[Congressional Record Volume 152, Number 57 (Thursday, May 11, 2006)]
[Senate]
[Pages S4447-S4460]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTH INSURANCE MARKETPLACE MODERNIZATION AND AFFORDABILITY ACT OF
2006--Resumed
The PRESIDING OFFICER. The Senate will proceed to the consideration
of S. 1955 which the clerk will report.
The assistant legislative clerk read as follows:
A bill (S. 1955) to amend title I of the Employee
Retirement Security Act of 1974 and the Public Health Service
Act to expand health care access and reduce costs through the
creation of small business health plans and of the health
insurance marketplace.
Pending:
Frist amendment No. 3886 (to S. 1955 (committee substitute)
as modified), to establish the enactment date.
Frist amendment No. 3887 (to amendment No. 3886), to change
the enactment date.
Motion to recommit the bill to the Committee on Health,
Education, Labor and Pensions, with instructions to report
back forthwith, with Frist amendment No. 3888, in the nature
of a substitute.
Frist amendment No. 3889 (to the instructions of the motion
to recommit), to change the enactment date.
Frist amendment No. 3890 (to amendment No. 3889), to
provide for the enactment date.
The PRESIDING OFFICER. Under the previous order, there will be 60
minutes of debate equally divided between the Senator from Wyoming, Mr.
Enzi, and the Senator from Massachusetts, Mr. Kennedy, or his designee.
Who yields time?
Mr. FRIST. Mr. President, we have a lot going on on the floor, and we
are going to have one more vote today, and it will be up to an hour
from now. But what we would like to clarify is who needs to speak from
our side. Chairman Enzi is right here. Do we have anybody on our side?
I know Chairman Enzi will be speaking. Is there anybody else from our
side?
I ask the Democratic leader through the Chair who will be speaking on
their side.
Mr. REID. Mr. President, the only request for time I have at the
present time is for the Senator from Arkansas, Senator Lincoln, for 7
minutes. Is there anyone who wishes to speak? Senator Kennedy wants 10
minutes. Senator Durbin may request time, I think 7 minutes for Senator
Durbin. No for Senator Durbin. So 7 and 10, 17 minutes over here.
Mr. FRIST. Mr. President, I ask our chairman approximately how much
time we would need. What we want to do is try to get the time down as
far as we can. We have a number of people who have plans that they need
to make, and we would like to vote as quickly as we can, but we want
adequate time to speak.
Mr. President, through the Chair, I ask the Democratic leader, would
it be agreeable that we have a unanimous consent request propounded
that we vote at 10 minutes after 6, the time equally divided between
now and then?
Mr. REID. Does that give us our 17 minutes? I ask to amend the
request to 17 minutes on each side.
Mr. FRIST. So to restate, I ask unanimous consent for 17 minutes on
either side, so the vote will be at approximately 14 minutes after 6
o'clock.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
The Senator from Arkansas is recognized.
Mrs. LINCOLN. Mr. President, I was so excited when we came to work
this week with the opportunity to focus our Nation and the debate of
this body toward health, the health of our Nation, the health of our
people, and the health of our businesses, the fabric of this country,
the fabric of our Nation. It is such an important thing for so many of
us--certainly, each of us in our own families. I have small children
and aging parents.
All of us have responsibilities in our own lives and responsibilities
to our constituencies. We have different constituencies such as the
elderly who live in our communities and the small businesses that are
striving hard to keep our economy going; children, and those with
chronic diseases and illnesses who desperately need to make sure that
the coverage they have is sufficient for what they may have or may not
have, but want to make sure that they are protected against in case,
unfortunately, something might happen.
So as we came to the Senate this week to talk about health and how we
could make health a very real part of the discussion in this Nation, a
real part of what it meant to our economy and to our people and the
quality of life, the real value of who we are as Americans, I was
excited. Yet I saw so much of it cut short. The discussion that started
on Monday ended with a line in the sand that said: My way or the
highway, not let's work a deal and let's figure out what will make
health care real in this Nation and sustainable and that will make
sense in our communities. Then we moved to talking about how we deal
with small businesses. To me, the most important thing we can do for
our small businesses is to make available to them affordable,
accessible health care but quality health care, the same kind of
benefits that we ourselves as Members of Congress are blessed enough to
be able to experience for our families and for ourselves.
As we proceeded into this debate, way too much of the debate centered
around not what we could work hard to do that was right but what people
wanted. Then, all of a sudden, we leave abruptly this incredibly
important debate.
We leave behind this incredibly important debate to talk about a tax
bill for tax cuts that don't even expire until January of 2009, instead
of looking at something real and new, such as a new tax cut for small
businesses to engage in the health insurance marketplace for their
employees and for themselves or looking at how we could extend tax cuts
that had expired, such as research and development and for education
and tuition and so many more things that have been productive in our
economy and in our communities. We go through this debate, and we come
back now to finalize debate on the health care of our Nation. And what
have we done? We have missed an opportunity to say to our seniors they
are important enough that we are going to extend a deadline, a deadline
[[Page S4448]]
that means so much for them to be able to take the time and the
opportunity to understand this new prescription drug component of
Medicare that we have passed.
I voted for it, Mr. President, and I want it desperately to work. I
have been out in the field in Arkansas, and I have made sure I met with
seniors. We have hosted meetings and tried to educate, but there simply
has not been time enough to get to the complexity of what is offered
out there. We look back at what efforts have been made. The GAO has
reported that one-third of seniors' calls to Medicare operators
resulted in flawed or no information. Think about that for a moment.
One in three seniors who called CMS for help were given bad or no
information. Now those seniors must make difficult, sound decisions
about their health care by Monday of next week. I wish we had been
given the opportunity to make a difference in that.
