U.S. Senator Tammy Baldwin's Remarks at Families USA Health Action Conference

U.S. Senator Tammy Baldwin

Families USA Health Action 2013 Conference

Thursday, January 31, 2013

I want to give a special thank you to Ron Pollack and Philippe Villers, and to everyone who has been a part of Families USA over the last quarter century.

I’ve been proud to work alongside many of the people in this room during my career in public service.  But I have to say, these gatherings have gotten a lot more fun since President Obama signed the Affordable Care Act into law a little under three years ago.

That victory was 70 years in the making – and it belongs to so many people who were part of this fight.

Doctors and nurses, parents and students, distinguished academics and citizen activists, Presidents and members of Congress of both parties.  Many have devoted their entire careers to health care reform.  Some elected officials have lost their jobs because of their commitment to reform.

But each of us has our own reason to be passionate about expanding access to quality health care.  And each of us brought our own perspective to this important work.

Economists who understood that bending the cost curve was one of the most important ways to reduce our deficit and put our nation on sounder fiscal footing.  Administrators who saw the perverse incentives that plagued a broken system – and doctors and nurses who saw how those perverse incentives affected patient care.

And a whole lot of people like me.  People who had seen first-hand how access to affordable health care was a key to middle-class security.  People who had lived in fear and suffered in silence because our system had failed them.  People who came to make the personal case – the moral case – for reform.

I was raised by my grandparents.  They were heroes to me. 

But when I was nine years old, I was diagnosed with a serious childhood illness similar to spinal meningitis.  I spent three months in the hospital. 

My grandparents had health insurance – a family plan.  But many policies, including theirs, were written in a way that excluded grandchildren.  They weren’t allowed to list me as a dependent.  Their insurance wouldn’t cover my care.

So they were forced to make great sacrifices to pay for the care I needed.  And, of course, they did it without a second thought.  Because that’s what a family does.

I got better, and my grandparents looked for an insurance policy that would cover me in the future.  But they discovered that, because of my illness, they couldn’t find such a policy.  Not from any insurer.  Not at any price.

Never mind that I had fully recovered from my illness.  I had been branded with the words “pre-existing condition.”

My story, of course, isn’t significant because it was unique.  In fact, it’s significant because it wasn’t unique.  When the Affordable Care Act was signed, 17 million American children wore that same brand.  “Pre-existing condition.”  Uninsurable.

Now, I didn’t know that that stone had been placed around my neck.  I was nine.  But now that I’m older, I can only imagine the burden it placed on my grandparents.

Think about how many families have seen their economic security shattered because no one wanted to insure their child.  Think about how many people – hard-working people like my grandparents – have lain awake, listening for the sound of a child’s cough in the next room, waiting for the floor to fall out from beneath their feet.

And think about how many Americans’ lives have been altered simply because they don’t have insurance. 

How many people have been trapped in jobs where they know they can’t advance, or dissuaded from starting a business of their own, because they were afraid they wouldn’t be able to find coverage?

How many seniors have had to choose between paying their heating bill and paying for their prescriptions?

And how many young Americans, just starting out and working in part-time jobs, let a health condition worsen because they couldn’t afford to pay a doctor out of their own pockets?

The Affordable Care Act is changing all of that.  As someone who didn’t have really good insurance until my late twenties, I was proud to champion the provision that allows young people to stay on their parents’ insurance until age 26.

There have been so many moments when we could have given up on health care reform.  Even the Affordable Care Act saw its obituary written many times. 

Remember the summer of 2009, when anger and discord consumed our political discourse and brought the worst of Washington to town halls all across the country.

Remember the winter of 2010, when Scott Brown’s upset victory in Massachusetts gave Republicans a chance to obstruct progress in the Senate and gave many Democrats second thoughts about proceeding with comprehensive reform.

Remember the early spring of that year, when the final days of debate were consumed with lies about death panels and cuts to Medicare.

Remember the polls showing that misleading arguments against reform were beginning to sound true to the American people.  Remember the attack ads falsely accusing us of executing a “government takeover” of health care.  Remember Election Night in 2010, when so many champions of reform paid for progress with their jobs.

Remember the dozens of times Republicans tried to repeal reform in 2011.  Remember the number of lawsuits they filed to stop it from taking effect.

Remember the months we spent waiting for the Supreme Court to render its judgment.  Remember the tense moments that June morning in 2012 as we heard its ruling.

At every turn, it was tempting to worry that Lucy would pull the football away once again.

After all, there’s a reason health care reform had been 70 years in the making – we’d failed to get it done for 70 years.

For every partial victory we won – Medicare, COBRA, the Children’s Health Insurance Program – there were setbacks. 

FDR, Truman, Nixon, Carter, Clinton – each tried to make progress toward universal health care.  Each failed.

And, even worse, for every attempt at progress, there were years in which reforming our health care system was relegated to the back burner – years in which proposals for reform were regularly featured in stump speeches, but rarely brought to the floor.

I have to tell you, though; I am the wrong person to tell that something can’t be done.  When I ran my first campaign, everyone told me I couldn’t win.  When I chose to run on a platform of Health Care for All, everyone told me it would never happen.  And even when I ran for the Senate in 2012, plenty of people told me I didn’t have a chance.

So I’m not a big believer in shrugging my shoulders and admitting defeat.  And neither were all of you.  We kept pushing forward.  We knew that this might be our generation’s last chance to achieve what had eluded so many generations before us.  And we saw this through.

Already, that provision for young adults I worked on is helping young people build their lives while covered by their parents’ insurance.  Already, kids with pre-existing conditions are no longer subject to discrimination.  Already, being a woman is no longer considered a pre-existing condition of its own, and insurance companies are prohibited from charging women 50 percent more than men.

