Stacey Plaskett

Ms. PLASKETT

Ms. PLASKETT. Mr. Speaker, for the next 60 minutes, it is with great honor that I rise to coanchor this CBC Special Order hour. For the next 60 minutes, we have a chance to speak directly to the American people on the issues of great importance to the Congressional Black Caucus, to Congress, and to constituents who represent all Americans. At this time, Mr. Speaker, we would like to use this time to talk about the Affordable Care Act. What do you have to lose? What do you have to lose, Mr. Speaker? Such was President Trump's constant refrain to the African-American community when rallying for their support of his administration's various policies. Mr. Speaker, today, I rise to say that with critical elements of the American healthcare policy on the chopping block, African-Americans have a lot to lose, possibly even their lives. There is as much at stake if President Trump and the Republican- controlled Congress healthcare policies take shape in their current form. By illustration, I want to address the impact on low-income families and individuals in the Virgin Islands who rely on Medicaid, and, presently, Medicaid is capped in the Virgin Islands. You can look at our territory as an example of what will happen when there is a cap on services, which could compromise a State or local government's ability to administer those most in need. Since its inception, Medicaid has been an open-ended program that was intended to expand and contract with need, especially when States and localities face crippling economic downturns of both manmade and natural origins. Medicaid covers one in five Americans, and of those, the majority of enrollees are children and individuals with disabilities. Under the Affordable Care Act, widely known as ObamaCare, millions of African Americans finally gained access to healthcare coverage. In 2015, approximately 11.2 million African Americans became eligible for Medicaid through the expansion, health care that they previously did not receive and which would have cost this country much more if that early-warning health care was not taken care of. President Trump and Republicans in Congress propose converting Medicaid from a shared payment program between States and Federal Government to an arrangement much like a block grant, where the Federal Government puts a cap on its payment assistance, creating a huge cost shift to the States. If you want to know what you have to lose if caps on Medicaid are enacted nationwide, look no further than my home, the Virgin Islands. It is a grim outlook. Federal caps on Medicaid programs in the Virgin Islands are set on a per-enrollee basis. Unlike States in the mainland where Federal Medicaid spending is open-ended depending on the needs of the people, the Virgin Islands can only access Federal dollars up to an annual ceiling. Beyond that cap, the Virgin Islands' government is responsible for the remaining costs. That means many Virgin Islanders who would qualify in other States and in other circumstances don't get the healthcare coverage that they need now. Under the proposed fiscal arrangement, spending caps don't take into account the cost of providing services or unpredictable changes in a community--such as the closure of a major employer or a natural disasters--forcing a cost obligation for critical support services onto the already strained budgets of the territory. As a result, States and local governments, increasingly, would have to make tough choices to either reduce services for recipients of Medicaid or restrict eligibility and enrollment of additional people who may need it. Those are the choices that Virgin Islanders must make. So the most vulnerable of our constituents--in this case, children--who need the safety net that Medicaid, by definition, is supposed to provide have that final option cut out from under them. When it comes to Medicaid coverage, the Virgin Islands struggles to provide low-income families with Medicaid services for three major reasons: First, while the Affordable Care Act raised the territory's Federal Medicaid assistance percentage up to 83 percent for newly eligible enrollees, this increase in Federal match funding did not apply to those previously enrolled, which the Federal Government only matched at 55 percent in the Virgin Islands, requiring that the remaining costs be covered by the Virgin Islands government, a government already strained to meet basic needs. The Virgin Islands and the smaller territories are not included in the Medicaid Disproportionate Share Hospital, DSH, program, which would shoulder the unanticipated costs our hospitals must take on to provide adequate care for individuals who use hospitals for basic services since they have no insurance. Three, With no Affordable Care Act exchange and no Federal subsidies to create our own health exchange, many Virgin Islanders were only able to obtain coverage through the Medicaid expansion if they met the already strenuous requirements. That means that 30 percent of Virgin Islanders presently have no health insurance. This is what the rest of the States are going to have if this American Health Care Act, as it stands, is passed. A cap on Medicaid is a cap on medical services that our constituents just can't do without; and in poor communities, it is going to be even more impactful. When ObamaCare provided increased funding to expand Medicaid, the island of Saint Croix was able to start a monthly homeless clinic at the Frederiksted Health Care Center about 15 months ago. That clinic has been able to serve many people, providing them with medical care, showers, meals, and transportation. On St. Thomas, with the East End health clinic, they were able to expand their services and increase dental services to people who were sorely in need of that. If this funding decreases or is lost altogether, it is highly unlikely that this initiative can be continued. Our current healthcare struggle is set to become a future hardship for mainland American States that provide Medicaid to a significant number of their population should the current proposals to cap Medicaid nationwide become law. How do we avoid this? Do not place a cap on Medicaid. Too many in the African-American community have everything to lose if healthcare policy goes in this direction. At this time, I yield to my colleague, the distinguished gentleman from Pennsylvania (Mr. Evans).

