Actions event in San Francisco, california. As we gather here to save our health care, people are gathering all over the country in democratic districts under the leadership of democratic members and republican districts with outside mobilization weighing income a day of action to preserve our care. This is absolutely essential, because this is again an assault on one of the most important rights, the right to good health. Reverend Martin Luther king said of all the forms of inequality, the injustice and health care is one of the most inhuman, inhuman. We know that. We know that. We will talk more about that, but we know this is in a very important value to our country to be respectful to the needs of the american people. There are many who will talk in the course of the morning on the republican plan and how that is. Eally so out of the question we are for the Affordable Care act. We want to see them come up with something that is not diminish what our goals were in the Affordable Care act. Those goals were to expand to as many people as possible in our country, to improve benefits for everyone, and to lower the cost, so it is not just about the 20 Million People, actually it is who have0 people today Health Insurance who would not have had a before. It is also about 155 main people who get their benefits through the workplace, and expanded benefits that they have, whether it is no preexisting condition being a barrier to insurance come whether it is no lifetime or annual limits on the coverage they receive, whether it is their children being able to stay on the policy until 26 years old, whether it is being a woman is no longer preexisting medical condition. [applause] or whether it is insisting that Health Insurance companies spend 80 of the money they receive on the health care of their policyholders and not on advertising and ceo pay. There are many things. In terms of Community Health centers, a central part of all would be overturned with the repeal of the Affordable Care act. The list goes on and on, but a new number i want you to carry with you and use is 27 . At this conference yesterday in washington, i heard a doctor make this presentation. Of of people under the age 65, not on medicare, under the age of 65, would be uninsurable because they have preexisting medical conditions. The would be so astronomical it wont be able to happen. That is not what our country is about. The republicans want to make america sick again. And we will not let that happen, so what can we do about it . Everybody sees the urgency. Many of you want to take responsibility as you see that urgency. We have this opportunity to have people take another look at the Affordable Care act, to dispel what they heard, the misrepresentations they heard before, and to that end, i am honored that we have two special guests to talk about this from their experience come secretary diana dooley, the California Health and Human Services secretary appointed by governor jerry brown. She served governor jerry brown in his first term. She has been involved in the private sector and the nonprofit sector. She knows the health issue from every angle. When she speaks on the subject, everyone listens. She is an expert, and california in being anway example to the country. Thank you, secretary dooley for being with us. [applause] before i bring her up, i want you to know who else is with us. Is the ceo ofich zuckerman San Francisco hospital. On so many occasions, she has hosted is there to make presentations, hear stories and the rest. She is on the front line of providing health care in our community. She has been a tremendous leader. , serves us allis well. We are all here, again, to make sure that health care is viewed as a right for all americans, not just for the privileged few. Dr. Ehrlich has dedicated her life to that. So i will first bring up with a respecty for Governor Brown who appointed her in the 1970s, and now all these years later, her experience is fast, longterm, and were delighted she is with us today. Secretary dooley. [applause] thank you so much. We are all lucky to have leader pelosi, but never more than now. Thank you so much. [applause] beand i do feel humbled to with you today at this important time. Through the leadership of the people of california, we have been at the forefront of making the Affordable Care act real for californians, and showing the rest of the country what can aside when we put partisan differences. California has understood for many, many years that we have challenges in the delivery system, and while the coverage expansion has been the primary focus of the work we have done, and certainly i am very proud of the work covered california has done, to add nearly 1. 5 main people to cover two would not have had it, but also through our medicaid expansion, where almost 4 Million People who could not get coverage before are now covered across california, but this has happened because we have worked very hard for many, many years to do this, and it was an acted california with the leadership but with aress, republican governor, and wed locked arms and made it work in california with people like dr. Ehrlich and our hospitals in our communities with our county eligibility workers and with our community clinics. I could go on and on. The way we have change health care in california is really nothing short of miraculous. The Brookings Institute just last week did a survey of the states that had embraced it to some degree the Affordable Care act and said california was leading the nation. Now dont get me wrong, i do not have a Mission Accomplished sign above is here. There is a lot of work to do, and we all know that there are axis problems and challenges with relationships between primary care and Specialty Care and hospital care and outpatient what the i think that obamacare and the rhetoric around this gave a name to problems in health care that did not have anything to do with the Affordable Care act. The Affordable Care act was to address those problems and solve those problems, and we have. We have done it in so many ways. In the employersponsored care, the premium cost is lower than it has been in 15 years. Ae trend before the aca was. 5 percent premium increases. Since the Affordable Care act, those premium increases have held at about 4. 5 . We have had an average of 7 increases, even in the covered california exchange, and the last it was under 5 until oneyear blip this year, so we are changing the way health care is deliver it. We are improving the efficiency, quality, transparency. We have essential benefits across all of the products that people can understand. Now believe me, it is hard to understand how to get the care we need, and we have more work to do him a but we certainly cant go backwards as the repeal, even the replace language i am working right now to keep my people running the programs that they have because if we get distracted and start analyzing every tweet and every possibility that its out there, they are completely irreconcilable. If you feel confused when you read the news every day, it is for good reason. You cant reconcile what they say about wanting to have better care and lower costs. That is what the Affordable Care act is. It is sort of sad that the people who are getting it right or the comedians, who say we have that. It is called the Affordable Care act in this country. In the six years i have spent making it work, believe me, this is a team sport. It has involved a lot of people across a lot of sectors in this, the mostso is not that a lot of democrats wanted. Many of us are singlepayer advocates and many of us still are. [applause] but, but we have a plan that is working, and we cant the perfect be the enemy of the good. This plan was romney care in massachusetts, and it was Sorenson Necker care in california before it was ever a obamacare. This is the marketbased plan, so the irony of having it be opposed by the people who designed it is just beyond me. I can understand it, but my job is to follow the law, and we have a law of the land. It is working in california, and it will continue to work if people all across this country on this national day of action will get through the rhetoric to the reality of a because what is real is people are getting the care that the president has talked about wanting, and if they can make it better, i will be there every day to try to make it better, but what i have seen so far will not make it better, and we need the kind of action that you represent here and across this country. I was born and raised in the San Joaquin Valley in california. I know how disadvantaged communities live and work. I had no Health Insurance myself until i had a job after college. The Central Valley of california has benefited perhaps more than any other region in california, leaders andhave that part of our state that are not acknowledging the benefit to their people, so we need to help our friends and colleagues and neighbors across the state and across this country understand what the Affordable Care act really is, not what it has been represented to be, so leader pelosi, i cannot thank you enough. I will be your partner to do everything we can to make it work. One important thing to remember about the Affordable Care act, medicare, medicaid, and the aca are wedded. In the aca, we have prolong the life of medicare. We began closing the donut hole for the cost of prescription drugs. The whole bill is about prevention and wellness. It is about a healthy america, not Just Health Care in america, but wellness in advance of that, and the medicaid piece of it is very central. While medicaid is thought of to be for poor children and their families and for a large number of beneficiaries are children, but a much smaller percentage of the money is spent on children. 50 of the funds spent in Nursing Homes on seniors in Nursing Homes comes from medicaid, comes from medicaid. I said medicare, forgive me. It comes from medicaid. Care,of the longterm whether a nursing home or day care for seniors, etc. , it comes from medicaid. It from me, the governor of ohio, republican , he said thankd god for medicaid because that will help me fight the opioid epidemic. It is about addiction, opioids, and the rest of that. [aus