I wish we had the ability to make the difference for small
businesses, offering them again the same opportunity we have, to enjoy
quality health insurance at a low cost, with many choices for the
variety of Federal employees who work in this great Nation. We can do
the same. We could allow employers and small businesses and self-
employed individuals--think about that, a one-man shop--to reap the
benefits of group purchasing power and streamlined administrative costs
as well as access to more plan choices.
The proposal we had looked to present would create all of that,
without any new bureaucracy. How about not reinventing the wheel? For
once, we in Government would use something that was time tested for 40
years, has a 1-percent administrative cost, that we could implement for
small businesses and bring to them again the same quality of product we
enjoy as Members of Congress.
On top of that, we could have incentivized it and brought them a new
tax cut, a new tax benefit in order to be able to invest in themselves
and in their employees and provide the kind of health care they
deserve.
It is hard for me to believe that we have missed all of those
opportunities: to be progressive, to be thoughtful, to invest in our
country, to make sure we are taking care of the fabric of this Nation
and who we are.
About 53 million Americans work for businesses with less than 100
employees. That pool is bigger than the Medicare population, which is
about 42 million. Think of what we could do in offering those small
businesses that type of a pool, to be able to bring down their costs,
increase their choices, and maintain the quality they have demanded,
the types of services they may need now or that they may need in the
future, whether it is diabetes or cancer screening, making sure that
immunization and child well care are all in there. We had an
opportunity to do this and many things and we have missed that
opportunity.
Working families and small businesses need help. Our seniors need
help. Our community providers need help.
Mr. President, I ask for an additional minute.
Mr. KENNEDY. Mr. President, how much time do I have?
The PRESIDING OFFICER. The Senator has 10 minutes.
Mrs. LINCOLN. Thank you, Mr. President. I encourage my colleagues to
look at the missed opportunities and pull together to make a difference
for the people of this country.
The PRESIDING OFFICER. The Senator from Nebraska.
Mr. NELSON of Nebraska. Mr. President, as many of you are aware, I am
a former insurance commissioner from Nebraska. For several years, I
served as the head of the National Association of Insurance
Commissioners and spent most of my adult working life, except for
Government service here and in the State house, in the insurance
business. I do not propose that I can propound I am an expert, but I do
think I have some experience in this field.
I know you have heard from small businesses in your States. The
average cost of health care premiums has doubled in 5 years for small
businesses. Everywhere I have gone around the State of Nebraska, every
small business owner I have spoken to has told me the same story: We
either can't afford or we can't find health care coverage for our
workers. We are very concerned about that. What can you do to find a
solution?
They pushed me toward the House version of the associated health
plans. I couldn't support that unregulated form of self-insurance for
the promoting of insurance on an association basis. I couldn't support
it. There was no guaranteed fund protection, no requirement for the
filing of forms--nothing. I could not support it.
I also knew the status quo where there are now more mandated
coverages in several States than people can afford, so the status quo
continues to add to the problem, creating more and more uninsureds. We
now have gone to the total of 40 to 45 million uninsured, and the
number continues to grow.
I am pleased that the Senate is finally debating the problem. We all
recognize it is here and it needs to be solved. I agree with my
colleague from Arkansas that we need to spend time on this. We just
disagree on how to get there.
More time is important, but I can tell you right now that the
chairman of the committee, Senator Enzi, has spent more time listening
and listening and acting on suggestions than I have ever seen happen in
this body. We could probably spend more time, but I think that is what
it is about, that is what a cloture vote is about, spending more time
rather than cutting it off at this point in the discussion. I believe
we were starting to make progress in finding the solution when Senator
Enzi and I and our staffs began to talk with one another about how we
might solve the problem of having an uninsured plan with an insured
plan with regulatory oversight, but cutting out the unnecessary cost to
reduce overhead expense, therefore reducing the cost of the premiums,
making it more available and more affordable to the employees and to
the owners.
I didn't want to create an adverse playing field between association
health care plans and the small group market. The traditional AHP bill
gave a rating and mandate advantage to association plans that resulted
in adverse selection and an unlevel playing field. The proposed SBHP
legislation has eliminated this unfair playing field by including rules
to prevent these problematic practices and at the same time requiring
all insuring entities to abide by the same regulations.
Therefore, there is more than a modicum of State regulation
associated with this plan--on a financial solvency basis, on a rating
basis, and fairness as to the practices that could be provided.
Unlike AHPs, SBHPs must be fully insured and marketed by State-
licensed insurance companies. The insuring entities must meet the
capital and solvency requirements within each State they operate,
comply with the consumer protection laws in each State, pay the
applicable premium taxes, and be part of any assessments associated
with high risk pools and/or guarantee funds. As a former State
insurance commissioner, keeping State regulation involved in this
process was important to me because I know the value of State insurance
regulation.
Competition will return to the small group market when we move
forward with this legislation. The market will expand. There will be
more opportunities today than ever before when this passes. The rates
will be in competition as well. Everybody will benefit.
There are those who have suggested that this is not in the best
interests of some special interest groups. Senator Enzi and I and our
staffs have met with these individuals and in some cases we have made
the changes that would take away the concerns they have, but they still
oppose the bill.
It seems to me what we need to do is refine this legislation after a
cloture vote and listen to the proposals that will be brought up. If
there are better ideas out there, I know this body will find them. But
to close it off at this point in time is to say no to small business.
It is to say we don't care enough to move forward, to consider other
proposals, but we simply are going to close debate.
I hardly ever vote to avoid moving forward and I am not going to vote
against it now. I am going to vote to go to cloture so we can get a
chance, if we get 60 votes. I would hate to see us be four or five or
six votes short of that process because I think there is too much at
stake for our small businesses, too much at stake for us not to be able
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to find solutions. I am afraid if we don't move forward and debate it
fully and see what we can do on the floor of the Senate, it will carry
over into another year.
