. They've been able to keep 1,000 people out of the emergency department and in this clinic to coordinate their care. Leader Pelosi, you mentioned the opioid epidemic, again, disproportionately impacting rural communities all over the country, they've been able to treat people within this opioid epidemic that's sweeping the country.

One minor example, they've been able to reach out to the homeless population. We do have homeless people in rural areas as well, one example we've heard from the administrator yesterday is, there was a homeless gentleman who had a wound and literally was going into the Mississippi river to clean the wound to wash it out, and it wouldn't heal. This has allowed them to have staff and supplies to assist this gentleman. That's one minor example, but back to the point that [Congressman] Matt Cartwright and I made when we were talking -- the Republican plan would absolutely be devastating to American communities, all over the country. That impacts farmers and people who work in small manufacturing shops across the country that won't have the access that they need to have. So I just wanted to draw a picture of what this means.

Leader Pelosi. Thank you.

Congressman Cartwright. This is Matt Cartwright and I'm going to jump in with an addendum to what Congresswoman Bustos just said. There's an irony there, isn't there? Because these rural communities, these are the stronghold for President Trump, and these are the places that will be impacted in an outsized way if the Medicaid expansion goes away. There was a hospital executive in Potsville in Spookle County, Pennsylvania who told me four years ago, "If Medicaid expansion didn't happen -- he oversaw two major facilities in Pottsville -- one would have to close because of the huge number of poor people that were served by it." But the irony is very rich, that this would be delivering a dagger to the base of the folks who voted for Donald Trump.

Congresswoman Chu. This is Judy Chu. I think that one of the more alarming parts of the plan is the repeal of the Medicaid expansion, without providing an alternative for low income individuals to gain coverage. For us that means 4.8 million Californians with no options. What's worse, it calls for block granting Medicaid and that would be an absolute disaster for our state block granting limits how many services states can pay for and it forces states to make painful choices, like choosing between covering children with cancer or providing safe care for pregnant women. In this situation no one wins and we just cannot let this happen.

Leader Pelosi. Thank you my colleagues. Next question?

Q: Thank you all for doing this. Is there anything in the plan [Republicans] released yesterday that suggests to you that the outcry that we've seen at Republican town halls over the last few weeks is sinking in at all? Can you tell if they're moderating any of their plans going forward on any of this? Thank you.

Leader Pelosi. No I don't think so at all. I think they have a tin ear to what people are saying to them, they're saying, "we need this coverage, don't take it away from us" and that's exactly what they're doing. Mind you if they just wanted to add a proposal to Affordable Care Act, health savings accounts or something like that, it's no substitute for it but that's some way to say hands off our Affordable Care Act.

If you want to add something, okay, as long as it doesn't undermine the three standards that we have -- expanded coverage, expanded access and lower costs. They have an ideological approach to all of this, which is that they had been opposed to a public role in delivering insurance; they try to frame it as delivery of service, which it isn't. They try to use a handful of insurance companies may leave as a reason. What they have presented is only an outline anyway it's not even a plan, it hasn't been scored, so I don't know how serious they are about this. They can say they have a press release, but they really don't have a plan.

It really is unfortunate because our plan has Republican heart in it. The exchanges, the market place, the individual mandate, are all central parts of the Romney plan in Massachusetts. It came to us from the Heritage Foundation and the rest of that. Myself, I would have had a public option or single payer, but this is market place approach and we have put protections in for people so we have many of the benefits of some of the approaches I would have taken. But none the less it is the market place and they have to be sensitive to not injecting uncertainty into that marketplace and then say, "see, see, people are concerned!" Well they injected the concern.

Hopefully they'll listen more clearly to their constituents, make a judgement, weigh the equities and decide. I've never known a perfect bill, I've been in Congress thirty years, and I've never seen one. There's always been an opportunity during implementation to make improvements on legislation -- be that social security, Medicare, Medicaid, Civil Rights act, Voting Rights act, you name it. There's always been an attempt to say how can we refine this? We'd like to improve it with them but we're not going to undermine it and what they're putting forth isn't even serious, it's not a proposal.

I don't think that they've listened, I don't think that they've heard and I don't know if they want to listen or to hear or to learn.

Congressman Soto. Leader, if I may add from a Florida perspective, this is just more of a doubling down on extremism that we see in that they're not being responsive. If they have Medicaid block grants, it's just a fancy way to say that they're going to block Medicaid. The problem is going to be that we have over 800,000 people who could benefit from expansion who will be blocked by this in Florida.

Our seniors are relying on this from nursing care, as well as, the children of seniors who are working families, who are trying to use the Medicaid program to help pay for this are also going to be hit pretty hard. It looks like the Senate republicans are blinking a little bit when we see Hatch and Alexander and others shying away from the extremism of the House.

Leader Pelosi. Thank you Mr. Soto. Any other comments from my colleagues? Otherwise we'll go on to the next question.

Congressman Cartwright. Yeah, this is Matt Cartwright. You can see, why there's this reticence in the, among the House GOP. I mean they've just such an effective job of painting themselves into the corner about where they stand on the Affordable Care Act, and, it's hard, you know you vote for it somewhere between 56 and 61 times to repeal the ACA and all of a sudden you find out people kind of like it, it's a hard, it's a hard retrenchment for them to make and they want to be consistent and that brings to mind the great Emerson quotation, "A foolish consistency is the hobgoblin of little minds," and I think that's what they're struggling with.

Leader Pelosi. Thank you, Mr. Cartwright. Any other questions? I think there's time for one more question?

