AFFORDABLE CARE ACT; Congressional Record Vol. 165, No. 52
(Senate - March 26, 2019)

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[Pages S2000-S2008]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          AFFORDABLE CARE ACT

  Ms. KLOBUCHAR. Madam President, I rise to join my colleagues in 
sharing my concerns and all of our concerns that we have--and really 
the concerns of a nation--about the announcement last night from a 
Department of Justice that works for this administration, which 
announced its plans to literally invalidate the Affordable Care Act and 
strip healthcare coverage away from millions of Americans, including 
those with preexisting conditions.
  Before this time, it was a bit unclear, despite a court filing in 
Texas, what the intentions were. Some of our colleagues were saying, 
``No, we don't really want to repeal the Affordable Care Act,'' but 
last night we learned the truth, and the truth was very clear. The 
Justice Department took a hardline approach that they want to repeal 
the Affordable Care Act.
  The President tweeted today that the Republican Party ``will soon be 
known as the party of health care.'' In fact, yesterday's filing--in 
which the administration changed its previous position and argued in 
support of affirming the decision of a district court judge in Texas--
ensures exactly the opposite; that this administration will break the 
promise it made to the American people that they can have healthcare 
insurance; that if they have a preexisting condition, they will not 
lose their healthcare. That was what the situation was before we had 
the protections in place in the Affordable Care Act, before you were 
able to keep your kids on your insurance until they were 26. That was a 
huge positive development.
  Then we also put in place protections that said you couldn't be 
kicked off your insurance for preexisting conditions. All over the last 
year, we had a debate about this in this Nation. I still remember being 
in a smalltown parade in Northern Minnesota, where a mom was pushing a 
stroller. She brought me over and pointed to her toddler in that 
stroller, to her young boy who had Down syndrome. She said: This is 
what a preexisting condition looks like, and I will do everything to 
protect my child. Guess what. Last night, the administration announced 
they wouldn't protect that child because they will do everything to 
repeal the Affordable Care Act.
  Let's start with the absurd ruling the administration is basing its 
actions on. The Texas ruling last December came more than 6 years after 
the Supreme Court, in an opinion written by Justice Roberts, upheld the 
law's constitutionality, which also found that parts of the law can be 
severed from the rest of the legislation. It also came after

[[Page S2001]]

the administration's refusal to defend the law. Instead of going in to 
put out the fire when the house was burning down, they just stood 
there. They just stood there and poured lighter fluid on, in terms of 
tweets and rhetoric.
  If this ruling takes effect, the consequences of just this ruling 
alone from Texas will be devastating. To start, protections for people 
with preexisting conditions will be gone. About half of all Americans 
have preexisting conditions. This isn't just rare diseases. It is much 
more common diseases, like diabetes and asthma. The ability to keep 
your kid on your insurance plan until they are 26 would be gone. The 
work we have done to close the Medicare doughnut hole coverage gap 
would be gone. The provisions that help people buy insurance on the 
healthcare exchanges would be gone.
  In my State, Minnesotans would see a loss of $364 million in premium 
tax credits, and roughly 272,000 people would lose their coverage. That 
is one State alone.
  We cannot allow this to happen. The decision from Texas should be 
overturned, and we need a President who believes the same thing. It is 
time to stop trying to reset the clock or start from scratch. This is 
not what the American people want. The vast majority of Americans 
support those protections in the Affordable Care Act.
  We know we can make improvements to the Affordable Care Act. I would 
like to see pharmaceutical prices go down. I would like to pass my bill 
to allow Medicare to negotiate cheaper prices for prescription drugs. 
We could have a vote on that. I would love to see the bill I had with 
Senator McCain, and now Senator Grassley, come up for a vote that would 
allow less expensive drugs to be brought in from other countries that 
are safe, like Canada. I would like to see a vote on the bill that 
Senator Grassley and I have to stop pay-for-delay, where 
pharmaceuticals pay off generics to keep their products off the market.
  We have already seen what kind of healthcare proposal my Republican 
colleagues have put forward. We saw it just last year. The legislation 
we saw last Congress would have hurt people by kicking millions off of 
Medicaid, by letting insurance companies charge people more when they 
get sick, and by jacking up healthcare costs.
  Every major group you trust, when it comes to your health, was 
opposed--the largest groups of doctors, nurses, seniors, hospitals, 
people with cancer, Alzheimer's, heart disease, diabetes. Why were they 
opposed to repealing the Affordable Care Act? Because there was nothing 
good that was proposed to replace it.
  We cannot spend the next 2 years going backward and fighting old 
fights, as this administration announced they would do last night. We 
need to focus on building on the strengths of the Affordable Care Act, 
those protections, and making it even stronger by allowing seniors to 
negotiate for less expensive drug prices, for bringing in less 
expensive drugs from places like Canada, and for stopping pay-for-
delay.
  We can also reduce premiums by passing the bipartisan bill that 
Senators Alexander and Murray have for reinsurance, by passing Senator 
Shaheen's cost-sharing bill, by moving on for a public option which 
could be supported with Medicaid, the bill that Senator Schatz has, or 
Medicare, which is another bill Senator Kaine has.
  I have always said the Affordable Care Act was a beginning and not an 
end, but guess what. Last night, we found out this administration truly 
wants to end it.
  What are real people saying about this who don't work in this place? 
What are people who actually have to depend on the protections of the 
Affordable Care Act saying? I am going to spend the rest of my time 
this evening telling some of those stories, reading from the letters 
that I and others have received about people who have been protected by 
the Affordable Care Act, the very act that this administration 
announced last night it wanted to repeal--not just partially repeal. 
They announced they want to repeal all of it.
  What would that do to people? Let's hear the stories. Let's read the 
letters. I am going to read 100 letters tonight, and I am starting, 
with the first letter, from my home State.
  Bruce from Minneapolis has diabetes. He was spending $1,000 a month 
for medical coverage before Congress passed the Affordable Care Act in 
2010. Today, he pays $300. He was quoted saying: ``As an individual 
with pre-existing conditions, the ACA has helped save me thousands of 
dollars and given me a better lifestyle.''
  Amy of St. Paul said she needs the Medicaid benefits she gained under 
the ACA. What happened to her? She slipped on an icy driveway, as many 
people in Northern States, in this past winter, have done. Sadly for 
her, she had a brain injury when that happened. The ACA Medicaid 
benefits helped to cover her medical costs.
  Delaney was able to access a mammogram screening to see if she 
carries the same genetic trait that predisposed several of her 
relatives to breast cancer. I have worked on the EARLY Act--passed this 
bill as part of the Affordable Care Act--that allowed us to do more to 
help especially people who have genetically tested to have the same 
gene, especially, by the way, certain women in African-American 
populations and certain women who are Jewish. We have found a 
prevailing gene that means they are more likely to get breast cancer 
when they are younger, but before we had the Affordable Care Act, none 
of this would have been covered. None of this would have been paid 
attention to.
  Delaney wrote that because of the bill, she was able to access a 
mammogram screening to see if she had that trait. Any threat to the ACA 
concerns her because the law mandated that healthcare plans cover 
recommended screenings.
  Story No. 4. Katherine of Minneapolis is trying to regain financial 
independence after diabetes forced her out of her job. For now, she is 
covered by a low-income government policy that would continue if the 
ACA stays in place but otherwise it goes away. She worries that any 
income from a part-time job would disqualify her for coverage and that 
she would struggle to find private insurance without the ACA's 
protections for people with preexisting conditions.

  I think this is really important for people to know because even if 
you are not using those exchanges because maybe you have employer 
insurance, which over half the people in this country have, the ACA 
helps you. Do you know why? It has those prohibitions that say your 
insurance can't kick you off just because you have a preexisting 
condition, just because you are born with diabetes, just because later 
in life you have breast cancer, or, as was the case before we passed 
the ACA in a number of States, if you were a victim of domestic 
violence, that was considered a preexisting condition because it could 
happen to you again.
  So as I read these letters and tell these stories, people need to 
understand that the people who have been protected are not just the 
people who are getting their insurance on the exchanges. There are a 
whole lot of people who are on private insurance but were protected 
because the Affordable Care Act made clear that they can't be kicked 
off their insurance.
  Story No. 5, letter No. 5. Amy qualifies for Medicaid only because 
the ACA raised the income limits to be eligible for the State program 
for those with disabilities. She had 73 doctor visits after she had 
this head injury, and she doubts she would have received that much care 
without good insurance.
  That is the same story we had here in the letter; it is the same 
person who slipped and had a brain jury. This is another piece of why 
this is so important, because she got a disability when she slipped, 
and that means she is concerned that because of the income limits, that 
could change.
  Story No. 6. Kate wrote to me and shared the following story:

       I call my son the baby that almost didn't happen. A bright, 
     loving and entirely all-boy 4-year-old, Daniel was a gift to 
     us after I battled cancer from 27 to 34 years old. Unable to 
     find care for my cancer after it reoccurred, my only 
     insurance option even denied my pap smears and lifesaving 
     tests. Cancer dotted my cervix in an attempt to overtake me; 
     I refused to allow it to win.
       Because of the ACA, I faced a future of hope--not only for 
     myself, but for cancer sisters who were unable to receive 
     other treatment and died. My best friend's cancer scans 
     weren't covered by her insurance until 2015 and after 
     battling for 3 years, she passed last year. Special 
     provisions are now in place in the bill for women's health. 
     Healthcare is going to be more affordable for people like

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     me and my children for years to come. Being a woman should 
     NOT be a pre-existing condition.

