Affordable Care Act
Floor Speech
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Mr. BOOKER. Mr. President, I am grateful to the Presiding Officer for recognizing me.
I want to say I am excited to be standing up tonight and talking, along with Senator Wyden, Senator Hassan, and we just heard from Senator Casey who is marking this 13th anniversary celebration with extraordinary determination not to see these great programs cut.
I was not in Congress when the ACA was passed into law. But in an affirmation of that old adage about politics being local, I saw in my local community of Newark, NJ, the powerful difference that the ACA made, the difference that health reform had on my community.
Folks would come up to me immediately in the months and years afterwards and talk about how they were finally able to get the healthcare that they needed, not only for themselves, but for their loved ones--how they moved from anxiety and fear to security and strength.
You had folks with preexisting conditions who were discriminated against in the United States of America before the law's passage, but now they had a pathway for quality, affordable healthcare.
Folks had to choose often between putting food on the table, paying rent, or just visiting a doctor; a choice between buying school supplies and getting their prescription drugs. Choices that, in this Nation--the richest Nation on the planet Earth--are outrageous, unacceptable, and fiscally irresponsible. What I saw as Newark's mayor is that, often, people would let their healthcare needs go until they ended up in the emergency room, which was a cost then borne by them and their family for unnecessary illness, but also to all of us. This should not be the Nation we live in, and we are celebrating the fact that 13 years ago this body made a difference.
I have seen this passion for the Affordable Care Act echoed in my 9 years as a U.S. Senator. One of my constituents told me, as a registered nurse from New Jersey, she spent her entire professional life caring for patients. Before the ACA, she witnessed those in need delay or simply refuse healthcare until it was too late. Soon, though, she almost became one of those patients herself after she retired and confronted her own health challenges and their accompanying costs. It was only thanks to the Affordable Care Act that she didn't have to resort to emptying her retirement accounts in order to afford the healthcare. She said it best herself:
The Affordable Care Act saved my life.
Another constituent of mine, a recent widow, wrote to me a few years ago. After losing her husband, she relied on the marketplace to get insurance--the Affordable Care Act marketplace. She was diabetic, had preexisting conditions, and told me:
I'm afraid of having no coverage. I could lose my home and everything I have saved during my 35-year marriage.
Now, despite the partisan attacks that you hear against the Affordable Care Act, despite the challenges in the courts, we know the Affordable Care Act has worked. The data is clear. From 2010 to 2021, the number of uninsured, nonelderly individuals has decreased substantially in the United States of America from 46.5 million to 27.5 million. That number has been nearly cut in half.
We also know that the ACA has been invaluable in the fight to achieve just greater healthcare justice by dramatically decreasing the uninsured rate for many ethnic minorities in our country. For example, those rates have gone from 20 percent uninsured in 2010 to just 11 percent in 2021; for Black folks, 33 percent to 19 percent; for Latino folks, 17 percent to 6 percent. We have seen a dramatic decrease for Asian Americans, Latino Americans, Black Americans, and more.
The law has saved lives, unequivocally. A 2014 study showed that the ACA prevented an estimated 50,000 preventable patient deaths in just 3 years from 2010 to 2013. And in the midst of the COVID-19 pandemic, the ACA marketplace was a lifeline to folks who were laid off and had no insurance.
One of the most important things that this law has done is to get people insured, to reduce deaths, to lower healthcare costs, and to expand access to Medicaid to people who were previously ineligible.
I live in a State that was one of the first to expand Medicaid to more of our citizens. We did it under a Republican Governor who recognized just how important it was that we expand Medicaid, how lifesaving it was, how good for the empowerment of families and children it was. It has helped so many more people in New Jersey obtain health insurance, and it has helped my State fight the opioid crisis by providing us the vital resources to do so.
New Jersey is one of 39 States, plus the District of Columbia, that has chosen to expand Medicaid. By all accounts, these 39 States with Medicaid expansion are outperforming those who have inexplicably--you might say outrageously--chosen to reject Medicaid expansion, despite the overwhelming evidence that it helps countless Americans stay healthier and better access quality affordable care.
Perhaps that is one reason why the State of North Carolina, with a Republican-led legislature and a Democratic Governor, are in the middle of a bipartisan process to expand Medicaid in their State, right now as we speak.
