since the a.c.a. took place, the number of options went down, and the premiums have gone up on average 175%. let me say this. in the hospital where i practiced, a university hospital, the majority of people with uncollectible debt are people with insurance. let me say that again. the majority of uncollectible debt are people with insurance. why? because the out-of-pockets and co-pays are so high that they can't afford it. that's one of the reasons we need this bill. and let me say, also, that a year ago i was facing a major operation, mr. speaker, cancer operation. i have the a.c.a. insurance. i looked at what my out-of-pocket was, what my co-pays were, what my premiums were, what my employer, the taxpayers of this country, paid for me. i would have been better off if i had just written a check for the cost of that cancer operation that i had. i had an insurance card. i didn't have insurance coverage. that's what i had with the a.c.a. insurance. so-called insurance. now that the mandate's gone -- i wan

brett kavanaugh has acted as a skilled political officer in undermining the a.c.a. and kavanaugh has made clear he would give shocking deference to presidential immunity and basically give donald trump a free pass with the mueller investigation. democracy is arift with the kavanaugh nomination. in is be a outrageous partisan power grab against women and all americans by historically unpopular president and we cannot let it stand. trump and his allies must follow the mcconnell rule and we must ensure that we defeat brett kavanaugh. all our rights are at stake. roe v. wade, health care, democracy itself. thank you. it's now my great honor to introduce a champion, a , mpion for all our rights kirsten gillibrand. [cheers and applause] ms. gillibrand: everyone here knows what is at stake. everyone here knows what is at stake. what is at stake is women's freedom. our freedom to make our own decisions. our freedom to decide when and how many children we are going to have. what's at stake is freedom for lgbtq americans, for equal rights, for civil rights, for voting rights,

it's through the a.c.a. exchange that my own family and i get our health care and so many others in delaware have had a chance to get access to health care. the 190,000 people in my little state of 900,000 people who have preexisting conditions no longer had to worry about being denied coverage and lifetime caps were a thing of the past. this matters. it saved lives. just listen briefly, if you would, to the story of nicole from my little hometown of hoak -- hoak hoe seen, delaware. her 3-year-old daughter was born with cystic fibrosis, a horrible disease that robs children, people of the ability to breathe. nicole's 3-year-old daughter with cystic fibrosis spend at least an hour a day getting breathing treatments from her mother and $5,000 a month getting her medications, not cheap. inic coal was confident without the a.c.a. she would have exceeded her caps and medical expenses before the end of the year. nicole reaching out to me made it clear. without the consumer protections of the affordable care act, sh

the a.c.a. they certainly expected neil gorsuch, another name on their list, to do the same when he got on to the supreme court, and in the short time he has been on the court, justice gorsuch has not disappointed them. is it any wonder that millions of people across the country are raising concerns over the nomination of yet another nominee on the federalist society and heritage foundation's wish list? isn't it reasonable to conclude that judge kavanaugh will also reflect the ideological agendas of these organizations? this is why judge kavanaugh does not deserve the benefit of the doubt. he has the exceptionally high burden of proof to assure the american people that he can be fair and objective. the senate has a constitutional obligation equal to the president's to vet a president's nominee to the supreme court and fulfill its advice and consent obligation responsibilities. i take this responsibility certainly -- seriously because a fight for the future of the supreme court will have ramifica

the trump administration has supported the argument of the republican governors, will not defend the a.c.a. in court. that will come to the supreme court unless i am very mistaken, judge kavanaugh will vote with the right wing majority and allow discrimination against people who have serious illnesses to once again be the law of the land. mr. president, time and time again judge kavanaugh has sided with the interest of corporations and the wealthy instead of the interests of ordinary americans. he has sided with electric power utilities and chemical companies over protecting clean air and fighting climate change. he argued, if you can believe it, that the consumer financial protection bureau, which has saved consumers billions and billions of dollars from the greed and illegal behavior of wall street and financial institutions, he argued that that bureau was unconstitutional because its structure did not give enough power to the president. he has argued against net neutrality. he dissented in an osha case arguing that sea world should not be fined for the death of one of its whale trainers