I have been here long enough to know when somebody says we will do it
next year, you can't always count on next year coming. I think it is
important we move this forward.
I yield the floor.
Ms. COLLINS. Mr. President, the Senate has spent much of this week
debating S. 1955, the Health Insurance Marketplace Modernization and
Affordability Act of 2006. I commend my good friend and colleague from
Wyoming for all of his hard work on this legislation, which is intended
to make health insurance more affordable for small businesses by
allowing them to join together to purchase association-based small
business health plans. Despite my support for the goal of this bill, I
think its approach is fundamentally flawed. Let me explain my concerns.
One of my top priorities in the Senate has been to expand access to
affordable health care for all Americans. There are still far too many
Americans without health insurance or with woefully inadequate
coverage. As many as 46 million Americans are uninsured, and millions
more are underinsured.
Since most Americans get their health insurance through the
workplace, it is a common assumption that people without health
insurance are unemployed. The fact is, however, that as many as 83
percent of Americans who do not have health insurance are in a family
with a worker.
Uninsured working Americans are most often employees of small
businesses. In fact, some 63 percent of uninsured workers either work
for a small firm or are self-employed. Taking a look at the problems
faced by small businesses is, therefore, a good place to start as we
attempt to reduce the numbers of uninsured.
Small businesses want to provide quality health insurance for their
employees, but the cost is often just too high. So I am totally in
agreement with the underlying goal of this legislation, which is to
make health insurance more affordable for small businesses and their
employees. To that end, I have introduced bipartisan legislation to
help employers cope with rising costs by creating new tax credits for
small businesses to make health insurance more affordable and by
providing grants to States to assist with the development and operation
of small employer purchasing cooperatives to increase the clout of
small businesses in their negotiations with insurers.
I do, however, have a number of very real concerns about S. 1955, as
it was reported out of the Senate HELP Committee.
First, the legislation preempts the States' traditional authority to
regulate insurance and allows not just small business health plans but
all health insurers to exclude important benefits like cancer
screenings, mental health coverage, and diabetes care that currently
are guaranteed under many State laws.
States have had the primary responsibility for the regulation of
health insurance since the 1940s, and based on my experience in
overseeing the Maine Bureau of Insurance for five years, I believe that
States have generally done a good job of responding to the needs and
concerns of their citizens.
As the founder and cochair of the Senate Diabetes Caucus, I also am
all too aware of the tremendous emotional and economic toll that this
devastating disease takes on an estimated 21 million Americans and
their families. I am particularly concerned that the bill would preempt
as many as 46 State laws guaranteeing coverage for the medications,
equipment, services, and supplies that people with diabetes need to
manage their disease and prevent costly and potentially deadly
complications.
This simply is penny wise and pound foolish. Diabetes currently costs
our Nation more than $132 billion annually. Eighty percent of those
costs are due to the complications associated with diabetes--
complications that, absent a cure, can only be prevented through
prevention and proper management of the disease. If cloture is invoked,
I will be offering an amendment with Senators Bingaman and Domenici to
preserve State laws requiring coverage for comprehensive diabetes care.
Both the American Diabetes Association and the Juvenile Diabetes
Research Foundation have endorsed our amendment.
I am also concerned that the bill would preempt State rating rules
and establish a new national standard. Proponents of the legislation
contend that the application of this new national standard may not
cause much disruption in many states. In Maine, however, which uses
modified community rating, it could alter the market substantially.
In fact, the nonpartisan Congressional Budget Office, CBO, estimates
that one-quarter of all small businesses will actually pay higher
premiums if this bill is passed. It is therefore likely that many small
employers in Maine--particularly those with an older workforce--will
wind up paying more, and in some cases substantially more, under this
bill.
This bill is no panacea, even for those small employers who will see
savings. The CBO estimates that health care premiums will only average
about 2 to 3 percent lower if S. 1955 is passed. Many small business
owners have been told that the bill will cut their costs by from 12 to
20 percent. Even those employers who do see savings are likely to be
disappointed that they are not as great as they had been led to
believe.
Finally, I am concerned that the bill, as reported by the committee,
could allow health plans to exclude a class of health care providers,
solely on the basis of their license or certification, restricting
patients' access to qualified health professionals. This is a
particularly important issue in rural areas like Maine, where there may
not be a sufficient supply of physicians to provide the care that the
health plan has promised to cover.
For example, virtually all health plans cover medically necessary
primary care services. Many rural Americans use a physician assistant
or nurse practitioner as their primary care provider because there
simply isn't an adequate supply of physicians where they live. In these
areas, if a plan only covers primary care services offered by a
physician, patients will either have to drive great distances to
receive the care they need or pay out of pocket for services that are
supposed to be covered benefits.
If cloture is invoked, I will be offering an amendment to maintain
the application of all existing State laws prohibiting health insurers
from discriminating against health providers who are acting within
their scope of practice under State law, solely on the basis of their
license or certification.
Mr. President, I do plan to vote for cloture. Congress should be
taking action to make health insurance more affordable for small
businesses, and I believe that this debate should go forward.
I do not, however, believe that we need to preempt the good work that
States have done in the area of patient's rights and protections in
order to help our small businesses. I would, therefore, oppose the
current bill on final passage unless it is substantially changed.
Mr. DOMENICI. Mr. President, I rise today to support affordable,
adequate and accessible health insurance. We have a bill before the
Senate, S. 1955, the Health Insurance Marketplace Modernization
Affordability Act of 2006. Chairman Enzi has worked very hard on this
bill for many months now and I believe that it will help small business
people who are struggling to afford health insurance for themselves,
their employees, and their families. I hope that the Senate will pass
this bill because the time for Congress to take action on this issue is
long overdue.