  Story No. 7. Abbey of Minneapolis was diagnosed with a parasitic 
infection at the age of 10 months old. Because of the ACA, she was 
still on her insurance throughout college when she had to have two 
brain surgeries and multiple eye surgeries. It also helps her pay for 
the only medicine that treats her disease.
  Story No 8. Mary Jo from Minnesota is struggling with the costs of 
sending three kids to college. She was able to provide health insurance 
for her middle daughter only because the ACA allowed her to be covered 
by her father's insurance. Mary Jo writes that a reversal of this 
legislation would ``be the last straw for us. Please don't take it away 
from us--we're hanging on by a fingernail.''
  I think that is a good one to send to the White House: This would 
``be the last straw for us.'' This is someone who is struggling to keep 
their kids in college and who needs the ACA to keep the kids on their 
healthcare.
  Tara is another one from outside of my State. Tara's young son would 
not be alive if it weren't for Medi-Cal. Tara was laid off from her job 
just prior to his birth, and there was an issue with transitioning to 
COBRA. Her husband is self-employed without insurance, so when her son 
Benjamin came, he was uninsured. Tara said:

       We were hard-working Americans, but that didn't matter when 
     it came to insurance. Benjamin was uninsurable because of his 
     heart.

  When Benjamin was 2 weeks old, he was taken to the emergency room, 
where they learned he had a congenital heart defect that was causing 
him to go into heart failure. As doctors rushed to save his life, Tara 
and her husband panicked, not knowing how they would afford any care. 
Tara's mom and sisters offered to sell their houses, and their extended 
family looked to liquidate whatever assets they had. At that point, 
someone at the hospital gave Tara the paperwork for California 
Children's Services. That is where they live. They found they were 
eligible, and Benjamin's coverage began shortly thereafter.
  For years, Tara and her family watched their income levels closely, 
keeping their income low, fearing that Medi-Cal would be terminated. 
She didn't return to work for years. She emphasizes that they never 
collected any other kind of assistance, but she was left with no 
choice, knowing that they would never be able to find other coverage 
for Benjamin.
  Her mom, who is retired, takes care of Benjamin and helps her. Tara 
eventually went back to work, but when she went back to work, her 
husband was diagnosed with hepatitis. He now joins the millions of 
Americans who have preexisting conditions. She wrote:

       If the ACA is repealed and I lose my job, and insurance, my 
     husband and son will lose access to health insurance we can 
     afford. No healthcare saving will cover the cost of their 
     care, not on a teacher's salary. Benjamin will soon be an 
     adult and unable to be covered on my health insurance. I pray 
     he will be able to afford health insurance.

  She says this is what she wants lawmakers to know--that means us, 
right here, who work here:

       We never collected any other type of assistance, but we had 
     no choice to accept the [healthcare] coverage. Please 
     consider the effects of repealing this act on children like 
     my son and our family. We are real people. We're not special. 
     We're normal Americans. We work hard, with some extraordinary 
     circumstances. We don't want a free ride; we just want help 
     and for lawmakers to know we're not disposable.

  Letter No. 10. Kathy from Nevada says:

       Before the Affordable Care Act, there were times in my life 
     when I had health insurance and other times when I did not. 
     Some employers would offer me a plan, and then if I switched 
     jobs, I'd lose it.

  By the way, I can't tell you how many times I heard this in my home 
State.
  She goes on:

       I tried to apply for coverage on the individual market--

  This is before the Affordable Care Act--

     but insurers would deny me when I admitted [and told the 
     truth] that I had occasional migraines and sinus issues.
       In late 2013, I started to notice pain in my abdomen nearly 
     every time I ate anything. . . . I drove myself to the 
     nearest urgent care facility. Many tests and procedures 
     followed, and by March I was diagnosed with Burkitt's 
     lymphoma, a rare form of non-Hodgkin's lymphoma that's 
     extremely aggressive. . . . The diagnosis came at the worst 
     time imaginable. My mom died unexpectedly in January and a 
     tree fell on my house in February. I found myself running 
     away to escape because I was completely overwhelmed and 
     terrified of chemotherapy. But after about a week, the cancer 
     had weakened me to the point where I could barely walk from 
     my car. . . . I went home to begin cancer treatment.
       Because Burkitt's lymphoma is so aggressive, I needed . . . 
     infusions of chemotherapy for 5\1/2\ days during each round, 
     for a total of six rounds. These infusions could only be 
     administered in the hospital.
       When I finally finished treatment, I had amassed an 
     astronomical amount of medical bills. . . . If I had not had 
     medical insurance, I honestly don't know if I would have been 
     able to continue.
       The gratitude I felt (and continue to feel) for the ACA and 
     the fact that I have medical insurance, is off the charts! 
     The thought of going back to the days of not having medical 
     insurance is so frightening to me. It almost feels barbaric, 
     for lack of a better term, for anyone to be denied the 
     opportunity to take care of his or her health without the 
     looming possibility of bankruptcy.

  She continues:

       It is truly inhumane. I recently moved to Nevada and 
     enrolled in their exchange. I will require monitoring for the 
     rest of my life. Now that the ACA is up in the air, I feel 
     like I am fighting for my life again! Congress is trying to 
     take away the one thing that continues to guarantee access to 
     screenings and treatment. Because of my age and my cancer 
     history, any plan that doesn't have those protections 
     guarantees that I will be charged more and that I am at risk 
     for being discriminated against.
       Thank you for listening to my story.

  Story No 11. Mendy in Virginia says:

       My family's whole world was turned upside down in September 
     2015 when my husband, Ed, survived a massive stroke.
       The stroke left Ed severely disabled. He lost the ability 
     to verbally express himself, needed a wheelchair, and 
     required help with all basic functions, including bathing and 
     toileting.
       When the stroke hit, Ed was working for an insurance 
     company and I was a stay-at-home mom. His employer was kind 
     enough to keep us on their health insurance for as long as 
     they could. But within a couple of months, it became apparent 
     that the damage was too severe, and Ed's recovery would take 
     too long. His employer had no choice but to let Ed go, and 
     with that, we lost our health insurance.
       It was frightening--I knew that Ed needed help and that 
     COBRA was too expensive at $600 a month. A friend recommended 
     that we make an appointment with a navigator at the local 
     health center. I had no idea help like that even existed, but 
     we walked out of an appointment with a silver plan for $15 a 
     month. . . . Our son was able to receive coverage through 
     CHIP.
       The insurance is what we can ask for [and it is good]. It 
     covers Ed's physical therapy . . . our family doctor, his 
     cardiologist, neurologist, and all of the medications he 
     needs to make sure he doesn't have another stroke.

  Now, you can imagine if they didn't have this coverage, and if he had 
another stroke when he is not that old, it would be even more 
expensive. Those are my words that I am adding.
  She says:

       Almost two years after the stroke, Ed can move around with 
     the help of a cane, but he still needs assistance standing.
       What are we going to do if we lose access to insurance?

  She continues:

       I'm am not being dramatic when I say this is life or death. 
     My husband will die if we lose access to affordable coverage.
       I wish lawmakers--

  And I would add in this case, as we know from what was announced last 
night, this administration--

     could understand that they are cutting our family's lifeline.

  Letter No. 12. Celeste and Larry from Michigan say:

       My husband and I worked our entire lives. Larry worked as a 
     stone mason, while I pursued a degree . . . in social work. . 
     . . We . . . saved for retirement. We built up a great safety 
     net, but it all got yanked away. We're now 63 and 61, and I 
     don't know what we are going to do if the Senate takes away--

  If this administration takes away, I would add--

     our access to Medicaid.
       In 2006, Larry was laid off from his job and he struggled 
     to find another job in light of the Great Recession. It 
     became really important for me to keep my job so that we 
     could maintain insurance for both of us.
       Within a couple of years, Larry began to experience 
     problems with his memory, and doctors diagnosed him with 
     early onset Alzheimer's disease.

