Pelosi Remarks at San Francisco Press Event on Lower Health Costs For The People

Aug 18, 2021
Press Release

Contact: Speaker’s Press Office,




San Francisco – Speaker Nancy Pelosi joined experts and advocates at Zuckerberg San Francisco General Hospital for a press event to discuss Democrats’ Build Back Better agenda, which will lower health care costs for families by strengthening the Affordable Care Act and bringing down the cost of prescription drugs.  Below are the Speaker’s remarks:


Speaker Pelosi.  Thank you, Dr. Ehrlich, for your kind words, for your great leadership and for the work that is done here.


Yesterday I was at the AIDS Memorial Grove honoring Jim Hormel, and we were talking – those of us there – about the incredible leadership of San Francisco at the time of HIV and AIDS.  And you can't talk about that without talking about the role that San Francisco General played at that time: a model for the nation.


So, for a long time now, that goes back over 30 years, you've had been, again, leaders – in the leadership of meeting the needs, whatever they may be – then AIDS, now COVID.  All along the way, just meeting all of the health needs of America's working families.


So, thank you, Dr. Susan Ehrlich, for your tremendous leadership and again, your hospitality, helping to bring – listen to this – quality health care to more than 100,000 patients each year.  Thank you.  Thank you.  


We all believe that quality, affordable health care must be a right, not a privilege.  The champions joining us here today were mentioned by Dr. Ehrlich, but I want to mention Priti Krishtel, and she will be talking about affordability of prescription drugs, which is a major – I'll talk more about that – but major initiative for all of us.  And Peter Lee, of course, our hero, and Covered California for a long time now, again, a model to the nation.


But our real VIPs are our constituents.  These are our VIPs, our very important people.  Erin [Lubin] and Jakub [Mosur] and their daughter, Zosia.  


Jakub Mosur.  Zosia.


Speaker Pelosi.  Zosia, Zosia.


They're going to tell their story.  And their story is very important to all of this.  When we were – should I start all over?  No I won’t.  


When we were fighting to preserve the Affordable Care Act from the assaults that were made on the previous – by the previous Administration, we had 10,000 events across the country of people telling their stories.  That is the most eloquent argument for case to be made for quality, affordable health care for all Americans.


We thank the Lubin family, for bringing their story to our attention, their generosity of spirit to do that.  


I just wanted to talk a little bit about the Affordable Care Act.  It has made monumental progress in lowering health care costs for American families. 


In 2018, in that election, our first principle, For The People, was lowering health care costs, bigger paychecks, cleaner government, but first and foremost, lowering health care costs.  And again, since then, we've expanded health care coverage to 31 million Americans, in addition to that, to having transformational protections.  Over 150 million families already had health care, but better benefits at lower cost.


And of course, the biggest, I mean – it's something that affects over 130 million Americans, making health care available to those with pre-existing medical conditions.  And by the way, at the time, before we passed the Affordable Care Act, being a woman was considered a pre-existing medical condition.  No more.


But again, despite the decades long attempt by the other side – of Republicans to, to take this down, it maintains – it still is a pillar of health and economic security.  It ranks up there, the ACA, with Medicare, Social Security, Medicare, Medicaid, the Affordable Care Act, and now we even have more formidable additions to it all as we go forward.


During the pandemic, the ACA has been a vital lifeline for struggling families because of job losses.  But the legislation that we passed enabled people who are unemployed to participate at the lowest possible cost with the maximum possible benefits.  Again, it is – it would have been important at any time but during COVID, very essential.  And I know that our guests can speak to that as well.  


And that is why the Biden Administration and Congressional Democrats took action to strengthen the ACA, making health care more accessible and affordable.  It’s called the Affordable Care Act.  We're always striving to make it more affordable.  

President Biden established a Special Enrollment Period, allowing families who lost coverage during the pandemic to purchase insurance at the ACA exchanges.  2.5 million families signed up nationwide, 364,000 here in California.  Thank you.


And in Democrats’ American Rescue Plan, which is – was just passed in March, Congress dramatically lowered the cost of insurance premiums for people buying insurance on their own.  Average monthly premiums fell 27 percent.  Nearly as I said, 2.5 million – even in California – now this is a bigger number – became eligible for new or enhanced subsidies.  700,000 Californians are now getting a quality plan for just $1 a month, for just $1 a month.  


Now Democrats are seizing the once-in-a-century opportunity to lower health care costs for families for good.  Many of these measures are COVID related and for a couple of years.  And we want to do this permanently.