Most people in the U.S. who have health insurance obtain it through
their employer or through a family member's employer as a workplace
benefit. Small employers however are far less likely than larger
employers to provide health insurance to their workers. In my home
state of New Mexico, I am embarrassed to say that almost 25 percent of
the citizens do not have health care. This is the second highest rate
of uninsured in the country. Furthermore, there are approximately
143,909 small businesses in New Mexico, and of these small businesses,
only about 37 percent of firms with fewer than 50 employees offer
health insurance. For much smaller firms with five or less employees,
the numbers are
[[Page S4450]]
even more staggering; fewer than 50 percent of firms offer health
insurance. This is unacceptable. Working people deserve better.
The current realities of the insurance market make it much more
difficult for a small business people to secure quality, affordable
insurance. I believe that by allowing small businesses to band
together, as this bill does, that economy of scale will be created and
small businesses will be able to leverage their larger purchasing power
to lower their health care costs. This would hopefully enable more
employers to afford such coverage and ideally reduce the number of
small firm workers without health insurance. It is a real first step to
providing more access in a market where small business is currently
struggling.
Over the past few weeks, I have heard from many advocacy groups who
are concerned with the way in which this bill addresses State benefit
mandates. I understand these concerns and agree that widely accepted
critical protections for patients must be preserved in any legislation
the Senate ultimately adopts. That is why I have joined together with
Senators Snowe, Byrd, and Talent to offer an amendment that would
require small business health plans to comply with the benefits adopted
by a majority of States. This amendment says if 26 States mandate it,
than a small business health plan must comply with it. This amendment
is a good and workable compromise that alleviates one of my primary
concerns with the small business health plan bill. This compromise will
help ensure that millions of Americans will continue to receive health
care coverage for most areas, including mammograms, diabetes care and
mental illnesses. It is vitally important that we pass a bill that will
bring health insurance to employees of small businesses who currently
are not covered without consequently diminishing coverage already
offered in other areas. This amendment should make it easier for us to
do so.
It is time for the Senate to take action on this issue. The House of
Representatives has passed this type of legislation multiple times. The
American people are tired of excuses and they are tired of the status
quo. They want to see change for the better. I again thank my
colleague, Senator Enzi, the chairman of the HELP Committee for his
hard work on this important issue. I have long said that something
needs to be done to address the problem of the uninsured, and I have
also said that I support the idea of legislation aimed at helping small
business. I sincerely hope that the Senate will pass a bill that will
allow small businesses to afford insurance for their employees.
Mr. LEVIN. Mr. President, I take a brief moment to explain why I will
be voting against cloture on S. 1955. The availability and
affordability of health care is one of the most important issues that
we can debate this year in Congress. As was highlighted during the
recent ``Cover the Uninsured Week,'' the United States spends more on
health care than any other nation, yet we still have almost 46 million
uninsured Americans. This means that over 18 percent of Americans are
uninsured and that there are 9 million children in our country without
health insurance.
The Senate's response to this health care crisis, however, has been
sorely lacking. The majority leader called this week health week and
scheduled debate on three bills that would do little or nothing to
assist the Nation's uninsured. The first two bills were medical
liability bills that did not even achieve a majority of votes in the
Senate. I have stated many times that I believe any meaningful tort
reform should be enacted on the state level and voted accordingly. The
third bill is S. 1955, and I would like to take this opportunity to
explain my reservations about the bill.
The concept of S. 1955 is to allow small business or trade
associations to pool together in an effort to purchase health insurance
at affordable costs. These new health plans would cross state lines and
therefore be eligible to bypass the state coverage and solvency
mandates that apply to health plans offered by larger employers.
S. 1955 is a well intentioned bill. Senators Enzi and Nelson and
their staffs have spent many hours meeting with all sides involved in
this important debate. This effort to bring everyone to the table
resulted in a bill that improved upon previous small business health
plan bills referred to as ``association health plans.'' However, S.
1955 still falls short.
I have several concerns about S. 1955. First, I am concerned that
this bill could reduce access to critical benefits. S. 1955 replaces
state benefit requirements with a new standard that would allow
insurers and small business health plans to offer ``basic'' benefit
plans, which would not have to include state-required benefits as long
as they also make available an ``enhanced'' benefit plan, which would
be equivalent to one of the benefit plans offered to state employees in
one of the five most populous states. However, this new standard is
meaningless since those coverage options are likely to include a high
deductible/low coverage plan that would afford little protection to
consumers who need health care, whether due to illness or age.
Currently, insurance rating rules and the regulation and approval of
insurance plans are by done by state insurance commissioners. Most
state insurance commissioners are elected officials charged with making
sure a state's market is based on rates that are fair and equitable to
all based on state law. In my home State of Michigan, we have few
benefit mandates, but those mandates are important to the populations
that are protected. Some of the benefits that would no longer be
required to be covered for Michigan citizens include hospice care,
newborn coverage, access to obstetrician/gynecologist, access to
pediatrician and diabetic drugs and prevention of diabetes programs. By
some estimates, this could affect over 2.7 million people in Michigan.
This pattern could be repeated in states across the country. My concern
about this is shared by many Governors, State Attorney Generals and
State Insurance Commissioners, who have written the Senate to express
their reservations about this bill.
A second concern I have about S. 1955 regards rate setting rules.
This legislation would create a new system allowing for insurers to
vary premiums based upon, among other factors, health status and age.
S. 1955 would wipe out state-based protections against discrimination.
This would affect older Americans and others such as groups with large
numbers of women, small businesses with fewer workers, and higher risk
industries.