States that expanded Medicaid have continuously shown to have lower uninsured rates, lower premiums on exchange policies, to have lower mortality rates. States that expanded Medicaid better live up to the ideals of this country that, fundamentally, we are about life--life-- liberty, and the pursuit of happiness.
Expanding healthcare access lowers death rates. It is about life. Expanding healthcare access is about liberty, freeing people from fear and anxiety, from being chained to the worry that comes from not being able to afford even an ambulance ride. And, ultimately, it is about happiness.
People in these States are going to the doctor more often for preventive screenings, visiting the dentist for dental care, getting mental health treatment. They have seen an increase in early stage cancer diagnosis when cancer is more treatable. People in those States have lower medical debt than in States that have neglected to expand Medicaid. It has actually had a positive effect on the overall economy. And I have led the charge to make sure that those States which expand Medicaid also provide coverage for birthing people, for moms, for a year postpartum.
We live in a country that shamefully has a maternal mortality rate that is far higher than our peer nations and especially higher for marginalized communities.
New data was recently released showing a significant increase in the maternal mortality rate in 2021. This problem is getting worse, with maternal mortality rates nearly doubling in the United States since 2018. The maternal mortality rate is bad for all Americans, and it is even worse for African Americans.
Given that Medicaid coverage covers half the births in the United States, the continuing expansion of coverage and care will help address these concerning trends and address those disparities and help ensure that more women can get access to the reproductive care that they need, and we could have more healthy births with healthy moms.
The bottom line is clear: Medicaid is integral to helping Americans get the care they need and to affirm our common values.
We love our children in this Nation, and the data for their births, for the children and their mothers, should reflect that love.
What does love look like in public? It looks like justice. It looks like healthy children being born. It looks like lowering the death rates for women giving birth.
Look, we have much work to do. We should note the progress on this 13th anniversary. We should stop the politicization of healthcare in this country when we make strides that belie all the outrageous claims that were made about what the Affordable Care Act would turn into. All of the lies that were said about this legislation, all the dire predictions have not come true.
Look, when I think about the ACA, I think back to the night I sat with my dear friend John Lewis, a hero to people on both sides of the aisle in this Chamber, a truly great American. When the Affordable Care Act was in crisis and threatened to be repealed, we sat on the Capitol steps, opened up Facebook Live, and started having a conversation.
I will never forget. Hundreds of people came to join us on the steps of the Capitol, and I will never forget that John Lewis made it clear to this large crowd of people and to a live, online audience--he said:
Affordable healthcare is the birthright of every American. At stake are not just the details of policy but the character [the character] of our country.
Think about that for a second, the character of our country.
Who are we? What do we stand for? Not just those unbelievable words on those founding documents, not just the spirit of America, but, in truth, you can judge the greatness of a country by the well-being of its people.
I believe that when we talk about healthcare, we aren't just talking about policy and legislation and politics, but we are taking about the very fabric--the moral fabric--of this Nation. We cannot be a nation that stands for life, liberty, and the pursuit of happiness if people don't have access to what is fundamental to those ideals, which is quality healthcare.
We are a nation that should be a beacon to the world. I believe we are. We are a nation of promise, a nation of hope, a nation of possibility, a nation of infinite potential. But there are still too many people in this country where that potential and that possibility are undermined by the mere fact that they cannot access a doctor, preventive care, birthing care. That is wrong.
I am endlessly grateful for the Affordable Care Act for helping us to make a stride toward our ideals, for bending the arc of the moral universe more toward justice, for making this a more perfect union.
Yes, tonight is a 13-year anniversary, but we should commit ourselves to going from doing good work, from making progress, to ultimately doing what we are called to be, which is a nation that is a light unto all nations. It sets the highest standards for healthcare and health outcomes; that we are not a nation that proclaims a nation of life, liberty, and the pursuit of happiness but demonstrates it relative to all other nations in the true fabric of our living. That is a cause that calls this body and the House of Representatives and our Federal Government that should call us not just to celebrate a 13-year anniversary but to continue to improve upon the good work that was done.
I am concluded with my remarks. I am just a warmup act for the Senator who is coming right now, from my second favorite ``new'' State after New Jersey, the great State of New Hampshire.
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