Ms. PLASKETT. From our experience in the Virgin Islands, that is what you do not want to happen. People talk about: Who is on Medicaid? Who are these types of individuals? Why don't they get jobs? I mean, in the Virgin Islands, when we had our largest employer, Hovensa, an oil refinery, close, of course, then our unemployment rate went up. And these are families in need, families who need the support. With a cap on Medicaid, we were only able to have 55 percent of individuals who would qualify for Medicaid with that cap, with that ceiling that was in place from the Federal Government. It means that a tremendous amount of children, homeless individuals, people, families that are out of work for a period of time, are not covered. That, then, creates this huge burden on a hospital for those families to be taken care of, for individual care and individual need. Particularly in the African-American community, when you have things like diabetes, hypertension, all of these diseases which need constant monitoring and primary care physicians to take care of and to ensure that they do not become life-threatening, and come to a place where then they are coming to the hospital, it is in the millions of dollars that you are going to need support and care for the servicing of individuals with these diseases. So I know that we are pushing that there be an expansion of Medicaid, that the cap not be put on Medicaid services, not because we want to coddle people who are poor, but because we know it is necessary. And the cost of not taking care of them on the front end of health care, with Medicaid, is an astronomical cost on the back end when they have diseases that have just gone out of control because they have not been able to go to primary care physicians and get the health care that they need. Mr. Speaker, I yield to the gentleman from Texas.

Ms. PLASKETT. I thank the gentleman for all of the examples that he has given, real-world, real-people examples. I think it is important that all of us, as Members of Congress, really take to heart the words that we are hearing from Americans that are going to be affected by this. Particularly in the African-American community, this is going to have a devastating affect on them to have this Affordable Care Act be repealed and this replacement. It does not take into account the lives that people are really living. This is really a tax break bill. That is what this boils down to in many respects, because the individuals who are going to be displaced from this are those individuals who are the poor. I just want to thank Congressman Veasey for the time that he has given us this evening and all of our colleagues who are here and spoke about the Affordable Care Act and what the African-American community and what many Americans have to lose from this bill. At this time, I conclude this CBC Special Order hour. Mr. Speaker, I yield back the balance of my time.

Ms. PLASKETT. Thank you so much, Congresswoman Kelly, for that information that you are sharing and for the work of the Congressional Black Caucus Health Braintrust and for the information that you are giving in the seminars and the groups, the different experiences that you have had throughout the country. I yield to the gentlewoman from Illinois (Ms. Kelly) so that she can tell us about some of the places that the Congressional Black Caucus Braintrust has had workshops or townhalls when sharing information with Americans.

Ms. PLASKETT. Mr. Speaker, I know the work that the gentlewoman from Illinois has done in health disparities that African Americans face. We disproportionately are struck with hypertension, high blood pressure, and diabetes, which are some of the things that we are concerned about. Lapse in coverage under the Affordable Care Act will affect African Americans in a large way because then those will become preexisting conditions, which are not covered under this healthcare plan. Mr. Speaker, I yield to the gentlewoman from Illinois (Ms. Kelly).