in response to republican , forts to sabotage the a.c.a. d.c. -- -- d.c., like states across the country, decided to do what they could, and in our case convened a working group that consisted of businesses, providers, consumers and insurance -- insurers, on how to preserve quality, affordable coverage locally. in february, the working group unanimously recommended creating a local individual responsibility requirement. and i thought the other side was all about localism. the district health benefit exchange authority executive board unanimously supported this recommendation. the district of columbia mayor then included an individual responsibility requirement in her budget and the d.c. council debated and unanimously passed the health insurance requirement amendment act of 2008, as required by congress. thus d.c. will join three states in requiring residents to maintain health insurance coverage and more states are considering doing the very same thing. i urge members to vote no on this undemocratic, offensive, and harmful amendment that wo

but we have also found in recent years that the a.c.a. has narrowed state differences on access measures like the percentage of uninsured in each state and the percentage of people who report not being able to get care because of cost. this is because the affordable care act set federal standards for health insurance such as services that health plans have to cover and also banning insurers from charging people more or denying them coverage on the basis of preexisting conditions. the affordable care act also provided substantial amounts of federal funding to states for subsidies in the individual market, the medicaid expansion like funding navigator programs to help choose plans. but the score card also finds that there still is considerable state variation across states in the areas of access. for example, the percentage of people who are uninsured ranges from a low of about 3.5% in massachusetts to nearly 21% in texas. it is very possible that recent congressional and executive branch actions that mary ela just listed regarding the indiv

nationally, the a.c.a. allows for a plan to hit $7,850. next year, the national a.c.a. limit would be $7,900, and if we peg it to this benchmark, it would cap the a.c.a. allowable limit at $7,550. we don't know what 2020 is, that will be available spring 2019, but we expect this relationship to hold as it usually has. the third standard is -- allows a medical deductible of $2,000, and employers must cover all the actual expenditures that count towards this. especially with the rising cost of health care, this is something that the work group agreed to maintain, so employers will still cover the costs of any expenditures that count towards this, but we -- but the only change would be to clarify some of that language to reduce confusion for employers and brokers, that they would not have to prefund the full amount right off the bat. and so we do believe that this will continue to remove that financial barrier for people to seek care such as those who would belower wage earners where having a high deductible is actually a barrier to seek care. so to make sure that this is

the a.c.a. created a requirement in federal law that forces account holders to go to their doctor to obtain a prescription for over-the-counter medications before purchasing them with their health savings account or flexible spending account. individuals who failed to jump through these hoops and purchase over-the-counter medications without a prescription face a tax penalty for making a nonqualified distribution. this policy drives unnecessary utilization of doctor services and decreases access to over-the-counter medications and discourages people from taking control of saving for their health care needs. h.r. 6199 repeals this harmful provision, puts consumers back in the driver's seat, and allows them efficient access to appropriate medications. lastly, this legislation permits individuals to invest their hard-earned health savings account dollars into their physical fitness and well-being. in many ways, income is a hurdle for individuals and families who would like to participate in a physic

this, to go back to the point, we put the a.c.a. together so that it would be paid for, that's why we had to come up with that money. and we did. so you couldn't repeal it and what you're trying to do is choke it to death. you're trying to bleed it. and what you're doing is forcing more and more people. you just went for $-- from 20 million down to 17 million because of the subsidies that you wouldn't put through, that was in the law. because the demand -- because of the mandate that was originally in the law. and what is the alternative? silence. health issues, the biggest issue this year, mr. speaker, i'm blacks c-span -- >> today, we continue to bring you unfiltered coverage of congress, the white house, the supreme court and public policy events in washington dc and around the country. c-span is brought to you by your cable or satellite provider. >> tonight, a senate subcommittee except ways to protect amateur athletes from sexual abuse. a house committee examines the implications of a supreme court decision, and representatives