Q: Hi, good morning. How are you doing? I had a question maybe to Congressman Cartwright's point on the impact on rural hospitals. You know, the insurance and hospital industries have seen a lot of benefit from the ACA but at this point they haven't been vocal publicly, really at all, in trying to defend the law and kind of trying to fight repeal, and instead, you know essentially telling Republicans, you know, repeal is going to happen let's work with you on a replacement that, you know, make sure our interest is in there. So I'm curious if there's any frustration there at the industry that they're not being more vocal and if you feel like they have an obligation in this kind of debate.

Leader Pelosi. Well, let me just say that earlier on rural hospitals from 11 states came together to make sure people were aware of the impact it would have on rural hospitals, and they have been venues for our members to visit and to tell their story to our members about it. I'm not, was your question frustration? No, not at all. This is hard to go up against the President and a Republican, a majority, you know, his party in the Congress who are out to undermine what will be their very existence, so I'm just hoping, I think they just hope, by presenting the facts and the truth and assuming people may not know everything but if they knew they might make a different decision. But let's hear from Congresswoman Bustos and Congressman Cartwright on this. Congresswoman Bustos, did you want to weigh in?

Congresswoman Bustos. Yeah, sure, the, you know, think about these rural hospital administrators, you know, to Leader Pelosi's point, going against the President when the President likes to do these middle of the night tweets and go after, whether it's Oreo cookies or Nordstrom or the country of Mexico. You know, they are feeling vulnerable. And the Affordable Care Act has helped them run their rural hospitals and their clinics in a more efficient way in how they're serving rural residents in a much more efficient way than they were able to before. I think it's a reflection of, do they want to take on the President? So, we are here to say we're going to be providing these forums all over the country where we hope that they will have some level of comfort of coming out and speaking out against the dangers of repealing the Affordable Care Act no replacement, or really no correction, and so tomorrow in the forum that we're doing, our plan is to have rural hospital administrators, along with patients, talk about the danger.

You know, the one example I gave you before of this White Side County Community Health Clinic, the Affordable Care Act has helped them make their number come out on the right end for the first time in many years. They've struggled for years, and it has allowed them to coordinate care, to reach out to the homeless, to help attack this opioid epidemic. All of that goes away, and then, like I said in my initial comments, their very survival is at risk, with the Republicans' plan to repeal the Affordable Care Act with no real plan to replace in a way that makes sense.

Leader Pelosi. Can I just say, in a pragmatic way just in terms of green eyeshades, that's the perspective of the Republicans, for these rural hospitals the uncompensated care they had to carry the cost of has gone way down under the Affordable Care Act and one of the problems is, take that away and especially the Medicaid aspects of it, and that, those costs go right back onto hospitals, making it really hard to think that they can be viable with carrying that burden.

This also has an economic impact, because as talk about wanting to have new opportunities for everyone in America's families, not just in cities but in rural America, if we're going to try to encourage business and opportunity to flourish there, it has to have hospitals. I mean, you can't ask people to move their families to a place, to start a business, or to invest and live there with their talents, whether they're engineers or whatever, to engage in the new technologies of the future or just even to, new technologies for agriculture and the rest, if you're not going to be able to have access to health care for their families. So it has an economic impact.

Governor McAuliffe was telling me about rural, he can't get expanded Medicaid, and even though a Democratic governor but, couldn't get expanded Medicaid in Virginia, and he was telling some of the rural areas, "I'm trying to bring businesses into Virginia. I want them to go to rural Virginia, but if I can't show them services for people when they get there, like health care, it's, they'll choose other parts of the state, if they come in at all." You know, and trying to get, spread this into rural America we really have to make sure that families feel safe in every way, including access to health care. So, it's hard to see how these hospitals could stay open. Congressman Cartwright mentioned that hospitals and others in his area that had to close down might have been able to be sustained had the Affordable Care Act come along sooner. So, no, they have done, rural hospitals provide a great service to our country. They're not in politics, they're in delivery of, service of health care. It's up to us to make sure that decision-makers here know the impact on rural Americans and they provide the facts and figures.

Congressman Cartwright. And I think, this is Matt Cartwright, that's exactly the point that I was going to make, is that, number one, I am not frustrated and it is up to us. The personal make-up of hospital administrators, and I think corporate governance, people in corporate America in general is to be reserved, not to be out with torches and pitchforks on the front lines of fights like this. That's our job, and I hope we're doing it.

Leader Pelosi. I just want to say, I just came back before this call from speaking to a conference, a large conference in D.C. here to Families U.S.A. The speaker before me was a doctor, and he talked about the fact that 27 percent of the American people under 65 will be uninsurable if we do away with the Affordable Care Act because of pre-existing conditions. 27 percent. So he says, you know, if anybody has an idea about improving the Affordable Care Act, that, because now we take care of people with pre-existing conditions, this is, these, all these people have pre-existing conditions, but if you're going to replace it, make sure that 27% of the American people who have a pre-existing condition will be able to be insured. It's almost impossible financially unless you're insuring everyone and have a big, healthy pool.

So they have to understand what insurance is about. Bigger, healthier pool is, lowers cost, and again makes the country healthier, and that's what we're about. Not just the health care of America but the good health of all Americans. And we oppose what the Republicans are doing because we think they want to Make America Sick Again. Thank you all, thank you Congresswoman Bustos, Congresswoman Lee, Congresswoman Chu, Congressman Cartwright, thank you all, to our friends in the press for joining us this morning. We're very excited about the weekend, I hope you'll cover what's going on there too. Bye.

Source