Already, we’ve made a difference.

But just as the Affordable Care Act wasn’t the beginning of the fight to fix our health care system, we who are gathered here today know that it won’t be the end, either.

There’s the obvious challenge posed by the fact that many of the law’s most important provisions haven’t been implemented yet – which buys opponents of reform time to call for its repeal before its benefits are fully realized.

I have to tell you, I spent the last two years in the House and watched Republicans vote to repeal the Affordable Care Act 33 times.  But I was still surprised to see that the first thing my fellow Wisconsinite Paul Ryan did in Wisconsin after the election was to attend a Tea Party rally to repeal Obamacare.

The good news is that Paul wasn’t attending that rally as the Vice President-elect.  Which means that the Affordable Care Act isn’t going to be repealed anytime soon.

Still – I said at my victory rally on Election Night that what we had really won in that election was a chance.  And that certainly applies to health care reform.

What we secured in 2012 was the chance to implement the Affordable Care Act the right way.  And now it’s up to us to do just that.

I want to briefly mention two challenges before us, and they both stem from the same reality, which is that the 50 governors have a tremendous amount of control over how this law is implemented.

First, they must decide whether to set up state-based exchanges so that their states’ small businesses, family farmers, and individuals can pool their purchasing power to find quality, affordable care.

Such exchanges have long received strong bipartisan support.  And why not?  They’re free markets at their best – transparent, consumer-friendly, and tailored specifically to the needs of each state.

And yet, many Republican governors, including Governor Walker in Wisconsin, have decided not to set them up.  Let’s be clear: There’s no policy reason to punt this work up to the federal government.  It’s a political statement.  And speaking solely on behalf of my state – its doctors, its research institutions, its insurers – Wisconsin needed the chance to gain competitive advantage much more than it needed a reminder about its governor’s politics.

The second is Medicaid expansion.

Health care reform is about bending the cost curve and improving the value proposition in our system.  But it’s also about protecting Americans at the most vulnerable moments in their lives.  And Medicaid expansion is about protecting the most vulnerable Americans at the most vulnerable moments in their lives.

Without Medicaid expansion, people who make between 100 percent and 400 percent of the federal poverty line will still receive federal support to purchase insurance through an exchange. 

But those who make between zero and 100 percent will not.

That means that 200,000 Wisconsinites who most need the help could lose out on coverage.

The guiding moral principle behind universal health care is that no one should fall through the cracks, especially not millions of our most vulnerable citizens.  Illness and accident can befall anyone.  But it shouldn’t mean bankruptcy or financial ruin.  And whether we can successfully put pressure on Republican governors to follow through with expanding Medicaid will go a long way toward determining whether this law lives up to that principle.

Governor Walker, like many other governors, has delayed his decision.  And if you’re a citizen activist, it’s hard to imagine a more important priority right now.  The Republican governors of Arizona, Nevada, and New Mexico have put politics aside and decided to expand Medicaid.  I can only hope that Governor Walker and others follow suit.

The Affordable Care Act will still be on the books a decade from now.  But the good it does will depend on what we do in these critical next few months and years.

Even then, we won’t be done fighting.

You know, people have called the Affordable Care Act everything from a savior to socialism.

But when it’s fully implemented, here’s what I think we should call it: a solid start.

There was a lot of debate in the progressive community about whether the bill we passed was strong enough.  I’m one of those who thought the public option was an important check on insurance companies and wished it had been in the final bill.

And I know that we must continue to work to bend the cost curve, eliminate waste, and remove barriers to care for many Americans.

The issues we in the reform community will face are similar to the ones we’ve been dealing with since we got involved.

But when we passed the Affordable Care Act, we proved that there is no political law of gravity preventing us from moving forward.

When we passed the Affordable Care Act, we turned the page on years – decades – of disappointments and setbacks.

When we passed the Affordable Care Act, we laid the foundation for all the progress we’ll make together in the years to come.

Because when we passed the Affordable Care Act, we began to change the conversation about health care in America.

We’ve all heard conservatives talk about “entitlement programs” as if the word “entitlement” were a slur.  As if Americans are greedy and slothful.  As if feeling “entitled” to some basic protection against the vagaries of life reveals a defect in our character.

You know, later in life, my grandmother – who had sacrificed so much to care for me – became ill herself.  I had to sacrifice to take care of her, and I was glad to do it, but I couldn’t have done it at all had it not been for Medicare.

I have no idea whether my grandmother felt “entitled” to some basic protection against economic disaster in the event of illness or injury after she had aged out of the workforce.  But I hope she did.  Because I think she was.

Now we’re hearing a lot of talk about cutting Medicare and Social Security, and we’re hearing attacks on the Affordable Care Act for creating another “entitlement.”

But I think we should feel “entitled” to know that, in the richest nation in the history of the world, our kids can’t be branded as forever uninsurable because they got sick.  We should feel “entitled” to know that insurance companies can’t interfere in decisions that rightly belong to us and our doctors.

We should feel entitled to health care.  In the United States of America, health care should be a right guaranteed to all, not a privilege reserved for the few.

That vision has guided us for decades.  But now we have begun to write it into our laws.  That is the true victory we won with the Affordable Care Act – the true victory we are here to celebrate today.

We have climbed to the top of a tall mountain.  And there are even taller mountains looming ahead.  But I’ve never felt more energized, more motivated, more confident that we can continue to ascend.  We are the generation of reformers who took the biggest step so far toward true universal health care.  And we aren’t done yet.

Thank you all for your partnership, for your great work, and for the opportunity to be here with you today.