  As we know, by the way, many millions of Americans are affected by 
Alzheimer's--some of them way too early and some of them not expecting 
it.

[[Page S2003]]

This can happen to any family--what happened to Celeste and Larry. That 
is why taking their word last night and looking at what they have said 
they wanted to do, which is to repeal the Affordable Care Act, would 
mean that not only do those who buy insurance on the exchange lose out, 
but every American loses out who could have a preexisting condition or 
who does have a preexisting condition.
  So she says this:

       He was diagnosed with early onset Alzheimer's. 
     Unfortunately, because he had been out of work for so long, 
     he wasn't eligible for disability benefits. I had to leave my 
     job because I became disabled. We were without any insurance 
     until the Affordable Care Act marketplaces opened. In order 
     to get by, we sold our houses, spend down our retirement, and 
     took drastic measures to pay our medical bills and day-to-day 
     living expenses. That first year, we bought a plan that cost 
     us only $27 a month. The next year, we qualified for expanded 
     Medicaid.
       We paid into the system our entire lives. I don't think it 
     is right that lawmakers are now threatening to take 
     everything away from us.

  She says this:

       My parents immigrated to this country. English wasn't their 
     first language. Four out of five of us kids went to college. 
     All of the grandchildren went to college. Everyone is doing 
     well because we worked.
       My family has collectively paid into the system more than 
     enough to cover us, but now they are talking about ripping 
     away benefits. Where is the justice in that?

  She adds this--this woman whose husband has Alzheimer's, who was 
protected by the Affordable Care Act. Do you know what she says in this 
letter?

       We are not losers. We are not freeloaders. We should not 
     have to be embarrassed or shamed for needing help. There 
     should be dignity in getting old, and we should be enjoying 
     our golden years, but that has been taken away from us. Don't 
     make it worse.

  Story No. 13, Mary and Erich:

       Let me tell you about my son Erich. He is friendly and 
     compassionate. When he grows up, he wants to be in a band and 
     to be a Power Ranger. He loves to dance to videos we find 
     together on YouTube. His greatest joy comes from being around 
     his friends at Miracle League Baseball, [and that is a 
     baseball league for kids with] special needs, where he plays 
     third base.

  Mary writes:

       Erich was born with Down syndrome and a severe intellectual 
     disability. At 20 years old, he functions at roughly the 
     level of a second grader. While many young adults with Down's 
     have been able to integrate into society and take on 
     employment, Erich's disability is so profound that he 
     requires full-time care, and he will never be able to live 
     independently.
       My husband, Mary writes, died suddenly in 2009. So today, 
     it is just Erich and me. After my husband's death, I was 
     forced to close down the business we owned, and we lost 
     access to traditional insurance. Erich and I were able to get 
     coverage through Medicaid. It has been a critical lifeline 
     over these last 9 years, and I don't know what would happen 
     to either one of us if it were to go away.
       Through the services provided by Medicaid and other 
     supportive programs in our community, I am able to keep Erich 
     at home where he belongs. He needs Medicare for speech 
     therapy as he has an enlarged tongue, small mouth, and weak 
     facial muscles. He has difficulty communicating and saying 
     words like ``water'' [and] ``phone''. . . . His sentences are 
     two and three words. Erich is prone to sinus and allergy 
     infections due to a smaller cartilage in his nose typical of 
     Down syndrome. He suffers from skin rashes due to the 
     infections that he gets. He does require many prescriptions 
     and doctor's visits and occasionally a visit to the emergency 
     room.
       As a boomer generation widow, I need to make sure that I am 
     healthy enough to show up for him. He has NO ONE else. I 
     depend on these services, too.
       When I hear about potential cuts [to Medicaid, when I hear 
     about repealing the Affordable Care Act], I think not just 
     about Erich, but about all his ``special needs'' friends he 
     has made over the years at the school, at the tutoring 
     center, and on the baseball field. Cutting or capping 
     programs like Medicaid will devastate us all. Many of his 
     friends require more services, are wheelchair bound, have 
     speech, hearing, heart, and constant ear problems.
       As a society, and the greatest country in the world, we 
     have to continue to support--

  In her words--

     our ``special people'' and families like ours. These 
     ``special people'' enrich our lives and show us what is 
     important . . . caring for each other, compassion, and 
     friendship.

  Story No. 14, Sara in Maryland. She says:

       I am a physician, and the ACA allows me to document 
     [healthcare issues] better and more fully. I no longer need 
     to worry that if a person is designated as, for example, 
     having acne and they have a serious condition later, they 
     will be denied insurance for a preexisting condition.

  I thought this story in the letter was interesting because it shows 
what the doctors were going through as they were trying to figure out 
how they report things so this person isn't denied insurance later 
because they have a preexisting condition. Now they don't have to worry 
about that anymore, but if the administration wins--if they win in 
their action to repeal the Affordable Care Act, like they announced 
last night they wanted to do--we would go back to that situation.
  Story No. 15, Tracey in Maryland. She says this:

       In 2011, I began dialysis due to end-stage kidney disease. 
     Before dialysis and well into it, I worked as a preschool 
     teacher, a notoriously low-paying profession. In 2007, when I 
     changed jobs, I lost my employer-based health insurance. 
     After 1 year of COBRA, a local insurance person and a good 
     friend of ours told me about the Maryland State Health 
     Insurance Plan. Through that plan, I was able to qualify. 
     When the ACA began, the MSHIP [State] plan ended. In a 
     meeting with a member of Howard County's Health Department to 
     figure out how to replace my insurance under the ACA, he told 
     me that because of my end-stage kidney disease, I probably 
     would qualify for Medicare. He was right. I also have a 
     supplemental plan (Care First) and a drug plan [through] 
     AARP, and my parents help pay the premiums for those. In 
     2015, I had to stop working because of exhaustion caused by 
     dialysis. I then qualified for disability. In 2016, I had a 
     kidney transplant. Medicare will continue to insure me. . . . 
     Our hope is that by then I will be back to work, but my 
     biggest concern is that without the ACA, my preexisting 
     condition will prevent me from finding health insurance.

  At the end of her letter, she asks a simple question: ``What will I 
do then?'' That is a question that millions and millions of Americans 
want to ask the President today. They woke up to read the newspaper or 
turn on TV and found out that this administration had announced that 
they want to repeal the Affordable Care Act--not part of it, no, no, 
the whole thing. So when they do this, this means these protections 
aren't in place. So there is a whole ton of people that joined Tracey 
in asking: ``What will I do then?''
  Story No. 16, Debbie in New Jersey:

       I am a 48-year-old woman with chronic health issues that 
     require me to visit doctors every few weeks and take 
     prescription medications. I suffer from migraines. . . . I 
     also have herniated discs in my back. . . . I am self-
     employed and run two businesses.

  Guess what. That means she is contributing in a big way to our 
economy.

       I purchase my coverage on the federal ACA exchange. Before 
     the ACA--

  Or as we know it, the Affordable Care Act--

     I had nowhere to buy affordable insurance coverage that would 
     actually cover my health issues. Repealing the ACA will have 
     a devastating impact on small businesses and the self-
     employed, especially those of us with health problems. I am 
     terrified that I won't be able to afford coverage as I inch 
     closer to the 50-64 age bracket. And if the ACA is repealed 
     and if there is no marketplace for me to purchase insurance, 
     I will be forced to close my businesses.

  Story No. 17, Stephanie in Massachusetts:

       I was born with hip dysplasia. I had surgery to correct it 
     at 9 months old. At best, the issue was corrected to 85 
     percent of what a normal hip will do. In college . . . I had 
     hip pain. I underwent four separate surgeries to fix 
     cartilage. That meant four sets of pre-op AND post-op MRIs or 
     other scans and four sets of post-op hospital stays.
       In just 27 years, my family and I racked up hundreds of 
     thousands of dollars in medical bills. In recent years, 
     insurance covered . . . [me].
       I'm honestly not sure what repeal of the ACA means for me, 
     but I guarantee it'll make life harder as it will for a lot 
     of people. I was lucky to have insurance.
       Please vote no on any bill that repeals the ACA. Save my 
     care.