Ms. PLASKETT. Mr. Speaker, I thank the gentlewoman from Illinois for the information and for being with us. I also thank Chairman Richmond for providing this opportunity for the Congressional Black Caucus to speak before all of you and let you know. I yield to the gentleman from Texas (Mr. Veasey), my distinguished co-chair, who has some great information to share with us about what do we have to lose under the new Health Care Act that is being considered by the Republicans at this time.

Ms. PLASKETT. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and include any extraneous material on the subject of this Special Order hour.

Ms. PLASKETT. Thank you so much to my distinguished colleague from Philadelphia (Mr. Evans) and for the information you have shared with us. Mr. Speaker, I yield to the distinguished gentlewoman from Chicago, Congresswoman Robin Kelly, who is also the chair of the Congressional Black Caucus Health Braintrust, so she can expound upon this question: What do we have to lose?

Ms. PLASKETT. Mr. Speaker, I agree very much with everything that the gentleman from Texas (Mr. Veasey) has said. I thank him for the stories of individuals because it is individuals that the Affordable Care Act was meant to cover, not groups of people, but everyday Americans, children, disabled, our elderly. Some of the reports say that TrumpCare would be the largest transfer of wealth from working families to the rich in our Nation's history; that the Republicans are handing $600 billion in tax breaks to rich and big corporations through this bill while taking money away from those Americans who have been able to have their healthcare needs taken care of in an affordable manner. You have families that are going to be paying more for less under TrumpCare. Deductibles and out-of-pocket costs are going to skyrocket, leaving sick people unable to afford the care that they need. Premiums will soar and quality coverage is going to be priced out of reach for many families. We also heard earlier about the middle-aged American paying an age tax that is going to come from this, that older Americans are going to be forced to pay premiums five times higher than what others pay for healthcare coverage. I yield to the gentlewoman from Florida (Mrs. Demings), the distinguished freshman Congresswoman from the 10th District of Florida, so she can explain to us how TrumpCare and the new Health Care Act is going to affect her constituents and all Americans and, particularly, African Americans in this country.

Ms. PLASKETT

Ms. PLASKETT. Mr. Speaker, later today, I intend to reintroduce a resolution commemorating the transfer of the U.S. Virgin Islands from Denmark to the United States. In that resolution, it discusses the 1733 slave revolt, the first slave revolt in the Western Hemisphere; the 1848 slave rebellion and emancipation, 17 years before the United States; and, of course, the 1917 transfer of ownership of the Virgin Islands from Denmark to the U.S. We also discussed great Virgin Islanders, such as Alton Adams, Edward Blyden, Camille Pissarro, Judah Benjamin, and Roy Innis. What does the transfer mean, and what have been the gains and benefits to the people of the Virgin Islands because of the purchase by the United States? The Americans were able to receive a pristine, geopolitically strategic location in the Caribbean with a people who are loyal to and proud of this country. What has been given to the Virgin Islanders, a people willing and eager to take on the responsibilities of that citizenship but who, in fact, have moved from a system of serfdom, under Danish rule, to second-class, limited privileged citizenship by the United States? We need to take this time in this centennial transfer year to look at what have been the gains and for the U.S. to make a more perfect Union by more perfect citizenship and more inclusion of the U.S. Virgin Islands into the United States.

Ms. PLASKETT

Ms. PLASKETT. Mr. Speaker, this is a very special day to many of us Caribbean Americans as we pay tribute to the life of Christopher Wallace, otherwise known as Biggie Smalls. Livin' life without fear, Putting five karats in my baby girl's ear, Lunches, brunches, interviews by the pool, Considered a fool 'cause I dropped out of high school, Stereotypes of a black male, Misunderstood, And it's still all good, And if you don't know, now you know.

Ms. PLASKETT

Ms. PLASKETT. Mr. Chairman, I yield 3 minutes to the gentlewoman from California (Ms. Maxine Waters).

