Madam President, I rise to speak today in opposition to the Cruz amendment, which would prohibit any funding in the continuing resolution from being used to carry out the goals of the Affordable Care Act.
The broad scope of this amendment clearly indicates that anything anticipated under the Affordable Care Act would be subject to defunding, and that is a broad category of activities. In fact, we already have seen the Affordable Care Act produce demonstrable positive results in my State of Rhode Island, and those results could be eliminated or reversed.
For example, because of the Affordable Care Act, there are protections in place today for children with preexisting conditions to ensure they are no longer denied coverage. There are over 15,000 children who have a preexisting condition who could have been dropped from insurance coverage prior to the enactment of the Affordable Care Act. Their parents and other adults--approximately 200,000 Rhode Island adults also living with preexisting conditions--will gain protection from being dropped from coverage beginning in January. We began with children, and now we are expanding it to adults. If we don't do that, then we are going to have a whole category, a huge segment of my population who may lose access to insurance, and the inevitable result will be that they will go to expensive emergency rooms, and they will cost all of us more money. Rather than saving money and dealing with the deficit in a responsible way, this will just add to our deficit problems and deny people health care.
The law, the Affordable Care Act, included new tax breaks for small businesses to make health insurance more affordable. Small businesses have been able to access a tax credit of up to 35 percent of their health care costs every year since 2010.
Beginning in 2014, these businesses may receive a tax credit of up to 50 percent of their health care costs for any 2-year period. Again this support under the Affordable Care Act could be jeopardized or eliminated under the proposed amendment.
Also in jeopardy are discounts on covered brandname and generic prescription drugs for seniors who have reached the prescription drug coverage gap known as the famous or infamous doughnut hole. Already in Rhode Island, seniors have saved--individual senior citizens of Rhode Island have saved $20.5 million as a result of these discounts since the law was enacted. These discounts will continue until the coverage gap--the doughnut hole--is eliminated in 2020. The Cruz amendment will stop that. Essentially we are telling seniors go back to the time of the doughnut hole, more money out of your pocket at a time when you can afford less and less for prescription drugs.
Many of my colleagues on the Republican side say they support these aspects of the Affordable Care Act, yet this amendment would effectively do away with them or cast so much doubt or confusion that they would not be effectively implemented. We have to, I think, continue to effectively implement the Affordable Care Act, not only in terms of providing access to quality care for all of our citizens but because within the Affordable Care Act were significant efforts to improve health care efficiencies. Indeed, through these reforms, we were able to extend the Medicare Program by, I believe, 8 years, to 2024, in terms of our funding models. All of that would be jeopardized by this amendment.
There are some other examples, too. For example, the Affordable Care Act would reauthorize funding to help immunize uninsured and underinsured children and adults. Every year my State of Rhode Island receives $3 million to immunize this population. Funding for immunizations is critical for the child and the family, but it also benefits all of us, because if you can immunize 75 to 95 percent of the population, immunologists and health specialists will tell us we are all protected through something that is technically known as herd immunity. It makes sense, if you have a sufficient number of people who are vaccinated against the disease, when an outbreak occurs the likelihood of it spreading is diminished dramatically. This is another example of a public health initiative under the Affordable Care Act, which, if it is repealed or defunded, will leave us all vulnerable to diseases. That is not a benefit, that is a detriment to all of us.
We have to, again, I think, consider other aspects of the Affordable Care Act. One other aspect I wish to mention is the critical area of health care workforce programs, programs that help train doctors and nurses. Many of these programs are funded in the continuing resolution and they, too, would be either eliminated or so uncertain as to be unreliable for the institutions. In my home State, colleges and universities, such as at the University of Rhode Island, are using these programs to help train a new generation of health care professionals, not just physicians but physician's assistants and nurse-practitioners. Indeed, what we are seeing, because of the Affordable Care Act, is a refocus to more emphasis on family practitioners, primary care that is less expensive and more effective over the long term in terms of prevention--all that would be jeopardized under this proposed amendment.
There are countless other examples of not only interfering with health care access for a vast number of Americans, but actually setting back our efforts to reduce the deficit and to sustain programs such as Medicare. The burden might be particularly felt by seniors because one of the things that was most compelling in the debate about the Affordable Care Act was closing this doughnut hole. Seniors believe we have taken a positive step to do that. This would be an about-face for the seniors of America, causing them to see more and more costs in their limited budgets.
These are not the messages we want to give to seniors or families. I urge my colleagues to oppose this amendment.