As we advance our Build Back Better agenda, House Democrats are fighting to extend and expand historic progress for lower health costs in the Rescue Plan.


It's outrageous that Big Pharma gets away with charging – with charging drug prices in the United States that they do not charge anywhere else in the world.  American consumers and patients are subsidizing cheaper prices for people overseas.  


While they are on track to spend more than a trillion dollars, the pharmaceutical companies, a trillion dollars on stock buybacks and dividends, many parents are in tears.  I see grown men cry as I go around the country because they're unable to keep up with the cost of life-saving medications.  


And that is why we will not relent until we can pass H.R. 3, the Elijah Cummings Lower – named for Elijah Cummings, dearly departed – Drug Costs – the Elijah E. Cummings Lower Drug Costs Now [Act], saving families hundreds if not thousands of dollars a year, if Democrats advance our Build Back Better agenda. 


The leadership of everyone is important.  This is a consensus in our country.  It's transformative.  It crosses a threshold.  People should not have to worry about the cost of health care.  It’s a health issue.  It’s a financial issue.  It's central to the kitchen table concerns of America's working families.


President Lincoln famously said, and I quote this all the time time, ‘Public sentiment is everything.  With it, you can accomplish almost anything.  Without it, practically nothing.’  But for public sentiment to prevail, people have to know.


So, I thank you all for being here to make sure that you can contribute to a drumbeat across America in our community as well.  


And now I'm going to yield to our real VIPs, as I mentioned earlier.  Their generosity of spirit to share their story will make all the difference in the world for them, hopefully, but also for so many others.  Erin Lubin, her husband Jakub and Zosia are with us.  Erin, thank you for joining us today, for the courage and generosity, as I said, of spirit to share your story.  I'm pleased to yield the podium to you.




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As I said, nothing more eloquent than the stories, the personal stories, that families are willing to share.  We thank the Lubins, for all three of you, participating in all of this.  


And before I introduce Priti, I just want to say that we will continue to invest heavily – as we do in our legislation – in the basic biomedical research to find a cure for diabetes, type two, juvenile diabetes, all of it, because it affects so many families in our country.


Sometimes you hear the pharmaceutical companies say, ‘If you lower the cost, we won't be able to make the investments in research and development.’  No, we're making billions of dollars of research and basic biomedical research, which is fundamental to the further research that they do.  And their argument would have more claim if they weren't spending even more money in buybacks and CEO pay and dividends and the rest, as well as in some cases with some of the companies, more money on advertising than they spend on research and development.


One more point in this, insulin has been around for a very long time.  Certainly whatever cost for research and development that went into that should not kill – continue to be carried out forever and ever.  So, let's be realistic about the cost and all that.  


And a real champion in all this is Priti Krishtel.  She's Executive Director of Initiative for Medicines, Access and Knowledge.  And I particularly want to commend her for the justice aspects of it, how this particularly affects communities of color and previously underserved communities, and, and the central centrality of the cost of drugs to that affordability.  Thank you, Priti, for your leadership.


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Thank you very much, Priti, for your leadership and the clarity of your message.  You have defined the challenge that we have.  We'll talk more about it I'm sure during the Q&A, but right now I want to bring to the podium, really, a hero for all of us in terms of affordability and health care in California.  


Peter Lee is the executive director of Covered California, and from Day One, Day One his leadership has served again as a model for the nation about how we could deliver quality, affordable health care to many more people in a way that is fair and just an overcomes previous underserved communities.


Thank you, Peter Lee, for your leadership.  He comes from a family distinguished for its service to affordability and innovation in terms of health care.  They all would be very proud of his leadership. I certainly am.  Peter Lee.




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Speaker Pelosi.  Thank you very much, Peter Lee, Executive Director of Covered California.  As you were ending your remarks, you referenced what we did and the – again, what we did in the Rescue Plan and how important that has been, but that we need to do more as we go forward.  And that is what we're striving to do now with the reconciliation, the Build Back Better legislation that President [Biden] has put forth.  And that is to make so many of these initiatives, not just a couple of years relating to COVID, but permanent, so that people can depend on it and have the leverage to make decisions in their lives, knowing that they will not be bankrupted by the cost of health care. 