Ms. PLASKETT. Mr. Chairman, I yield myself such time as I may consume. We are opposed to the bill because we have received letters and concerns from a cross section of Americans, a cross section of organizations, who recognize that this is not really a codification of an executive order, but this is overreach on the part of the majority of Congress at this time. They feel that they are able to do it, and so they are going to ram this through. H.R. 1009 would add another layer of bureaucracy to an already slow rulemaking process. The Consumer Federation of America says: The bill creates a regulatory working group to provide input to agencies about how to improve their regulatory process, including an evaluation of risk assessment techniques. It appears like this is what we are going to be doing throughout Oversight and Government Reform, is creating new task forces and new groups to review rulemaking and review regulations at the cost of the taxpayer. H.R. 1009 would jeopardize the independence of agencies like the Consumer Product Safety Commission, the Securities and Exchange Commission, the Commodities Futures Trading Commission, the Federal Communications Commission, as well as other independent agencies because it will give the Office of Information and Regulatory Affairs, OIRA, the ability to review significant rules which are outside of their scope now. That is why these agencies are called independent, because Congress wanted them to be independent. We are now giving OIRA overreach into independent agencies. The Consumer Federation of America goes on to say: Authorizing OIRA to conduct its own analysis would not only add pressure from the executive branch and add time and expense to the already slow regulatory process, but would also give the special interests seeking to quash a safety measure yet another avenue to prevent a rule from being promulgated. Significantly, independent agencies were created by Congress to prioritize public health and safety, ensure a fair financial marketplace, and consumer privacy. This bill would undermine the authorizing statutes and the missions of these independent agencies by allowing those agencies to be in some way touched by the White House. Again, we have the Natural Resources Defense Council. Their letter to all of the Members said: The bill would also revive legislative language that Congress repealed elsewhere because it made it impossible to protect the public. Specifically, in H.R. 1009, OIRA was charged with ensuring that the regulation imposes the least burden on society. Congress removed such language when it updated TSCA because the phrase had made it impossible for chemical safety regulations to pass judicial muster, even when the chemical was asbestos, well known to be a potential carcinogen. No one wants to impose unnecessary burdens on society, but the phrase ``least burdensome'' has been interpreted to put an agency in an impossible position of providing that there is no other conceivable way to accomplish its goal of having to cost out every theoretical option. The reason we are opposed to this bill is because it makes it more difficult for independent agencies to remain independent and not be moved by the White House by political machinations that this Congress is now trying to impose on them. Mr. Chairman, I reserve the balance of my time.

Ms. PLASKETT. Mr. Chair, I yield myself such time as I may consume. Mr. Chairman, I oppose this amendment, and it is unfortunate because we believe that this amendment, on its own, is something that would draw bipartisan support. Unfortunately, this amendment is attached to H.R. 1009, because the amendment would make the role of OIRA in the rulemaking process more transparent. The Government Accountability Office has consistently found that OIRA is not transparent about its involvement in shaping rules. The GAO testified to the Oversight and Government Reform Committee, in March of 2016, that it has made 25 recommendations to OMB to improve its process, but OMB has only implemented six of those recommendations. This amendment would be a step in the right direction. And as usual, my colleague, the esteemed gentleman from North Carolina, always comes up with rational, well-reasoned amendments and ideas that can be supported across the aisle; and for that, you know, we believe and we are hopeful that Mr. Meadows will work with the committee on a bipartisan basis to pursue these types of productive transparency reforms. It, unfortunately, does not fix the problems with the underlying bill and is rather packaged with a partisan bill the House is considering today. For this reason, I am in opposition to the amendment. Mr. Chairman, I reserve the balance of my time.

Ms. PLASKETT. Mr. Chairman, the fact that the esteemed gentleman of North Carolina is willing to work with me means that it has been a wonderful day for me, and I am just so glad because I understand, although I don't always agree with everything that he says, and I know that the gentleman from North Carolina's heart is in the right place; that he is working towards resolutions of issues; that he is principled in his beliefs. Mr. Chairman, I yield 1 minute to the esteemed gentleman from Virginia (Mr. Connolly).