Finally, I am concerned that S. 1995 would increase the potential for
fraud and abuse. This concern is the basis for the recent letter to the
Senate from 41 State Attorney Generals expressing opposition to this
bill. S. 1955 will potentially erode state oversight of health
insurance plans and eliminate consumer protections in the areas of
mandated benefits and internal grievance procedures. The bill provides
no additional authority or resources to enforce the new Federal
standards created within it. This is eerily reminiscent to me of an
experience our country had in the 1970's with Multiple Employer Welfare
Arrangements or MEWAs. MEWAs were then exempted from state regulatory
insurance requirements, and the result was that almost 400,000
Americans were left with more than $123 million in unpaid health
insurance claims.
Yesterday, the majority leader used a procedural tactic to prevent
Democrats from offering meaningful amendments to this bill which could
have improved it. One such amendment would have been the Democrat
substitute to use the Federal Employee Health Benefit Plan as a model
pool to allow for lower health care costs for small businesses. I would
have liked to have had the opportunity to also debate other health care
issues as well such as extending the Medicare Part D enrollment
deadline, lifting the Federal restrictions on stem cell research and
other efforts regarding the nation's 46 million uninsured.
Health care costs are rising too quickly, and I am sympathetic to the
plight of small businesses. As a senior member of the Senate Small
Business and Entrepreneurship Committee, I often hear from small
business constituents of mine about annual double digit health premium
increases. However, rising health care costs are not unique to small
businesses--it is an untenable situation shared by most
[[Page S4451]]
Americans--and this bill takes the wrong approach to solving this
problem. For all of these reasons, there is strong opposition to this
bill from many state leaders, and from a coalition of more than 200
organizations, including the AARP, the National Partnership for
Families and Women and Families USA.
At a minimum, we needed the chance to improve this bill. I cannot
support cloture to end debate and restrict amendments on this
legislation.
Mr. REED. Mr. President, I would like to comment on the legislation
the majority has brought forward during what it has dubbed Health Week
and on health care more broadly.
While I do not support this legislation as drafted, I commend Senator
Enzi for attempting to address the important issue of health insurance
for small businesses.
As of 2004, over 45 million Americans were uninsured. Unfortunately,
these numbers continue to rise with each passing year as more and more
employers cease offering coverage to their employees. In Rhode Island,
the percentage of companies offering health insurance coverage declined
from 80 percent in 1999 to 68 percent in 2005. In my State, a small
business is more likely to drop coverage because of the prohibitive
cost.
While some employers have stopped offering coverage altogether,
others have struggled to keep up with escalating costs. Since 2000,
premiums for family coverage have increased by 73 percent compared to
an inflation growth of 14 percent and a wage growth of 15 percent over
the same period.
Health insurance affordability not only affects employee
satisfaction, it also has a direct impact on a company's
competitiveness.
We need to address these issues, but S. 1955 is not the answer. It
decreases cost by changing rating structures, allowing cherry-picking
of healthy individuals, and offering plans with very few benefits.
S. 1955 would amend the Employee Retirement Income Security Act of
1974 (ERISA) to allow for the creation of small business health plans,
SBHPs, sponsored by business or trade associations that would, like
self-insured plans, be exempt from State laws. As was the case with
legislation proposing the creation of association health plans, AHPs, a
considerable number of health care experts have expressed concerns that
this legislation would exempt SBHPs from important State regulations
that protect consumers, guarantee access to coverage and treatment, and
ensure financial solvency. Millions of Americans could lose coverage
for such important care as screening for breast, cervical, colorectal,
and prostate cancer; well-child care and immunizations; emergency
services; mental health; and diabetes supplies and education.
I have serious concerns that this legislation could weaken the
already fragile insurance market we currently have in the United
States. States have worked diligently to craft insurance regulations
that reflect their individual needs. They have developed rating systems
and mandated benefits to best protect their citizens.
This bill will affect not only health insurance for small businesses
but also health insurance for all markets. In a letter to the chairman
and ranking member of the Health, Education, Labor, and Pensions HELP
Committee, the Rhode Island health insurance commissioner expressed his
strong concerns about how S. 1955 would affect the State's health
insurance regulatory system, its ability to hold health plans
accountable, and develop solutions particular to our Sate. I will ask
that the text of this letter be printed in the Record.
I have serious concerns about the health insurance that would be
offered under this legislation. If insurance does not offer adequate
coverage, it is insurance in name only. It is of little use if you
can't afford it or access it when you need it.
A recent program on PBS' NOW focused on what it termed ``junk
insurance plans'' and profiled two particular cases where the insurance
was really no insurance at all, leaving couples who had faithfully paid
premiums with astronomical medical bills. In one case, the insurance
plan sold was marketed through an association for the self-employed.
It is important to try to address the problem of the uninsured, but
we need to be sure that it is being done in a sensible and thoughtful
manner.
While Senator Enzi has taken a great deal of time to meet with a
variety of stakeholders in drafting this legislation, there have been
no hearings on the bill, even though my colleagues and I on the HELP
Committee requested such hearings. Moreover, 41 attorneys general have
signed a letter in opposition to S. 1955; 19 State insurance
commissioners and State departments responsible for insurance
regulation have written letters opposing this legislation.
There are better options. The Lincoln-Durbin proposal would be more
effective in curbing health care costs and expanding coverage, as well
as help small businesses and their employees. It would create the Small
Employers Health Benefits Program SEHBP and provide tax breaks for
employers that offer financial assistance for insurance premiums to
low-income employees. SEHBP is based on the Federal Employee Health
Benefits Program and would extend the purchasing power of the Federal
Government to small businesses that choose to participate. In addition,
SEHBP enrollees in local plans would enjoy an array of coverage
options, while at the same time benefiting from State consumer
protections.