the a.c.a. builds upon the current system that we have of private health insurance and provides health insurance to those who aren't fortunate enough to work for a company that provides a subsidy for health insurance or provides health insurance to its employees. that's all it is. it's really an effort to fill the gap in this country between those who have insurance through their employer or through medicare or through medicaid and those who have no insurance. and the a.c.a. was a remarkable success for a period of years because it vastly cut the number of uninsured people in this country. so why we're trying to kill it, to strangle it, to mug it, to sabotage it just doesn't make sense from any point of view, either from the point of view of providing health care and health insurance to people, which saves lives, or trying to maintain the semblance of the current system. so here we are in the midst of an ongoing attempt to basically sabotage this system. back be in october 2017, the administratio

wouldn't have been approved by the heritage foundation in they weren't certain that he would repeal the a.c.a. he wouldn't have been approved by the federalist society if leonard leo wasn't certain that he would repeal roe v. wade. judge kavanaugh has argued that the trump administration could keep a young girl in federal custody to prevent her from obtaining constitutionally protected health care, and he has argued that employers should be able to deny their employees access to affordable contraceptive coverage. if judge kavanaugh feels that way about contraceptive rights, imagine what he feels about a woman's right to choose. and i would make one other point about judge kavanaugh. he's a deeply, deeply conservative justice, way out of the mainstream. he has written troubling decisions rejecting something 90% of americans want, commonsense gun laws. he has undone environmental protections. he's challenged them. and our clean air and clean water acts would be at risk. he would make it far more difficult for regulations to exist to enforce those laws. and here's the most amazing thing. he has

its efforts to shape the supreme court are a part of a conscious concerted strategy in a war on the a.c.a. and perhaps as troubling as any other fact about this nominee to many of us who have seen the horrific, unspeakable effects of gun violence, judge kavanaugh is the degree candidate of the n.r.a. he has taken the view that almost all common sense, sensible measures to stop gun violence violate the constitution. he is the dream pick of the n.r.a. he is a nightmare for the students of parkland, the survivors of orlando, and columbine, and san bernardino, and all of the mass shootings, including sandy hook, and all of the victims and survivors and their loved ones and families and friends who know the tragic effects of those 90 people gunned down every day in america, those 90 victims every day of gun violence in this country who die as a result of gun violence bear witness as to why we should reject this nominee. just minutes after judge kavanaugh's nomination was announced the, n.r.a. -- announced, the n.r.a. supported him, judge kavanaugh heard the sequel to heller, a case regarding t

this, to go back to the point, we put the a.c.a. together so that it would be paid for, that's why we had to come up with that money. and we did. so you couldn't repeal it and what you're trying to do is choke it to death. you're trying to bleed it. and what you're doing is forcing more and more people. you just went for $-- from 20 million down to 17 million because of the subsidies that you wouldn't put through, that was in the law. because the demand -- because of the mandate that was originally in the law. and what is the alternative? silence. health issues, the biggest issue this year, mr. speaker, i'm glad i'm on the right side. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from massachusetts reserves. the gentleman from minnesota is recognized. mr. paulsen: thank you, mr. speaker. contrary to some of the claims you heard a little bit before us about the bill doing nothing to help everyday average americans, i would remind members that this bill reverses a harmful tax t

so where do you get the idea that he'll, he's a predictable vote to undo the a.c.a.? for those of us for repeal, we maybe ought to vote against him because he hasn't voted that way on the d.c. circuit. those of us that thought the affordable care act should be repealed, because he may not be a sure vote to do that. and even if he were, there's still five votes to preserve it. the left-wing groups might want to put away then their crystal ball. even "the new york times" fact checker threw cold water on the argument that kavanaugh was a sure vote against the affordable care act. "the new york times" labeled the left-wing attacks, quote, unquote, exaggerated. another attack on judge kavanaugh is that he's hostile to abortion rights. but this attack misrepresents his record on the d.c. circuit. there, judge kavanaugh acknowledged that the court must decide the case based on roe v. wade and subsequent abortion decisions. he applied the precedent as presidents requires judges to so do. we hear the same fearmongering over abortion every time that there's a supreme court vacan