  As for this story, even though she didn't know quite how it would 
affect her, I can tell you that with hip dysplasia, something I have, 
she has a preexisting condition, and that would mean that she couldn't 
qualify for insurance, especially when it came to further hip 
surgeries.
  No. 18, Tegan in Ohio:

       It would put me at risk of losing coverage [if you repeal] 
     because of a genetic pre-existing condition. Congenital 
     dilated cardiomyopathy killed my grandfather, nearly killed 
     my aunt, killed my sister, and nearly killed my brother. When 
     my brother, a 12 year old at the time, needed a heart 
     transplant, doctors told our parents that the insurance could 
     simply decide to not cover the procedure. They had buried a 
     toddler just 4 years earlier, and they were faced with the 
     possibility of losing another child.

  Tegan writes:

       We need to ensure that all Americans have access to care. 
     You can't predict when you

[[Page S2004]]

     will get sick or injured, and you can't predict when a 
     dangerous genetic mutation may emerge in your family. How we 
     treat our fellow Americans is a measure of who we are as a 
     people.

  That is a good one to send to the White House tonight.
  No. 19, Shirley in Massachusetts. She writes:

       My second daughter was born with liver disease, which was 
     diagnosed 9 weeks after her birth and required surgeries and 
     medications. Pediatricians, cancer specialists, heart 
     doctors, and family physicians all agree that . . . 
     [healthcare suggested changes that would repeal the 
     Affordable Care Act] will make things worse, not better.

  No. 20, Sheila in Illinois:

       The ACA allowed us to start a new business, in spite of the 
     fact that my husband was diagnosed in 1992 with hepatitis C 
     after receiving a tainted blood transfusion in the `70s. We 
     became, in her words, job creators because we were finally 
     able to get coverage for him outside of employer provided 
     coverage.

  She says:

       I have been self-employed for 28 years but have gotten a 
     job because at age 61, the fear of losing affordable 
     healthcare at my age could ruin our finances.

  No. 21, Carter, 22 months. This is written by his family.

       Meet Carter. He loves cars, swimming, and building blocks. 
     He requires therapy (speech, occupational, and physical), 
     orthotics . . . glasses, and nebulizer machine. He sees an 
     infectious disease, pulmonologist, and neurologist. His 
     disease is progressive . . . [he needs healthcare].

  Story No. 22, Myka, age 7:

       Myka is 7 years old. She loves the Girl Scouts, ice 
     skating, and playing with her friends. Myka was born with a 
     congenital heart defect. What does access to affordable 
     quality healthcare mean? It means Myka is still alive.

  No. 23, Leonore in New York. She writes:

       I have Parkinson's, and I have had it for 18 years and have 
     Medicare disability since 2008. I am 62, and the ACA allows 
     me to have a preexisting condition and . . . [still get 
     help].

  She talks about her son, who is 24 years old and disabled and says:

       We'd both be in terrible trouble if we lost our coverage.

  No. 24, Joanna:

       My name is Joanna. I am here to share the story of my 
     daughter Jasmine. . . . I will start at the beginning of her 
     life, 3 years ago, when she was . . . inside my belly.
       I was four months pregnant . . . when I received the most 
     devastating and heart wrenching news. . . . I was told that 
     my precious little . . . [baby had a heart problem]. I was 
     told she had one of the most complex and deadly conditions 
     around.
       I was told she would have half a heart with many of her 
     organs flipped.

  But she was given options.

       I prayed for a decision. I was quickly reminded of the 
     recent Obamacare legislation that would give Jasmine a chance 
     at life. One that is hopeful and compassionate, that protects 
     innocent children like Jasmine from being denied medical care 
     due to preexisting heart conditions, one that refuses to put 
     a dollar sign on her life by imposing lifetime caps, and one 
     that would ensure essential healthcare benefits to keep her 
     alive.

  She was born, and she had the surgery. She says:

       Thank goodness for Essential Health Benefits that allowed 
     me to receive proper maternity care when Jasmine was in the 
     womb . . . and emergency services.
       I am sharing my story today as a plea to not steal these 
     lifetime protections away from Jasmine. . . . Please do not 
     tell my child and children like her that they are too 
     expensive, not worthy of life any longer. Please know, this 
     is a life and death fight for me and my daughter, and I will 
     do everything in my power to protect her and to stand up for 
     whatever is needed to keep her alive.

  No. 25, Kendall in Oklahoma.

       The moment I finally realized what it meant to be poor and 
     sick in America, I was sitting by myself in the cancer center 
     an hour from my home. I had arrived early for my infusion 
     that day, checked in and gotten that day's hospital bracelet. 
     Before I could be hooked up to an I.V., I was pulled into a 
     side room and told my insurance had denied my claim.

  That is the story, and that is what is going to happen over and over 
again if we go back to those old days before we had the Affordable Care 
Act.
  No. 26, Jennifer.

       My husband Chris is one of many ACA success stories in red 
     state Oklahoma. In January 2006, at age 29 at the time, Chris 
     began working for a nonprofit that offered healthcare 
     benefits after a certain period of employment. A few months 
     later, we went to the ER thinking he had appendicitis. 
     Doctors quickly took him to surgery thinking the same. After 
     several hours, the surgeon (accompanied by a chaplain) said 
     he removed a large tumor from Chris' colon. He was on the 
     brink of death with a rare aggressive form of colon cancer. 
     Removing the tumor increased his chances for survival but the 
     cancer was far too advanced for traditional chemotherapy. The 
     only course of action at that point was to see an oncologist 
     every month for CEA labs and a colonoscopy every 6 months 
     until the oncologist determined he was out of danger for 
     recurrence. We crossed our fingers and hoped for the best.
       Between 2006 and 2009, Chris tried to get health insurance 
     but [was] rejected due to cancer diagnosis being a 
     preexisting condition. Once the ACA became law, because of 
     its protections for people with preexisting conditions, my 
     husband was able to purchase a [healthcare] policy through 
     the federal exchange and continue seeing an oncologist for 
     needed care.
       Miraculously, Chris has not had a recurrence--so far. 
     Without ACA protections for preexisting conditions, my 
     husband will be forced [and] (priced) out of the market. 
     Given the high probability for recurrence and increased costs 
     impeding an early diagnosis of recurrence, survival is less 
     likely for my husband. I cannot bear the thought of losing my 
     love, my best friend . . . my hero.

  Story No. 27 is from Texas. His name is Mike. All he says is this:

       My wife and I are uninsurable without the ACA. I take life-
     saving medications.

  Think of how many people just write those simple words.
  No. 28, Amanda in Texas.

       My son, Cooper, is 3 years old. We found out he has cystic 
     fibrosis when I was 14 weeks pregnant. Though he has been 
     very healthy for a child with CF, literally a simple cold 
     could change that. He will always have CF, and both 
     preexisting conditions and lifetime maximums keep us up at 
     night. Just being insured won't mean anything if there is a 
     lifetime maximum. By the time he reaches grade school, he 
     will likely have exceeded the typical ``million dollar 
     maximum'' we dread so much. Please keep our boy healthy.

  She pleads not to repeal the Affordable Care Act.
  No. 29, Adele in Massachusetts.

       I was diagnosed with epilepsy at 18 years old. Beforehand, 
     I was dealing with chronic depression which required high 
     doses of antidepressants. . . . My mother is a single parent 
     and I am currently 22, so we try our best to be able to 
     afford our medications. . . . If the ACA [is repealed] it is 
     possible that we will no longer be able to afford our 
     medicines and that I could fall into a deep depression. . . . 
     If the ACA repeal is passed I will no longer be proud to be 
     an American.

  No. 30, Helen in North Carolina.

       Insuring me through COBRA when my husband retired would 
     have cost us a full third of our small, fixed income. The ACA 
     provided [us] not only assured access to health insurance for 
     me, but insurance with a premium and an out-of-pocket maximum 
     that fits [with] our budget.

  So many of these stories involve people trying to fit their budget 
with healthcare.
  She writes:

       That insurance allows me to continue my treatments for my 
     illnesses. Without my medications, I will be in extreme pain, 
     will have more joints eroding to the point of being 
     nonfunctional, and will be landing in a hospital multiple 
     times a year. . . . Without the tax subsidy I get through the 
     ACA, my insurance premiums plus the max for my current plan 
     would cost 80% of our income.

  No. 31, Jennifer in Arizona.

       I am an attorney and have been employed full-time since 
     graduating law school in 2006. I take care of myself, make 
     healthy choices, and work hard. I have encountered multiple 
     medical challenges in the last 15 years. I was diagnosed 
     with thyroid cancer in my first semester of law school and 
     had surgery to remove my thyroid over Christmas break that 
     year. The surgery damaged my [parathyroid] glands which 
     produce a hormone that helps the body process calcium. I 
     have to take replacement thyroid hormone, activated 
     Vitamin D, and calcium supplements to stay healthy. Over 
     the last 15 years my prescription costs have gone up from 
     $30 a month to about $110 a month.
       In 2012, I had an unexplained placental abruption with my 
     first pregnancy and delivered my son 9 weeks early. He spent 
     5 weeks in [intensive care] learning to eat and breathe.
       Last year, my son tripped over his Pull-up and broke his 
     femur. He was placed in a full-body cast for almost 8 weeks.
       We [have good jobs] with good employer health coverage.