I filed three straightforward, commonsense amendments to guarantee
more comprehensive coverage, to preserve State authority, and to make
sure SBHPs actually reduce costs. I first proposed these amendments
during the HELP Committee consideration of this bill. The first
amendment would create a commission to establish a Federal floor of
benefit mandates in accordance with the laws adopted in a plurality of
the States, which would preserve some of the critical benefits
currently mandated by Rhode Island and other States. The second
amendment would limit the preemption of State laws by clarifying that
unless specifically provided for, nothing in S. 1955 would override any
State or local law related to health insurance. The third amendment
requires the Government Accountability Office GAO to evaluate the
program 24 months after its implementation, and if there is no evidence
of a decrease in cost or increase in access to health care, the program
would be terminated.
I am disappointed that the majority is not allowing us to engage in a
full and fair debate on these and other amendments in the absence of a
broad agreement on the bill.
Earlier this year, we saw the implementation of another program that
was not well thought out and was fraught with problems as a result.
Many of the problems with the Medicare Part D prescription drug benefit
could have been averted. This crisis was anticipated for some time by
independent researchers and advocates for Medicare beneficiaries, yet
the Republican-controlled Congress repeatedly blocked remedies and
continues to do so. Working to improve the Medicare drug plan is not
even on the agenda for Health Week.
I did not support the Medicare Modernization Act because I felt the
benefit was insufficient and the emphasis on a privately administered
program made it excessively complex for beneficiaries. This plan
imposes penalties for those enrolled to change plans but allows the
plans to change the prescriptions they cover at will. Millions of
retirees faced with choosing among a large number of private drug plans
struggled with different rules, lists of covered drugs, and premiums.
Many who are eligible to sign up have avoided doing so all together.
The problems have been so widespread that more than 20 States,
including Rhode Island, had to step in to pay drug claims that should
have been paid by the Federal Medicare Program. At least two dozen
States have taken emergency action to help low-income individuals who
could not get their medications under the program, and States spent
many millions of dollars on this assistance.
Since its launch on January 1, doctors and pharmacists have
complained that many drugs theoretically covered by the new Medicare
drug benefit are not readily available due to the insurers'
restrictions and requirements. Many pharmacists can't keep track of
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the plans' myriad policies and procedures and doctors say the diverse
requirements are onerous and can delay or deny access to needed
medications.
The May 15 deadline for enrollment in Part D is looming. We should be
taking action to extend the deadline and improve Part D during this
sole week the majority has dedicated to so-called health care reform.
Let's put America's Medicare beneficiaries first.
Another issue that is imperative for us to address is stem cell
research. Last May, the House passed the Stem Cell Research Enhancement
Act, H.R. 810, by a wide margin. We heard Senator Frist last summer
announce that he agrees with lifting the stem cell ban, but we have not
seen any movement on this issue.
President Bush's policy limits Federal funding of embryonic stem cell
research in practice to 22 stem cell lines that have been in existence
since 2001, and these lines are unsuitable for research. In recent
years, we have seen amazing medical breakthroughs thanks to a
dedication to research. HIV disease, which was a virtual death sentence
just over a decade ago, has become for many a chronic disease. The 5-
year survival rate for childhood acute lymphoblastic leukemia is
approximately 85 percent, a dramatic increase because of new lifesaving
treatments.
I hope to be able to stand on this Senate floor a few years from now
asking for support for new research and highlighting the advancements
that have been made in the treatment of spinal cord victims, children
with diabetes, and those with Parkinson's because of embryonic stem
cell research. The Senate should be marking the 1-year anniversary of
the House passage of H.R. 810 by having a vote on the bill. We have an
obligation not only to those stricken with these devastating conditions
but to the family and friends who care for them. H.R. 810 opens the
door to medical research that could unlock the mystery behind many of
these devastating diseases while ensuring strong ethical and scientific
oversight.
I share Senator Enzi's desire to stem the rising costs of health
insurance, which pose a challenge to many, including our Nation's small
businesses and self-employed individuals. While Congress should
certainly do more to address this matter and expand coverage to those
who currently lack it, S. 1955 would have little impact on these
crucial needs.
There are other equally critical health issues facing millions of
Americans. In addition to Medicare and stem cell research, we should be
considering legislation to expand health insurance coverage to every
child in this country, legislation to strengthen our public health
system, and legislation to ensure an adequate number of nurses and
other health professionals to care for our aging Nation. While the
majority is stunting this week's debate, it is my hope that the Senate
will actually take the time and find a way to work together to have a
serious debate on important health care issues this year.
I ask unanimous consent that the before-mentioned letter be printed
in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
March 13, 2006.
Hon. Michael B. Enzi,
Chair, Committee on Health, Education, Labor, and Pensions,
U.S. Senate, Washington, DC.
Hon. Edward Kennedy,
U.S. Senate, Washington, DC.
Dear Chairman Enzi and Senator Kennedy: I am writing to
express my strong concerns Senate Bill 1955, and to ask that
it not be passed.
Context: Rhode Island has a strong history of active health
insurance regulation. In 1996, the state passed broad managed
care regulations regarding utilization review, member rights
and appeals and health plan oversight. These provided
protections which were later duplicated in other states. In
2000, the state overhauled its small group rating laws to
bring more equity between large group and small group rates.
In 2004, the legislature created a first-in-the-nation
cabinet-level health insurance commissioner role, to (in
part) ``direct health plans towards policies that promote the
public good through increased access, and improved efficiency
and quality''.