May I just say about the prescription drugs: in 2005, when we first made our attempt to win the House, we had a – for that 2006 election, we had something called ‘Six For ’06:’ six bills we would pass in the first 100 hours of the new Congress when we won.  We did win.  Five of those bills became law.  The sixth one we passed in the House could not get 60 votes in the Senate, we didn't have 60 in the Senate, and therefore, it did not become law.  And that was legislation to enable the Secretary of HHS to negotiate for lower prescription drug prices.  So, we've been on this case for a long time. 


That's what the Elijah Cummings H.R. 3 legislation would do: enable the Secretary to negotiate for lower prices.  This is important to families and individuals, because when we originally did it, we just didn't negotiate for Medicare.  But in H.R. 3, it’s for Medicare and for the private citizen, for the private sector, as well.  So, this is a big important leap forward.  And this is what we're hoping to get in the reconciliation, and that's part of that debate. 


But, it will – something must happen in that regard.  We want it to be the best possible and strongest initiative For The People because it affects families, affects corporate America, paying the bills, affects small businesses, it affects the taxpayer who's carrying the load for subsidizing Big Pharma for them to have big profits while charging so much.  So, that is – again, as I said earlier, I've seen grown men cry across the country as I travel because of the burden of uncertainty and the cost of prescription drugs. 


With that, I'd be pleased to take any questions you may have.  We'd like to focus on the subject at hand, at first.  Then, after, pleased to answer any other questions you may have.  Yes, Ma’am.


Q:  If I could just go back – [inaudible] when you’re talking about extending some of these provisions permanently, for the long term.  It seems the pandemic is going to be around for many, many months, if not years.  Do you envision having to extend emergency provisions to give families more security while you continue to negotiate the long-term provisions?


Speaker Pelosi.  Well, right now, we still have, according to the Rescue package, this will last for a couple of years.  Hopefully, we will be rid of the pandemic long before all of that.  But we're there to meet the needs of the American people.  The big one, again, whether there ever was a pandemic or not, we had the need to lower costs, and that is what we intend to do.  Dr. Lee – I mean, Peter, did you want to speak to that?


Peter Lee.  That – again, the American Rescue Plan was specific to the pandemic, and these benefits go through 2022.  We've already signed up – hundreds of thousands of people have benefits right now in California.  We are open for enrollment right now.  So, if people are uninsured today.  They can walk up to our doors, go to and get insurance that will be for the balance of ‘21.  But, we're already doing planning to enroll people throughout 2022.  The issue before Congress, though, is 2023 and ongoing. 


As the Speaker noted, the American Rescue Plan lowers costs in ways that need to be permanent, that irrespective of the pandemic, we have people who have families with diabetes, with cancer, lower income Americans need more financial help.  That's exactly what the American Rescue Plan models for a permanent need that Congress will be – have before it in the next four months.


Speaker Pelosi.  Thank you for your question.  Any other questions on the subject at hand?


Q:  I have a related question.  When we talk about equitable access to health care, Speaker Pelosi – we’re talking about booster shots for Americans here, COVID-19 shots, while countries around the world are still struggling for access for their broader populations.  Why is it important to prioritize a third shot here instead of prioritizing sharing our supplies with the world?


Speaker Pelosi.  Well, I think we have to do both.  The fact is, is that we are learning, the data shows, that those who had received booster shots, say eight months ago or something are, the protection is waning.  We do have knowledge of who that could be, nursing homes, though, mostly who people got it earlier were those with a pre-existing disposition to be receptive to the virus, but also older people and the rest.  I put myself in that category.  And the – and so we have that responsibility. 


But, we also do have a responsibility to the rest of the world, because unless we're all protected, none of us is really protected.  There are, there are initiatives.  We are sending out some, some vaccine.  We have to strive to do more.  And we cannot, cannot ignore what the rest of the world wants. 


Any comments on that question?  Any other subjects on this – questions on the subject?  Yes, sir? 


Q:  Speaker Pelosi, you said you were at the AIDS Memorial Grove yesterday.  Here we are at SF General.  It’s been a passionate priority for you, over the decades to – with health care and [inaudible] affordable care.


Speaker Pelosi.  Yes, well, when I first went to Congress, the first thing I said on the Floor of the House, I said that I told them – I said, ‘I told my constituents that Sala sent me’ – Sala Burton – ‘that Sala sent me, and I'm here to fight HIV and AIDS.’  That was my very first words on the Floor of the House.  Some people were startled by that because they still were just not used to accepting that as a priority for a Member of Congress. 