  But here is the problem. Because of her problems with her thyroid, 
she would have a preexisting condition. They would not get health 
insurance.

       We are working on continuing to be contributing members of 
     society, investing our savings . . . [and making sure we 
     participate] in the economy in every way.

  No. 32, Debra in Illinois.

       Our older daughter is severely disabled.

  By the way, anyone who dealt with the past attempts to repeal the 
Affordable Care Act knows that the disability

[[Page S2005]]

community was mobilized as never before. Because they, of anyone, the 
families of people with kids with disabilities, understand more than 
anyone how important this preexisting protection is.
  Yet, last night, without regard to them, without regard to anyone in 
America with a preexisting condition, the administration just announced 
they are going all out to repeal these protections in the Affordable 
Care Act.
  That is what happened.
  Debra from Illinois.

       Our older daughter is severely disabled. Essentially a 
     preexisting condition since birth. In 2014 I underwent 
     treatment for Stage 3 . . . breast cancer. I was horrified. 
     Then I pulled myself together. If I can survive cancer, I can 
     survive [this].

  But without healthcare, we can't survive.
  No. 33, Felicia in Texas.

       I have struggled with chronic pain for over 20 years. For 
     years I've gone to specialist after specialist, and pain 
     clinic after pain clinic. No one could tell me why regular 
     approaches to joint and tendon pain never worked for me.
       Just last year I was finally diagnosed with . . . a genetic 
     . . . connective tissue disorder.

  She goes through and describes what this means to her: There is no 
cure for my chronic condition, only pain management.

       Because these conditions are rare, [these physicians don't 
     know] how to help me.

  She says she depends on healthcare specialists. She says she needs 
the affordable healthcare act because of the preexisting condition 
protection. I believe her.
  No. 34, Janet in Illinois.

       I have a son who survived cancer and a daughter with 
     Crohn's disease. My daughter's husband has Cystic Fibrosis.

  Repeal of the ACA would change everything.

       Let them stay healthy.

  No. 35, Elizabeth in Illinois.

       I am lucky (for now), in that I have coverage through my 
     employer. That said, even I could be impacted if lifetime and 
     annual benefits caps are put back in place. I have two family 
     members undergoing cancer treatment right now, what happens 
     to them? What if one of my children is diagnosed with a . . . 
     disease like my best friend's 5-year-old daughter was?

  No. 36, Patricia in Illinois.

       I have a preexisting condition as I have Multiple 
     Sclerosis. My treatment includes MRI's yearly and medications 
     that cost nearly 60,000 dollars yearly. I am now in Medicare 
     and Medicaid and would be left with no options as I am on 
     disability and could afford no insurance.

  No. 37, Noel in Maryland.

       I will soon be 26 and off my parents' health insurance, and 
     it is thanks to Obamacare that I have been able to stay on 
     that insurance while I have been struggling with a chronic 
     disease. . . . I have made great strides in recovering my 
     health . . . should not be punished for having a preexisting 
     condition.

  No. 38, Megan in Texas.

       My dearest friend recently donated her kidney to a two year 
     old child who was on dialysis, and saved his life. At the 
     time of her donation, Obama was President and preexisting 
     conditions seemed protected, and she didn't question such a 
     transformative medical procedure. Pre-existing Condition 
     coverage must remain in order to protect living organ donors 
     and encourage people to save lives by donating. Who would 
     donate an organ if they knew insurers could charge them or 
     not accept them? We must protect this important provision!

  No. 39, Jeffery in Illinois.

       I have MS. . . . Every 48 hours I inject myself with 
     prescription medication to prevent the disease from 
     advancing.
       If the ACA was repealed, I would not have protection, and 
     MS would, of course, be considered a preexisting condition.
       The ACA has allowed me to remain a productive wage earner 
     supporting myself and my family.

  How many times do you hear this?

       Please consider the personal and societal costs of 
     repealing the ACA.

  No. 40, Lauren in California.

       When I was a freshman in college, I donated blood to the 
     Red Cross. A couple of weeks later, a letter from the Red 
     Cross informed me that I had Hepatitis C--I was 18, living 
     away from home (clear across the country) for the first time, 
     and I had no idea what to do or how I might have contracted 
     the virus. After a year it was determined the diagnosis was a 
     false-positive . . . but every blood test since has indicated 
     liver enzyme levels outside of normal, which means Hepatitis 
     C will be a pre-existing condition that follows me around for 
     the rest of my life. I just earned my PhD and I'm still 
     looking for my first postdoctoral job, which means I'll need 
     health care coverage until I am insured by an employer. . . . 
     I'm screwed [if I don't have the ACA]. I've worked hard to 
     make good choices for my health, but now an administrative 
     mistake that I have no control over--

  That was the information she received when she gave blood--

     has the potential to wreck my chances for affordable health 
     insurance [if the ACA protections aren't in place].

  No. 41, Koula in Texas.

       I have high blood pressure & pre-diabetic. I am retired and 
     currently I'm covered under my employers plan as a retiree (I 
     pay premiums at twice what an active employee pays) until the 
     age of 65 then I switch to Medicare and my employer insurance 
     will become secondary. If you cut the requirements that 
     corporations offer to their employees and retirees I will be 
     greatly affected as I'm living on a fixed income. My 
     condition is heredity and no amount of exercise or dieting 
     will ever bring down my blood pressure enough for it to be 
     normal. . . .

  No. 42, Joy in Texas writes:

       I would be dead and/or bankrupt without ACA coverage. 
     Within 6 weeks of moving to Austin from New York City in 
     2012, I was diagnosed with stomach cancer; I had had breast 
     cancer . . . I came with insurance associated with my 
     business, a plan unavailable in Texas. When that expired, I 
     was kind of stunned to discover I was uninsurable. . . . For 
     the next 6 months, I was in the state pool and basically 
     self-insured until the ACA became effective. . . . Although 
     not perfect, it provided the coverage I needed at a price 
     point I could afford.

  No. 43, Liz writes:

       I wish the ACA had been around 10 years ago. Back then I 
     was almost 30 years into a happy and successful teaching 
     career. . . . But then along came that little glitch in the 
     economy, and schools were tightening belts. I found myself 
     unemployed, uninsured, and living with a pre-existing 
     condition requiring very expensive, but life extending 
     medications. Worse, I was living in a country where health 
     care is tied to one's job status.
       Jobs were scarce, and age was not on my side in a tight job 
     market. So I worked in daycare centers, and did babysitting. 
     My Cobra ran out. Private insurance was totally out of reach.
       Ultimately I had just one option left: I was just old 
     enough to retire early as a teacher and to qualify for 
     retired teacher benefits with TRS. It was a last resort. . . 
     . By law, I would no longer be eligible to teach. . . . 
     Without the ACA, I had to choose between my job and my life.

  No. 44, Jerry writes:

       Fifteen years ago I was self-employed and working furiously 
     to get a new company off the ground. Things were going fine 
     until I ran up against a brick wall--health insurance. My 
     wife and I had been happily paying for health coverage 
     through my previous employer via COBRA, but then we 
     approached the time limit allowed under that coverage. It was 
     impossible for us to buy a policy on the individual market 
     for two reasons: my wife had not only been recently treated 
     for cervical cancer, but she was also pregnant with our first 
     child.

  He says:

       Protect our care. Entrepreneurial and creative Americans 
     deserve the freedom to chase our dreams without having to 
     risk financial ruin by being denied access to comprehensive . 
     . . healthcare. Isn't that risk-taking spirit . . . what . . 
     . [people say] . . . is needed to build our economy ever 
     higher?

  No. 45, Lisa writes:

       No healthcare coverage for my chronic illness will result 
     in my death [because of the ACA.]

  No. 46, Hannah writes:

       My spouse is a research scientist. Some years ago, while 
     working at the University of Texas, he received a highly 
     prestigious national research fellowship. The fellowship made 
     him ineligible for employee health insurance. . . . Due to a 
     preexisting condition he contracted as a teenager, however, 
     he was denied affordable insurance. . . . We oppose the 
     repeal of the ACA because the denial of healthcare to 
     individuals based on their employment status, their economic 
     status, or their health conditions is deeply unethical and 
     ultimately deadly.

