Congressman John Garamendi

Representing the 3rd District of California
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Former California Insurance Commissioner Rep. Garamendi on House Republican Plan to End Medicare & Exchanges: "Apparently what you really want to do is hand over the entire game to the insurance companies"

May 3, 2011
Press Release

Congressman John Garamendi (D-Walnut Creek, CA), California’s Insurance Commissioner for eight years and a key health care advisor to President Bill Clinton, today spoke on the House floor in opposition to H.R. 1213, a Republican bill that would dismantle the state insurance exchanges found in the Affordable Care and Protection Act. Garamendi also highlighted the impact of this legislation in the context of the Congressional Republican assault on Medicare. Video and a corrected transcript are below.

1. Part 1
2. Part 2
3. Part 1 + Part 2 Playlist
4. Complete Exchange

I guess I don’t understand. I don’t understand what our Republican colleagues want to accomplish here. They talk about free market; they talk about the opportunity have options and opportunities. I think that’s exactly what an exchange does. So I don’t quite understand what this is all about.

I was Insurance Commissioner, the elected Insurance Commissioner, in 1991, and we set up an exchange. Unfortunately, Governor Wilson vetoed it, otherwise we’d have had this exchange years ago.

And a year ago, the California legislature with the signature of a Republican Governor, Schwarzenegger, created an exchange, based upon the Affordable Care Act. And they want to put it in effect.

The Republican proposal on the floor here would make it impossible for California to do what it wants to do. That is set up a marketplace where people have access to insurance. The notion being that by creating the exchange, you spread the risk across many populations, so that, like a huge corporation, you have an opportunity as an individual purchaser or small business to participate in a large pool and accept the lower rate of insurance.

So what’s this all about? What are you trying to accomplish here? Is it some ideology that you just simply can’t stand the Affordable Care Act, and you want to rip it apart piece by piece. Apparently so. And you don’t want to just stop there.

You’re going after Medicare, a program that has been in effect for 42 years. That provides a universal insurance policy to anyone over 65. You’re going to terminate Medicare. What’s that all about? And give it to an insurance company and not have an exchange?

So what’s an individual going to do when they’re 65 and possessing all kinds of preexisting conditions? Go without insurance? Be at the mercy of the insurance companies? And by the way, you want to repeal all the insurance reforms. All of the protections that individuals have in the Affordable Care Act.

This doesn’t make much sense to me. I don’t understand what your goal is here, except to maybe have some political scorecard. You can say, ‘Yeah, we repealed the Affordable Care Act. Good for us.’

But what effect to the population of America?

No exchanges. They’re gone.

No opportunity for small businesses to enjoy a large market, a large pool, in which they can have a lower price. They’re gone.

Oh I see, you’re going to have an association health plan. I spent eight years of my life chasing after association health plans that were frauds. They were out and out frauds sold across state lines. Is that what you want? Apparently so. I don’t get it. I don’t understand what the goal is here.

The Affordable Care Act establishes an exchange allowing individuals and small businesses to be part of a large pool to have four different options on their insurance, and you want to do away with it. I don’t get it.

You want to do away with clinics at schools so kids can have access to health care. I don’t understand.

You cut all the money out from the community clinics so that people have to go to the emergency rooms in a more expensive situation. What’s this all about? I don’t understand what the goal is that our Republican colleagues have in mind.

The exchanges make sense. They created a marketplace for small businesses. The exchanges create a market, gentlemen and ladies, they create a market! It’s a market-driven program, in which competition occurs, competition between the insurance companies who have to offer quality and price. You got a problem with competition? Apparently so.

You want to do away with the exchange. Apparently what you really want to do is hand over the entire game to the insurance companies, removing all of the controls, removing all of the necessity for them to compete, and apparently create some sort of association plan so the public can be ripped off.

Let’s be very clear about this. The Republican proposal, the Republican budget proposal that is before this Congress, terminates Medicare as we have had it since 1965. For those young men and women who are not yet 55, they will never see Medicare. It’s over.

And instead of having Medicare, which is a guaranteed health insurance program, when they retire at the age of 65, they will be given a voucher that will be worth a percentage of what the insurance will cost.

They will be thrown into the market at an age where they have preexisting conditions, and under the Republican proposal, there are no ways they are going to be protected from the insurance companies, who we know have one motive, and that’s profits before people. (Will you yield?)
Profit before people [Will the gentlemen yield?] has been the way it has been for the insurance companies from the get go, and that’s precisely what the Republicans want to give us. We will not have it. [Will the gentleman yield?]

And while they’re at it, they want to take those reductions in your expenditures and continue giving money to the most wealthy people in America. [Will the gentleman yield?] I will not yield. So that the most wealthy people in America can continue to enjoy ever more wealth while the middle class enjoys ever more poverty. It is an abomination and there is no way this nation should abandon a proven program that for 42 years has provided quality medical care to the seniors.

Now if you want to go after the cost of medicine, then let’s go after the overall cost of medicine – not denying tomorrow’s seniors the benefit of Medicare. It is time to understand precisely what the Republican budget does. It terminates Medicare while giving benefits to the most wealthy Americans. It should not happen. I yield back my time.