The results speak for themselves, Rhode Island has one of
the lowest rates of uninsurance in the country, lower medical
costs than its neighbors, high health plan satisfaction
measures, excellent scores in HEDIS and public health
performance measures, and nationally recognized innovations
in health care quality measurement and health care
information technology innovation. Studies by my office
indicate that rating forms have closed the health insurance
price gap between large and small employers.
Effect: In spite of recent amendments, the proposed bill
would put all this in jeopardy by eliminating the ability of
states to bring together stakeholders to develop local
solutions to the problems of affordable health insurances for
small businesses.
Specifically: Imposing national underwriting rules and
coverage standards for small businesses creates 1 local
instability in pricing and hinders innovation. States should
be allowed to develop programs for affordable health
insurance products and pricing, and then learn from one
another. Just this year, small business health insurance
reform bills have been introduced by both Democrats and
Republicans in the RI legislature that call for crafting new
affordable health plans, subsidizing their purchase through
reinsurance mechanisms and promoting price transparency.
These innovative programs would not be possible under this
bill.
The bill weakens health plan accountability. Health care is
delivered locally. It is intrinsically tied to public health
and important community institutions. Health insurers need to
be held accountable by local entities for their actions in
states--for the incentives created by their payment
mechanisms, for their support of local community health
activities and state-wide health policy. Bill 1955, in spite
of recent clarifications regarding the role of insurance
commissioners, would make it harder for national health plans
to be answerable to their local stake holders. It would usurp
public authority and place it with large national insurers,
who would be accountable to no one.
The bill does not address the real problem. The fundamental
health policy challenge facing the U.S. is the effect of
rising medical costs on the number of uninsured. As both of
you have noted, we need to move beyond underwriting and cost
shifting solutions to addressing the underlying utilization
drivers. This is best accomplished through local
experimentation and accountable insurers--both of which are
weakened by this measure. Mass group purchasing--which this
attempts to create--will not result in informed purchasers
driving system change, but a one-size-fits-all approach which
cedes power to national insurers.
As witnessed by the efforts of the sponsors with the
National Association of Insurance Commissioners, much good
work has gone into amending this bill. Unfortunately, major
concerns remain. The bill in its current form fails to
address the critical issues states and communities face in
developing an affordable, sustainable health care system that
works for employees in small businesses. To accomplish this,
we need accountable health plans, not association health
plans.
Sincerely,
Christopher F. Koller,
Health Insurance Commissioner,
State of Rhode Island.
Mrs. FEINSTEIN. Mr. President, I rise today to speak about my concern
for the 6.6 million uninsured individuals in California and the impact
the Enzi Small Business Health Insurance bill, S. 1955, will have on
both the uninsured and the insured in my State.
While the goal of this legislation is one I agree with--finding a
solution to lower health insurance costs and greater access to health
insurance for small business owners and their employees--I have serious
concerns about the fundamental shift toward insurance deregulation and
bare bones insurance coverage under the Enzi bill.
It is my understanding that some changes have been made in the
substitute amendment to the Enzi bill but that those changes do very
little to change the fact that this bill will result in a loss of
covered benefits and an increase in costs for older, sicker workers.
While I respect the position of small businesses that support this
legislation, I simply cannot support a proposal that I believe would
result in higher costs for older, sicker workers and would result in a
loss of covered benefits my State fought hard to guarantee.
My concerns are shared by a wide range of people.
It was also the conclusion of the nonpartisan Congressional Budget
Office, 41 State attorneys general including the attorney general of
California, 13 Governors, the California State insurance commissioner,
the California Public Employees' Retirement System and countless
national organizations such as the AARP, the American Medical
Association, the American Cancer Society, and many more.
California has one of the most comprehensive set of required
insurance benefits in the country. A partial list includes: Coverage of
routine patient care costs of cancer clinical trials; coverage of
breast, prostate, cervical,
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colorectal and other cancer screening; coverage of breast cancer
screening, diagnosis and treatment, including prosthetic devices and
reconstructive surgery; the right to a second opinion when requested by
insured individual or health professional treating an insured
individual; minimum maternity hospital stay; coverage of equipment,
supplies, including prescriptions, and management of diabetes; coverage
of alcoholism and drug abuse treatment; coverage of blood lead
screening; coverage of contraceptives approved by the FDA; coverage of
services related to diagnosis, treatment and appropriate management of
osteoporosis; coverage of domestic partners and coverage of infertility
treatment.
The legislation before us sets a ceiling, not a floor for insurance
coverage of vital services. Amendments that have been discussed such as
creating a 26-State benefit mandate threshold are a ceiling, not a
floor.
The reality is that any attempt to ``harmonize'' State benefit
mandates will likely result in harm to Californians.
Just like legislation passed by the House last March called the
National Uniformity for Food Act which I strongly oppose, this
legislation preempts States rights.
California voters and elected officials have determined what they
think is best for the State and this legislation override the will of
Californians whether they work for a small business or large one.
I am also concerned about the impact this bill will have on premiums
for small business employees. California has rules to protect premium
adjustments from increasing year to year beyond 10 percent.
And in California, insurance companies may set premium rates for
employees based on only three risk factors: age, family composition,
and geographic region.
Under this bill, not only will employees be subject to rating based
on additional factors such as the size of business, gender and type of
business, but California's age and geographic region limitations are
preempted.
The new rating factors in the bill disadvantage certain small
businesses and they disadvantage businesses with a high proportion of
women of child-bearing age.
I find it deeply troubling that Senators on both sides of the aisle
have been denied the opportunity to vote on amendments to address the
problems with this legislation.
I would like to address another healthcare issue that I have been
deeply concerned about and that is stem cells.
The Senate has spent a week dedicated to health care and yet, the
majority leader has not scheduled a vote on embryonic stem cell
legislation.