  No. 47, Jaime writes:

       I am a 62-year old and am currently in the hospital 
     awaiting open heart surgery. I am only able to have this 
     surgery due to being in ObamaCare.

  No. 48, Devora in Maryland writes:

       My daughter Esther was diagnosed with Leukemia when she was 
     12. She would not be able to get health insurance under the 
     proposed bill. She has been through enough.

  That is what a lot of people in America would say right now to the 
Trump administration. They have been through enough because of their 
health problems and because they have worked hard, and they deserve to 
be carried. They have been through enough because they have had that 
healthcare threatened over and over. They voted in 2018 because they 
wanted to have their healthcare protected.
  Yet now, last night, the administration--not listening to that--
announced

[[Page S2006]]

they would repeal the entire Affordable Care Act.
  No. 49, Darla in Michigan writes:

       I'm on disability from chronic pain because of a doctor's 
     mistake with back surgery. I am going to have my fifth back 
     surgery. I live alone and am on disability. I already pay 
     huge premiums.

  She says: If you repeal the Affordable Care Act, ``I will be 
homeless.''
  No. 50. Nathan in Michigan writes:

       I am a builder who builds and maintains homes for many of 
     the wealthiest people in our State. I have worked hard and 
     climbed my way to the top over the last 20 years. None of the 
     employers in my area offered insurance, and only until the 
     ACA was I able to afford the healthcare I need. I have severe 
     asthma and have arthritis in my right hip. Even with the ACA, 
     we still struggle to pay my medical bills, but we manage.

  He says:

       Now, we are worried that . . . [if we lose the ACA] I could 
     be priced right out by being put in a high-risk pool because 
     I have preexisting conditions. I am making top dollar working 
     for the people who are going to reap the profits. . . .

  He finishes by saying: This is taking away my ability to do the work 
on their houses.
  No. 51, Ellen in New York writes:

       My husband has been disabled from a stroke for almost 20 
     years and unable to work. I am a licensed clinical social 
     worker within busy Private Practice doing counseling with 
     individuals, couples, and families. If Mental Health Services 
     are dropped . . . I will not be able to support my family.
       My husband and I are both seniors and anticipate insurance 
     premium rates going up. . . . [if we don't have the 
     Affordable Care Act]. . . . we both have preexisting 
     conditions.

  Erika in Washington writes:

       I have triplet sons, each of which have all had a form of 
     healthcare issues that would be deemed under this plan to now 
     be pre-existing conditions.
       I can't fathom the thought that another woman or a mom 
     would not be alive or her children would not receive the same 
     care we have. I will stand against anyone who threatens my 
     children's future access to health. I don't know a single 
     mother who won't be right there alongside me.

  Well, I think they are going to have to go to the White House now 
because we just heard last night that they want to repeal the entire 
Affordable Care Act.
  No. 53, Marcy writes:

       I'm in fairly good physical health, but mental health has 
     been a lifelong struggle for me. I take medication and have 
     turned to therapists . . . several times over the years. I do 
     my best to stay mentally healthy. But there have been many 
     times when I needed help. . . . I believe everyone should 
     have access to mental healthcare. It's not something you 
     should choose as part of your health care plan or not.
       We ALL need full, comprehensive, excellent healthcare 
     coverage. Essential coverage for mental health, maternity 
     care, well care check-ups, medication, etc. is important for 
     EVERYONE.

  No. 54, Samantha in Massachusetts writes:

       My husband has a genetic kidney disorder . . . and at the 
     age of 47, needed a kidney transplant. He is now, thanks to 
     the miracles of modern medicine and the incredible generosity 
     of his donor, back at work, paying taxes, and living a good 
     life. The transplant took place one week before the last 
     election, and the last thing we did before the surgery was 
     vote early--in large part to try to stave off the repeal of 
     the ACA. My husband's prospects are very good. . . . The 
     financial implications to both my family and the kidney 
     donors are impossible to predict or calculate, but the cost 
     of losing ObamaCare would be steep, terrifying, and entirely 
     un-American.

  No. 55, Amal in Tennessee writes:

       I feel ridiculously lucky that the ACA existed when I had 
     my baby, and here's why: My husband and I were both 
     freelancers when I got pregnant and were on ObamaCare in New 
     York. When I was 5 months pregnant, we moved to Nashville for 
     his job, which didn't provide insurance. Because of the ACA, 
     we were able to buy coverage, even though somehow pregnancy 
     is considered a preexisting condition. It could once again 
     become the basis for an insurance company to reject you or to 
     increase your premiums if the ACA is repealed.
       Denying a pregnant woman insurance coverage can have far-
     reaching effects. She might stay in an unhealthy job to 
     maintain coverage, or stay in an unhealthy or abusive 
     marriage to maintain her husband's coverage. A family might 
     forego a good opportunity to move for a better life for their 
     child. . . .

  No. 56, Matthew in Washington writes:

       I was diagnosed with a chronic medical condition when I was 
     9. Growing up, I was fortunate to have a mother who was able 
     to fight for me, from keeping me enrolled in a public school 
     to getting me access to experimental drugs at any of trials. 
     . . . But I also saw her in tears over medical bills when my 
     father was laid off after 9/11 and we had to go on COBRA, and 
     how draining negotiations with insurance companies were.
       I am now successful, independent, and working in 
     international relations in Washington, D.C., which I love. If 
     the ACA is repealed, I will live in constant fear of being 
     laid off or fired and losing my insurance, or worry that I 
     will have a flare-up that would devastate me financially.

  No. 57, Page writes:

       I was fired in 2015 when I was 5 weeks pregnant. Thank 
     goodness we had the Affordable Care Act because I could not 
     be discriminated against under any preexisting condition 
     limitations. I knew my maternity care would be covered. I 
     logged onto the exchange, compared plans, [and] signed up . . 
     . I'm just so grateful that happened for me.

  No. 58, Kelsey writes:

       My brother has Type 1 diabetes and prior to the ACA, he was 
     covered on my parents' insurance, but I don't know what's 
     going to happen to him [when we don't have the ACA, if they 
     took it away.]

  No. 59. Macon writes:

       I'm a member of a union that takes care of me, but a lot of 
     people are not that fortunate and I'm scared for them. I have 
     family members with preexisting conditions, and by every 
     accounting, this bill, if it passes, is going to take 
     coverage away from people who are vulnerable. . . .

  No. 60, Samantha writes:

       I'm fighting the repeal of the ACA because my father has a 
     preexisting condition and he's hoping to retire in the next 
     few years. I don't believe plans should be changed because of 
     a bill that would remove protections for people with 
     preexisting conditions. . . .

  No. 61, Golchin from Nevada writes:

       It will be really hard for us to get insurance since I will 
     be [considered having a preexisting condition]. . . . We 
     would love to start our family. . . . Having kids is all we 
     talk about, so please don't take that away from many of us.

  No. 62, Cathy writes:

       ObamaCare saved my life. I had health insurance. I needed 
     brain surgery. My health insurance company kept delaying 
     approvals. . . . Because they refused to pay for a CT scan 
     that was needed to confirm a diagnosis, I had to pay for one 
     out of pocket. . . . But, because of the public pressure, 
     when ObamaCare was being drafted, my surgery was eventually 
     approved by the insurance company in 2009.
       I am deeply concerned that legislation repealing ObamaCare 
     could leave in place devastating and historic cuts to my 
     hospital. Please do not gut protections for those of us with 
     preexisting conditions. . . . Do not eliminate services for 
     special needs kids.

  No. 63, Jennifer in Nevada writes:

       If the ACA is repealed, my healthcare might go away and I 
     could never afford continuing care with my . . . [heart 
     condition] . . . and my husband's arthritic condition. When 
     my battery runs out in four years, if I don't have health 
     insurance, I'll probably die or have to go bankrupt. . . . My 
     brother also has heart trouble. . . . And for what? So that 
     the wealthy can have more . . . ? Our government is supposed 
     to work for our best interests. . . .

  No. 64, Adrian writes:

       In 1986 to 1987, I was diagnosed with [genetic] breast 
     cancer and was told I had a 25 percent chance of living 5 
     years. I quit my job to have medical treatment, and, after 
     COBRA coverage ran out, was put in a high-risk pool 
     (Illinois). My insurance payments were high . . . I had to go 
     back to work to pay for . . . [them]. If that's what happened 
     30 years ago . . . [what would happen now if I had a 
     preexisting condition and couldn't get insurance coverage]?

  No. 65, Michelle writes:

       I have had three surgeries for the ``chronic disease''. . . 
     . Prior to ACA, these surgeries would not have been covered. 
     . . .