Ms. PLASKETT. Mr. Chair, I yield back the balance of my time.

Ms. PLASKETT. Mr. Chairman, I rise in opposition to this amendment.

Ms. PLASKETT. Mr. Chairman, I do not oppose this amendment. However, like the manager's amendment, it does nothing to improve the bill. This amendment, in fact, really does not move the needle at all. Agencies, including the Office of Management and Budget, are required to preserve records according to the records schedules under the Federal Records Act and regulations issued by the National Archives and Records Administration. This amendment says that OIRA must do what it is already required to do. This amendment provides a platform to express frustration with OIRA's response to a subpoena issued by the chairman during the Obama administration, as demonstrated by his statements just a few moments ago. I look forward to him expressing the same outrage if the current administration does not provide documents that the Members on this side of the aisle, the Democratic members of the committee, request. Mr. Chairman, I yield back the balance of my time.

Ms. PLASKETT. Mr. Chairman, I claim the time in opposition to this amendment.

Ms. PLASKETT. Mr. Chairman, I cannot support this amendment because it is duplicative of requirements already in place and will waste limited agency resources through additional burdensome requirements. On January 18, 2011, President Obama issued Executive Order 13563 requiring each agency to implement plans for reviewing existing rules. Section 6 of that executive order requires each agency to ``periodically review its existing significant regulations to determine whether any such regulations should be modified, streamlined, expanded, or repealed so as to make the agency's regulatory program more effective or less burdensome in achieving the regulatory objectives.'' There can be no real doubt that this executive order covers the review and elimination of duplicative and conflicting regulatory actions. Frankly, the elimination of regulations that are duplicative or conflicting is one of the most efficient actions an agency can take to make its regulatory program more effective and less burdensome. Forcing agencies to spend time and resources to describe what they are already doing is wasteful and unduly burdensome. Agencies already keep the public apprised of their regulatory activities through the easily-accessible websites reginfo.gov and regulations.gov, both of which are managed by the Office of Information and Regulatory Affairs. Through these websites, the public can search for rules, comments, adjudications, and supporting documents. The public can also access each agency's unified agenda, which contains the regulatory agenda for each agency. The public can also access a list of pending agency rules. Each of these rules has easily accessible links that can allow the public to obtain further information about the rule, including its status and Executive Order 12866 meetings about the rule. This amendment does nothing to improve the deficiencies in H.R. 1009, and will force agencies to waste their time and limited resources on work that is already being done. I urge Members to oppose this amendment. Mr. Chairman, I reserve the balance of my time.

Ms. PLASKETT. Mr. Chairman, I claim the time in opposition to this amendment.

Ms. PLASKETT. Mr. Chairman, I yield back the balance of my time.

Ms. PLASKETT. Mr. Chair, this amendment would require agencies to report on their efforts to coordinate with State, local, and tribal governments throughout the regulatory process. I agree that it is important that State, local, and tribal governments are properly included in the regulatory process. The amendment, however, simply adds new requirements without addressing the flaws in the underlying bill. The amendment fails to address the fact that this bill does not exclude independent agencies from its coverage. Congress designed independent agencies to be just that, independent. The amendment fails to include an offset for the additional $20 million in administrative costs that this bill will likely cost Federal agencies. The amendment also fails to insert a provision into the bill to ensure that OIRA reviews do not contradict existing laws. The amendment also fails to mandate a specific timeframe within which OIRA must complete its review. The amendment simply does nothing to improve the numerous deficiencies in this bill. Mr. Chairman, I yield back the balance of my time.

Ms. PLASKETT. Mr. Chairman, I claim the time in opposition, but I do not oppose this amendment.

Ms. PLASKETT. Mr. Chairman, I am just so grateful that my colleague is interested in making investments, monetary investments, with taxpayers' dollars. I will be looking to him and his other cosponsors and supporters when we are looking for investing in working class Americans and working people and protecting health care and other benefits when we have the budget discussions. I have no further statements at this time. I yield back the balance of my time.