seems that republicans in washington have a maniacal obsession with decimating medicaid, wiping out the a.c.a. protections, including -- including -- protections for preexisting conditions. so now that we've changed the law, which said if you have cancer, you can still get coverage or treatment, now i guess some here want to take us back. we've got 5.3 million people in pennsylvania with preexisting conditions. 643,000 of them are children. we're not going back. we're not going back to those days when those 5.3 million people in pennsylvania don't have protection. we are not going back. and if they want to have a fight about it, we'll fight about it. last year i heard from liz from westchester, pennsylvania, suburban philadelphia who was diagnosed with cancer at the age of 26. here's what she told me. quote, for years i worried about losing my job and with it my insurance because i have costly preexisting conditions. this stress added to the stress of my diagnosis, treatments, and work life balance. unquote. then she goes on to say, quote, weight lifted off my shoulders when the preexisting c

wouldn't have been approved by the heritage foundation in they weren't certain that he would repeal the a.c.a. he wouldn't have been approved by the federalist society if leonard leo wasn't certain that he would repeal roe v. wade. judge kavanaugh has argued that the trump administration could keep a young girl in federal custody to prevent her from obtaining constitutionally protected health care, and he has argued that employers should be able to deny their employees access to affordable contraceptive coverage. if judge kavanaugh feels that way about contraceptive rights, imagine what he feels about a woman's right to choose. and i would make one other point about judge kavanaugh. he's a deeply, deeply conservative justice, way out of the mainstream. he has written troubling decisions rejecting something 90% of americans want, commonsense gun laws. he has undone environmental protections. he's challenged them. and our clean air and clean water acts would be at risk. he would make it far more difficult for regulations to exist to enforce those laws. and here's the most amazing thing. he has

the trump administration needs to abandon its efforts to undermine the a.c.a. and start working with those of us who want to improve rather than tear down our health care system. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the the gentlewoman from florida seek recognition. >> >> mr. speaker, i ask unanimous consent to address the house for one minute. revise and extend my remarks. the speaker pro tempore: without objection, the gentlewoman is recognized for one minute. ms. ros-lehtinen: thank you so much, mr. speaker. i rise today to congratulate miami bridge on its 33rd anniversary. located in my congressional district, miami bridge works to provide a safe haven for teens who are abandoned, neglected, or homeless in miami-dade county. miami bridge is the only emergency home in south florida which shelters children from ages 10 to 17. this organization provides and promotes positive youth development programs and families to enable children and teens to become productive members of our community

into a voucher program, block granting or imposing per capita caps on medicaid, and rolling back the a.c.a's medicaid expansion. my legislation builds on the succeed of an amendment i introduced with my colleague from indiana, senator donnelly, during last january's budget debate to protect these programs. although our amendment did not pass, it came pretty close, when two republicans joined us in supporting it. it is good to know that some republicans are concerned about seniors, children, and working people who rely on medicare and medicaid every single day. i think it is just astonishing that as we are talking about cutting medicare and medicaid for hundreds of seniors, hundreds of seniors in hawaii that these kind of changes are are being proposed by the very president and the people in -- in congress who gave the richest 1% of the people of our country and corporations a huge -- a huge tax break. by the way, the president is talking about giving the rich people in our country even more of a tax cut. it's just astounding to me that while all of that is happening on the one hand, on the