  No. 66, Elizabeth writes:

       Please do not allow States the ability to opt out of 
     holding insurances companies accountable to cover essential 
     health benefits like maternity care, mental health treatment, 
     and rehabilitation treatment. As an elementary public art 
     educator, I know firsthand the importance of [the] mental 
     health care [provision]. The school district I serve . . . 
     has suffered the loss of four students who have taken their 
     own lives just this year to battles with mental and emotional 
     issues, the youngest of whom was 12 years old and a former 
     student of mine from the first year I taught. . . . These 
     saddening and possibly preventable deaths have rocked our 
     community. Coverage for mental health and treatment will 
     allow parents the ability to seek help for their children 
     whose precious lives hang in the balance in the politics 
     of healthcare. Affordable care helps destigmatize mental 
     and emotional illnesses, giving these students the 
     confidence and ability to speak up.

  People have long stories, and they care about this a lot.
  Story No. 67, Karen:

       My friend Mary was never able to purchase health insurance 
     until ObamaCare passed. She bought a policy the very first 
     day it was available to her. A few months later, she was

[[Page S2007]]

     driving, and she was almost killed. She required prolonged 
     care and rehab, which would not have been available to her 
     before she had health insurance. Through good care, hard 
     work, and persistence, she is alive and again a productive 
     member of society. Please do not take healthcare away from 
     people like my friend Mary.

  No. 68, JoSelle in Florida:

       I am self-employed as a freelance editor and writer and 
     have been for most of my post-college life. Unfortunately, I 
     also have preexisting conditions.
       Pre-ACA, I was ineligible for insurance despite taking some 
     of the cheapest, most common medications on the marketplace. 
     I was forced into a high-risk pool in the State where I lived 
     at the time, Utah, which placed an enormous financial burden 
     on me. . . . Post 2014, I can afford to pay for my insurance.
       Of course, the ACA isn't perfect. I am sympathetic to those 
     who faced premium increases under it or who found their 
     access to healthcare diminished. However, the logical thing 
     to do is to improve it, not demolish it.

  That is a pretty good line. Send that one to the Justice Department.

       I urge all people reading this to stop and think. Whether 
     you voted for Clinton or Trump, whether you preferred one of 
     their primary challengers to either of them, whether you live 
     in a red, purple, or blue State . . . it does not do to not 
     have the Affordable Care Act.

  No. 69, Kat in Kansas:

       I had advanced stage 3 breast cancer and inflammatory 
     breast cancer. I am now on disability. Contrary to what many 
     have said, I did nothing to bring this on myself. I ate right 
     and exercised. I didn't smoke. My cancer was genetic. So was 
     the heart problem I had. I did not ask for this. Disability 
     is no picnic. I can barely make ends meet. If the ACA is 
     repealed, I will be homeless at the best and, at worst, dead.

  No. 70, Lois in New York:

       Breast cancer runs throughout my family on both my parents' 
     sides. My mother, aunt, and cousins have all had this 
     disease. Some have died from it, including my mom. When I was 
     23, I had a lump removed. Luckily, it was benign. The 
     anxiety, pain of discovery, and treatment are excruciating 
     enough without having to worry if you can afford care.

  No. 71, Penny in New York:

       My son has a life-threatening preexisting condition for 
     which he received medical treatment and medication through 
     the ACA expansion of Medicaid in the State where he lives. 
     Without this, he will be unable to pay for his medications 
     and doctors' visits and will surely decline. Both my mother 
     and my husband's father were able to be cared for in nursing 
     homes, until their dying days, because of Medicaid. I am 
     desperate to make sure we keep our healthcare.
       Thank you for listening.

  No. 72, Jen:

       In 2015, I donated a kidney to a stranger, kicking off a 
     chain of three transplants. I didn't have to worry about how 
     it would affect my health insurance because, thanks to the 
     ACA, I could never be charged more or be denied coverage 
     because I shared my spare kidney. I am 55 years old and self-
     employed. This repeal will be a direct attack on my financial 
     and health security.

  No. 73, Jolene:

       I know many of my friends rely on Medicaid. Losing it means 
     the loss of their lives. They cannot afford their medications 
     without the ACA.

  No. 74, Deborah:

       My family's story is over, but I want people to know how 
     much the ACA meant to us at a very difficult time. Our niece, 
     a single adult, lost her job and her insurance coverage when 
     she was in the middle of the fight for her life, battling 
     advanced melanoma. Because of the ACA, she was able to sign 
     up for insurance on the marketplace. I will be very honest 
     and say it wasn't easy, and she was forced to change 
     insurance companies because of changes in available plans. 
     However--and this is big--

she writes in capital letters, sort of similar to the President's 
tweets--

     she was able to get coverage despite the fact that she was 
     very ill. Anyone who has watched a loved one suffer from this 
     devastating disease of melanoma knows how terrible it is. 
     Even though she eventually succumbed to the melanoma that had 
     spread throughout her body, she was able to have continued 
     quality medical care and, eventually, hospice care until her 
     death. I beg you to consider how your decisions will impact 
     people. Even the least of those among us--

  That was a quote she put--

     deserve the dignity of receiving quality medical care.

  Think about this. This is a story of someone whom she lost in her 
family, and she is making a point that, I think, many would make in 
this Nation. Even when people are going to die, they want to have them 
die peacefully. They want them to have good healthcare. They don't want 
to have them taken off of their insurance because of preexisting 
conditions.
  Story No. 75 talks about how a financial burden in the early 2000s 
forced him into bankruptcy. The reduction of work hours and required 
continuing medical costs left him unable to afford healthcare.

       Now, with the potential loss of affordable healthcare on 
     the horizon, my wife is facing a similar situation with her 
     preexisting condition.

  He writes:

       Anyone is one step away from a financial disaster due to 
     the onset of a serious medical condition. Believe me, I lived 
     it first hand, and I didn't see it coming. I think most 
     people who get suddenly sick would say the same thing. They 
     have gone through their lives. They are working hard. They 
     didn't see it coming. That is why we need the protections of 
     the Affordable Care Act.

  No. 76, Jackson:

       Most of the people in my family are likely to lose coverage 
     without anything less than the protections established in the 
     ACA. Any one of us without the ACA would be one car accident 
     or illness away from bankruptcy.

  That kind of says it all.
  No. 77, Allison in Utah:

       My husband and I are self-employed, so we buy our insurance 
     on the open market. Although we were much healthier than some 
     people when we applied for insurance prior to the ACA, we 
     were both rated out because of preexisting conditions. I was 
     even rejected by one company. This seemed ridiculous since 
     the preexisting conditions that caused the rate increases 
     were injuries from being active and were both completely 
     resolved. This made our insurance astronomically expensive.
       When I say we are healthy, we really are healthy. We are 
     lean; we are trim; we are in our mid forties; but we can run, 
     hike, climb, and do more pushups than most people in their 
     mid-20s. We eat healthy, exercise hard, and never get sick. 
     At the most, we might catch one cold a year between the both 
     of us.
       Since the ACA, we have had no problem getting health 
     insurance, and we are not rated out because of preexisting 
     conditions, but the best part is we feel comfortable that we 
     have health insurance. Now it sounds like people are scheming 
     to take away the protection we enjoy under the ACA.

  OK. They are not just scheming. They actually announced last night to 
the entire country that they were going to do this. People woke up. 
They watched the TV. They looked at their newspapers. The 
administration said, yes, it is not going to repeal just part of the 
ACA; it is going to repeal the whole ACA.
  It goes on to read:

       We are against their attempt to take away the mandate that 
     prohibits insurance companies from discriminating against 
     individuals with preexisting conditions.

  No. 78, Erin in Missouri:

       Ours is a story of a genetic mutation that none of us could 
     fathom would bring incredible health challenges to our 
     family. We are the lucky few that have jobs that provide us 
     with insurance. My grandfather's sister was the first to be 
     diagnosed with breast cancer. My mother's cousin and her 
     sister were next. Then my mom was diagnosed with uterine 
     cancer. Then I came along at 32 with the diagnosis and then 
     my sister. Now, as I type this note, my 78-year-old mother 
     awaits another radiology appointment.
       This story is filled with heartbreak and much love. These 
     are the things patients should have to worry about, not 
     whether they can afford their care or be discriminated 
     against because they carry a gene that is beyond their 
     control.

  No. 79, Mary in Massachusetts:

       We have MassHealth and great hospitals. Without both of 
     these, my daughter would have died at birth. Everyone, no 
     matter their income, deserves proper access to healthcare 
     even if you have a preexisting condition or a previous 
     illness. Every time I look at my daughter, it affirms this.