But, we have been very blessed in our community, really, starting here.  Dr. Paul, Paul Volberding, so many leaders in our community, were on the forefront of community-based care, community-based research, community-based prevention.  Community-based, I say that over and over again – listening to the community, and it served as a model for the nation.  When we wrote the Ryan White Care Act, much of the intellectual resource drum of it came from here, and, again, from the standpoint of care, from this very institution, San Francisco General. 


So, yesterday, we were there talking about where we go from here on that subject, but I also had the sad privilege of placing flowers at Jim Hormel’s name there, who had been, right from Day One, at the start of the AIDS epidemic used his philanthropy, his leadership to help fight against HIV. 


Just one thing I will say, when this all – more than a year ago, I called the head of the – had a phone conversation with the head of the World Health Organization, and I said, ‘Tell me how, has our fight against HIV/AIDS helped in this fight on COVID?’  For example, something that was bipartisan, with President Bush, the PEPFAR initiative to get drugs in an affordable way into communities, so that people would no longer feel stigmatized but hopeful about it, they revealed their status.  And it has been important in terms of the science, in terms of the distribution of clinics, in terms of the receptivity that people will have to something new.  And I salute President Bush for his ongoing interest in all of that, as well.  Okay.  Yes, sir. 


Q:  Off topic. 


Speaker Pelosi.  Any other comments you want to make about –


Dr. Susan Ehrlich.  Dr. Susan Erhlich, Chief Executive Officer here.  I just want to make a comment about weaving in this idea of the Affordable Care Act and the service that we provide here on campus.  We've been here for more than 150 years, providing care to the community through any number of plagues: smallpox, bubonic plague, tuberculosis, HIV/AIDS and now COVID.  And what I've seen in the past year and a half is what it is, why is it that we've been able to do this so effectively in this place?  


And it's because we live in a city that is supported by the leaders.  It's supported by the community.  It's focused on the community.  And it uses science, data and facts to respond to the problem at hand.  It's why we have the lowest death rate from COVID in the United States.  We have the lowest – we have the highest vaccination rate, one of the highest vaccination rates in the world.  And our hospital has been busy, but we've done relatively well in the United States.  And so I just want to express my gratitude to the Speaker for being one of those leaders and to this community for supporting us in the work we do.  Thanks.


Priti Krishtel.  Can I just respond to the question about the booster shots and the global vaccine equity?  You know, I think, as Americans, we have a tremendous responsibility today to really think about the rest of the world.  Many of us have received our first or second doses.  And there are so many people in countries worldwide that are surging across Africa.  India just went through its surge.  Indonesia, Brazil.  So, I think we have a tremendous responsibility as Americans to be advocating for people all over the globe.


And then at the same time, as a mom, I'm thinking about my child starting preschool in two weeks.  And I'm wondering when my kids are going to get vaccinated.  So, I think I just want to recognize that these are really complicated decisions before us.  And I really love how the Speaker put it.  It doesn't have to be a ‘but.’  It can be an ‘and.’  And we have to get ourselves out of that scarcity mindset and really figure out how we're going to expand the supply of vaccines so everybody everywhere can get vaccinated.


Speaker Pelosi.  Thank you so much, Priti.  I just want to say thanks to this institution.  San Francisco General has had many great leaders, to, again, give us confidence, meet the needs of the people of our area, as a trauma center and the rest.  Everybody has to know how to get to San Francisco General, a leader not only in our city, but in the West.  But all of them would be very proud of the leadership of Dr. Susan Ehrlich, the CEO of the hospital now.  She has just – brings so much knowledge and judgment to the position that she holds.  And I join her in commending our leadership in our city.  Mayor London Breed has done a wonderful job.  I get a daily report from my staff member, Dan Bernal, who's the Chair of the San Francisco Health Commission, that the pandemic is – the rate is decreasing in San Francisco, because the precautions that are taken.  I’m asked about mandates federally, but the mandates locally here, for example, have enabled us to proceed – some that will come into effect next week – proceed in a way that reduces the spread of the virus.  And I salute the Mayor and also support Gavin Newsom for what he is doing.  The campaign against him now is using – they want to take down any mandates for masks, take down any recommendations for vaccinations.  That's their campaign.  So, this recall has become a matter of life and death when you see the other side opposing the initiatives put forth by the Governor for reducing the pandemic in our state.


You had a separate question, sir?


Q:  What do you have to say to the women of Afghanistan?