most americans don't believe the government should get out of health care altogether, medicare, medicaid, a.c.a. the goal of the heritage foundation. but they put these judges forward. president trump has gone along with their lists of their nominees, and unfortunately you don't hear a peep out of our republican colleagues as the hard right hijacks the judicial bench in america. the goal of this campaign is to achieve by judicial fiat what republicans have been unable to accomplish through legislation. this hard-right agenda, extremely pro -- extremely antigun safety must be pursued through the courts, because the hard right, the koch brothers and all of these hard-right groups realize that they never get things through even a body like the senate where they have a majority of the republicans or the house. they want the one nonelected branch to turn the clock back decades if not centuries. it will hurt america. it will fractionalize america. the middle class will be worse off, but the hard right knows that these types of nominations don't get much focus. and at the apoto sis -- apotheosis is th

in december, congressional republicans eliminated the a.c.a.'s individual coverage requirement as part of a massive tax giveaway to the wealthiest one percent of people and corporations in our country, a tax break, by the way, that they didn't even ask for. and, with that, 10 million americans stand to lose their coverage and millions more will see their premiums rise as a result. and earlier this year, the trump administration made it easier for insurance companies to offer minimal -- minimal insurance plans to consumers. and these plans are called junk plans for a good reason -- because they don't require insurers to cover some pretty basic, essential health services -- benefits. things as basic as annual physical, trips to the emergency room, or prescription drug coverage. in other words, your junk plan will not provide coverage if you really get sick. two weeks ago the president announced a draconian cut to the a.c.a.'s navigator program, a program that helps people sign up for health coverage. in hawaii, funding for a.c.a. navigators is a p

the trump administration has supported the argument of the republican governors, will not defend the a.c.a. in court. that will come to the supreme court unless i am very mistaken, judge kavanaugh will vote with the right wing majority and allow discrimination against people who have serious illnesses to once again be the law of the land. mr. president, time and time again judge kavanaugh has sided with the interest of corporations and the wealthy instead of the interests of ordinary americans. he has sided with electric power utilities and chemical companies over protecting clean air and fighting climate change. he argued, if you can believe it, that the consumer financial protection bureau, which has saved consumers billions and billions of dollars from the greed and illegal behavior of wall street and financial institutions, he argued that that bureau was unconstitutional because its structure did not give enough power to the president. he has argued against net neutrality. he dissented in an osha case arguing that sea world should not be fined for the death of one of its whale trainers

its efforts to shape the supreme court are a part of a conscious concerted strategy in a war on the a.c.a. and perhaps as troubling as any other fact about this nominee to many of us who have seen the horrific, unspeakable effects of gun violence, judge kavanaugh is the degree candidate of the n.r.a. he has taken the view that almost all common sense, sensible measures to stop gun violence violate the constitution. he is the dream pick of the n.r.a. he is a nightmare for the students of parkland, the survivors of orlando, and columbine, and san bernardino, and all of the mass shootings, including sandy hook, and all of the victims and survivors and their loved ones and families and friends who know the tragic effects of those 90 people gunned down every day in america, those 90 victims every day of gun violence in this country who die as a result of gun violence bear witness as to why we should reject this nominee. just minutes after judge kavanaugh's nomination was announced the, n.r.a. -- announced, the n.r.a. supported him, judge kavanaugh heard the sequel to heller, a case regarding t

federalist society intent on repealing roe and by the heritage foundation intent on rolling back government involvement in health care, whether it be a.c.a., protecting preexisting conditions or medicare. special counsel mueller's probe appearing to be discovering more and more evidence of president putin's interference in our election and potential cooperation of american citizens in that interference. given that a justice kavanaugh could one day be faced with ruling on the matter of whether or not a sitting president can be indicted or subpoenaed, i hope senators from both parties scrutinize judge kavanaugh's beliefs about executive powers. on all other courts, defendants, potential defendants don't get to pick their jurors. the president, particularly this president, shouldn't have that power either. i yield the floor and note the absence of -- i just yield the floor. a senator: madam president. the presiding officer: the senator from connecticut. mr. murphy: i ask to dispense with the quorum call. the presiding officer: the senate is not in a quorum call. mr. murphy: thank you, madam president. madam president, in my lifetime, no ame