  No. 80, Brent:

       When I graduated high school, my dad informed me that he 
     had paid enough for my health insurance, and now that I was 
     an adult, he wasn't going to pay for it anymore. That's it. 
     That was the entire conversation. I had no idea how to get 
     health insurance for myself, much less how to pay for it, so 
     I just went without for 7 years. Within that time, I had 
     health problems.
       My sister lives in France.

  He talks about her getting protections.

       Instead of being punished, we should be able to have 
     healthcare. This is no way to run a democracy. This is no way 
     to be a decent human.

  No. 81, Tina in Texas:

       I have stage 4 colon cancer, and I am currently on private 
     insurance. I will be forced on to Medicare in another year as 
     I am currently on disability. My life span is at risk if the 
     provision to cover preexisting conditions is abandoned. I 
     have literally risked my life in order to participate in a 
     phase 1 drug trial to help advance our knowledge of treating 
     cancer. How good is that knowledge if we will not be covered?

  No. 82, Julia:

       I am a 29-year-old adult who was diagnosed with a syndrome 
     at age 9, and all through

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     most of my life, I have had no real help besides my mom, but 
     she is a single mom. There is not just me but my brothers and 
     sisters as well as there is only so much one person can do.

  She writes:

       Help me.

  No. 83, Nicole in Kansas:

       I am writing on behalf of my 15-month-old daughter, Mira. I 
     experienced a normal pregnancy, a normal birth, and a normal 
     maternity leave, but around the 4-month mark, we learned that 
     Mira had a neurological disability that may very well render 
     her unable to walk or talk. I could not return to work for a 
     year while I was acting as her mom.
       The ACA is the only thing that kept our family afloat in 
     the most difficult year of our lives. If the ACA is repealed, 
     Mira, who has absolutely no control over the state of her 
     health--

a 15-month-old kid--

     she will suffer needlessly. Please help us.

  No. 84, Jane:

       I am a psychologist with a Ph.D., employed for the past 30 
     years in community mental health centers. I have a serious 
     preexisting condition that made me completely uninsurable 
     before the ACA. Access to healthcare matters.

  No. 85:

       Because the ACA mandates access to free mammograms, I got 
     one this year that resulted in a breast cancer diagnosis. 
     Because the ACA mandates coverage for genetic testing, I was 
     able to have that done and found out I have a gene that means 
     I am at risk for cancer. My risk of ovarian cancer was 60 
     percent. My risk of breast cancer recurrence was 70 percent. 
     I get to ensure that won't happen to me. Yes, early menopause 
     and a mastectomy suck, but they are a whole lot better than 
     radiation, chemo, and possibly death.

  No. 86, Ashley:

       In 2012, at the age of 29, I had my first job and was 
     diagnosed with a heart disease. This is a pregnancy-induced 
     form of heart failure that occurs in women with no prior 
     history of heart disease. My recovery has been a long and 
     brutal one of heart disease. I was on a life vest--a portable 
     defibrillator--for the first month, and I should have been on 
     it longer. I will always have a preexisting condition. The 
     ACA makes me safe.

  No. 87, Lea:

       I am a wife, mother, grandmother, sister, aunt, and great 
     aunt. In my family, my husband and I owned a small business 
     and couldn't change health insurance because of a preexisting 
     condition in one of my children. As a sister, I watched my 
     older sister fight cancer while still working 12-hour shifts 
     as an RN. As a great aunt, I have watched my niece handle two 
     sons with medical conditions. These people deserve the health 
     insurance that does not have any lifetime maximums, and they 
     should be able to pay reasonable premiums.

  No. 88, Hillary from New York City and Kansas.

       Although I live in New York now, Kansas City is home. I was 
     raised in KC, attended Shawnee Mission Schools and KU. My 
     friends, family, and a piece of my heart remain there. I was 
     born with spina bifida, so I have always had a preexisting 
     medical condition. I need affordable healthcare.

  No. 89.

       Eleven years ago, I had just turned 23.

  She talks about her pregnancy, how she needed the protection, and how 
the Affordable Care Act--now that she has a preexisting condition and 
has a photography business and her husband's work insurance doesn't 
cover her, ACA has saved her and allowed her to work, and she has a 
beautiful baby.
  No. 90, Laura.

       My son Danny was born at 30 weeks gestation via emergency 
     C-section. He was diagnosed with spastic cerebral palsy at 
     the age of 1. Without the protections of the ACA, we would 
     not have him. Now we don't have to worry about lifetime 
     limits, preexisting conditions, and the security of knowing 
     we could keep him on our insurance until he is 26.

  No. 91, Kerry.

       My initial surgery, a bulging disk, happened when I was 17 
     and a senior in high school. When I was 18, the disk 
     herniated. I had back surgery at 19, and then I felt like a 
     new person. No more crawling to the bathroom every morning, 
     no more chronic pain. In June 2003, I was days away from 
     being kicked off my parents' insurance when I reinjured my 
     back.

  Then she talks about how, later, the ACA helped her.
  Now I am going to finish up with letters from my own State.
  No. 92, Kayla from Belgrade. Kayla lost her child to cancer and wrote 
to me that if protections for preexisting conditions are taken away, 
more families will suffer similar heartbreak.
  No. 93, Katie. Katie told me that without protections for individuals 
with preexisting conditions, she would not have been able to have 
gotten her diagnosis and beat cancer.
  No. 94, Tony. Tony is afraid that without the protections provided by 
the Affordable Care Act, he will be unable to afford healthcare or be 
denied coverage because of his preexisting condition.
  No. 95, Alison. A nurse named Alison from Minnesota is concerned that 
changes to the health law could make the homeless populations she works 
with even more vulnerable.
  No. 96, Julie. Julie is concerned for her young son, Hudson, who has 
asthma and a rare food allergy. Without protections for individuals 
with preexisting conditions, Julie believes Hudson will be forced into 
a plan that will dramatically reduce his access to healthcare or, 
worse, prevent him from getting health insurance to begin with.
  No. 97, Sarah. Sarah was diagnosed with stage IV colon cancer when 
she was 34 and has undergone countless rounds of chemo. She fears what 
the ``scarlet letter'' of having a preexisting condition will mean for 
her access to care and wonders how she will be able to receive the most 
cutting-edge treatments.
  No. 98, Kate. I remember Kate. Kate did a video, and she became 
famous. She wrote to me about her son, Cooper, who has severe, 
nonverbal autism. Because of Medicaid, Cooper has access to the care he 
needs, and Kate can keep her job. Why were they famous? Cooper was 
featured on Jimmy Fallon and the ``Today'' show for being the cutest 
toddler to say ``mama.'' He started a contest, and his mom Kate decided 
to enter herself and her son saying ``mama.'' Cooper can't speak, but 
he uses a speech device to help him communicate. She sent in her video, 
that was the one they picked, and Cooper became a star.
  Kate is afraid that changes to Medicaid could force her to quit her 
job in order to take care of Cooper. How could she explain that to her 
sons?
  This is another story of someone who has a family member--in this 
case, her beloved son--with a disability that would then be considered 
a preexisting condition. Maybe there would be a way to cover him, of 
course, under disability insurance, but then you start messing with 
whether his mom can work. We would be right back where we were before 
these protections took place.
  Story No. 99, Penny of St. Paul. Penny works with disabled veterans, 
but she has a chronic condition of her own--rheumatoid arthritis. 
Thankfully, her current insurance allows her to get the care she needs. 
But without the ACA, Penny is concerned that she and many others with 
treatable conditions will be unable to afford their medications.
  Last, Ariane. Ariane had triplets at just 28 weeks, and her pregnancy 
included three hospitals stays and bedrest. Without the ban on lifetime 
caps, Ariane said she would have lost everything.
  Those are just 100 stories. Think of the millions more, the millions 
of people who would like to tell the President and the Justice 
Department and this administration what it would mean if what they said 
they wanted to do last night actually happened. These are just 100 
people from across the country.
  I hope my colleagues are listening to this because just last night, 
this administration announced that they were going to go all-out, that 
they were going to do everything to repeal the Affordable Care Act. 
These 100 people are not going to let this happen. You have heard the 
stories of those moms who will do anything for their kids with 
disabilities. You heard the story of the woman who, while her family 
member was lost to melanoma, that coverage for a girl who would have 
had a preexisting condition allowed her to have a peaceful life in her 
last weeks of life.
  These are the stories this administration needs to hear to understand 
that this isn't just some political battle to see how this sits with 
your base, to be against ObamaCare; these are real Americans with real 
healthcare needs. We will fight this on their behalf to the end.
  Mr. President, I yield the floor.

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