Speaker Pelosi.  Yes.  Well, the women of Afghanistan have been – the women and girls in Afghanistan have been a very high priority for many of us in Congress – Democrats and Republicans alike, House and Senate, White House, Laura Bush, Michelle Obama, Jill Biden – all of us have had that as a high priority.  Quite frankly, I think some of the support for our presence in Afghanistan across the country sprang from the interest of the American people of the state of women and girls in Afghanistan.


I've been to Afghanistan nine times, many times led by Susan Davis of California for a Mother's Day visit.  Well, of course, our whole purpose is security, to thank our troops –some of them moms, some of them grandmas – fighting the war, and also to remind some of the others to call home for Mother's Day.  But nonetheless also to visit the women in the hinterlands, not just in Kabul.  That's obvious with doctors, professors, lawyers, judges – you know, women, they’re highly visible and the need for us to protect them, but also the poorest of the poor women throughout the country.  And seeing the girls go to school, to see the next generation to have opportunity that they did not have.


So, we have to make this subject of the greatest transparency, shining the biggest, brightest light on what the Taliban may do.  So far, you know, they're painting over beauty salons and things like that.  We'll see where it goes from there.  People ask me, ‘Do you trust them when they say, we're not going to change our – we're not going to hurt women and the rest?’  We'll see.  But we can't take that chance.


I'm just seeing that Malala – you know, luckily Malala, who has been so courageous, is speaking out on this.  And I have a call in to her to say, ‘Any way we can help you.’  But we do want that.


Now, you give me an opportunity to say, please call our office if you have a concern about Afghanis, about people getting out.  What do we say?  Let me give you the right – because there’s so many.  I have so many websites, but this one is –




Speaker Pelosi.  That's my San Francisco place for you to call.  We have speakership saying this, that, but go there.  And then we are in touch with the State Department about specific cases with NGOs there.  Let me just say that I was very proud, and I spoke to my colleague, Jason Crow, this morning, who took the lead on the visas for those who helped us there and largely helping in the military aspects of it, but many NGOs were helpful.  Roots For Peace, local to us here.  Also, there are other groups that were helpful, that were not U.S. NGOs, but NGOs there that need that relief, that visa relief coming out.


The most recent communication from DOD this morning was that they've identified a large number of Americans – we're just talking Americans right now – who have visas and need to get out.  Well, they're Americans.  They don't need a visa.  But the question is, how do you get them to the airport?  And that's a question of the intentions of the Taliban as well.


So, this is all-consuming in every way.  San Francisco is a very welcoming place.  It has always been there.  When we had the Muslim ban – remember that over four years ago?  Well, that was a direct hit on the people who helped us, and therefore the diplomats and military all came forward and said we have to get rid of the Muslim ban, because that hits the people who helped us so much in Iraq and Afghanistan.


And at that time – I just always like to say this, because I think it's important.  At that hearing that we had – of course it was a romp hearing, because we didn't have the majority.  But we had it anyway.  At that hearing, the leader of the American Evangelical community came to oppose that Muslim ban.  And he said this, he said, ‘the US refugee resettlement program is the crown jewel of American humanitarianism.’  We just have to remember that and be more welcoming, especially those who helped us – but nonetheless, for those who have a well-founded fear of persecution, wherever it may be.


So, again, it's about values. It's about values and our responsibility to other people, as other countries, other people affected by all this.  That’s why I was asking about HIV/AIDS, could we use that mechanism to be able to get more drugs to more people to fight the pandemic in the southern hemisphere specifically.


Is that it?


Staff.  Last question.  Anyone?


Speaker Pelosi.  Yes, sir?


Q:  I’m one of your constituents.  I just wanted to say I appreciate you being here to help lower the price of drugs, but we don't want insurance.  We want free health care, Medicare For All.  And you can do that.  You can pressure Joe Biden to give us Medicare for All – every citizen covered.  No more insurance.


Speaker Pelosi.  Well, let me just say, with all the respect in the world for you, my constituent, my boss.  I always say my constituents are my bosses, that I owe you candor.  And I believe in health care for all Americans.  I believe the route that we are in expanding – please, I listened to you – expanding the Affordable Care Act.  Now, we do have in our reconciliation package that we're hoping to pay for with prescription drug money.  But nonetheless we have in our – expanding Medicare benefits: hearing, visual and dental.  So, that that is a better benefit.  But frankly, the Affordable Care Act benefit is a better benefit.  And that we share one view, and that is we want health care for all Americans.


Thank you all very much. Thank you.




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