It has been 8 years--1998--since I introduced one of the first bills
dealing with the ethical issues around stem cell research.
It is almost one year--May 24--since the House passed the Castle-
DeGette bill.
It has been 9 months--July 29--since the majority leader shocked the
Senate and announced his support for stem cell legislation.
But no bill has been passed by the Senate.
What we have learned over that period is that the more than seventy
lines the President said were available when he set his policy in
August 2001 are down to just over twenty.
Those approximately twenty lines are contaminated with mouse feeder
lines and they are old. They are of no therapeutic value.
We need more lines if we are going to untie the hands of researchers
so they can do the research needed to learn about the biology of
diseases, the restoration and repair of damaged tissue, and the
development of treatment therapies.
Time and time again researchers say they need more embryonic stem
cell lines.
But, the leadership of the Senate and White House won't listen. They
would rather obstruct the work of scientists who want to work with
embryonic stem cells. The result is scientists moving to other
countries to do their work.
The time to act is now. The price of inaction goes up every day.
Since this fight began, we have lost Christopher Reeve on October 10,
2004, Dana Reeve on March 6, 2006, 4 million Americans to cancer, 1.8
million Americans to diabetes, and 144,000 Americans to Parkinson's.
I have heard opponents of embryonic stem cell research talk about the
promise of adult stem cell research. No one I know is arguing that we
shouldn't pursue adult stem cell research. That's why the Senate passed
the cord blood bill unanimously last year.
But, we must not fund this research to the exclusion of embryonic
stem cells.
There is no question that this country needs an effective stem cell
policy--both to provide Federal funding for viable stem cell lines and
to provide Federal ethical guidelines.
It is simply appalling that here we have a week dedicated to a debate
on health care and the leadership of the Senate has not scheduled a
vote on the Castle-DeGette, embryonic stem cell bill.
I personally believe this week should be renamed the ``week of missed
opportunities'' instead of ``health week''.
Instead of addressing problems associated with the Medicare drug
benefit such as the amendment I filed to the pending legislation to
protect seniors from insurance plans who may decide to end coverage of
drugs they said they'd cover when the senior enrolled in the plan, we
are doing nothing.
Instead of allowing the Federal Government to use its bulk purchasing
power to negotiate with drug companies to provide lower prices for
seniors, we are doing nothing.
Instead of addressing the fact that millions of confused seniors will
face a penalty in Medicare forever if they are eligible and don't sign
up for the drug program by this Monday, we are doing nothing.
And yet we will have a cloture vote on a bill that will leave
millions of Californians without a guaranteed access to cancer
screenings and treatment, diabetes coverage, the right to a second
medical opinion if they request it, among many others.
All of those protections will be lost, and Senators will have been
denied without the opportunity to vote on any amendments to address the
problems associated with this legislation.
It is a shame that the leadership of the Senate has allowed this week
to become one of missed opportunities when we have bills such as the
Castle-DeGette embryonic stem cell bill that have passed the House and
are sitting at the President's desk waiting to be taken up and passed
by the Senate.
Mr. SALAZAR. Mr. President, access to affordable, quality health care
is on the minds of virtually every American. As I travel across my
State of Colorado and this nation, people urge me and my colleagues in
Congress to solve our health care crisis. I rise today to again add my
voice to the millions calling for meaningful, comprehensive health care
reform--reform that allows Americans to get the health care that they
need; reform that will stop the crippling effect that the rising costs
of health care has on our citizens, businesses and economy.
Last year, Senator McCain and I introduced the National Commission on
Health Care Act, S. 2007. Its purpose is simple and bold--to fix our
broken health care system.
The need to reform our health care system could not be more
compelling. An astounding 46 million Americans lack health insurance.
They come from every community, every walk of life, and every race and
ethnic group. But the most telling part about them is that they come
from working families who struggle to put food on their tables and pay
their bills. They live in constant fear of getting sick. When they get
sick, they often go without medical care and get sicker.
For those fortunate enough to have health insurance, the picture is
also grim. Health insurance premiums for family coverage have risen by
over 59 percent since 2000, with the average annual premiums for
employer-sponsored family coverage costing nearly $11,000. Rising
premiums place working families at risk of joining the ranks of the
uninsured.
Rising health care coverage has also threatened the ability of
American businesses to maintain insurance coverage for their employees
and compete on a global level.
Congress must act now to reform our system. We need much more than a
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week of gimmicks or piecemeal bills. We need comprehensive reform. S.
2007 reflects that need. The act creates a bipartisan commission of 10
elder states men and women. I want to stress that this is a bipartisan
commission. Our health care crisis is not a Democratic or Republican
problem. It is a national problem that we must solve together.
The members will conduct a thorough investigation into our health
care system, building on the work of others to comprehensively look at
availability, affordability, quality and costs relating to our health
care system. It will look at the uninsured, the small business
insurance market, the increases in premiums and health care costs, and
the problems that businesses face in maintaining insurance coverage.
The commission will study our government programs and the private
health insurance industry. And, most importantly, the commission will
develop comprehensive proposals and recommendations to actually solve
problems associated with our Nation's health care system. It is not
enough to chip away at the problem by enacting policies related to one
aspect of our health care system. We need a comprehensive study and
comprehensive solutions.
The National Commission on Health Care will not duplicate the very
important work that has already been done by other commissions and
think tanks. What it will do is study the proposals from a
comprehensive perspective, engage business, labor, health care,
consumer, insurance and other groups to develop workable policies that
if enacted will solve the crisis we face today.
I look forward to working with my colleagues on both sides of the
aisle to pass the Commission Act to reform our broken health care
system.
Mr. President, I want to take a few minutes to talk about the
Medicare prescription drug program. I want to talk about the need to
extend the deadline for seniors and people with disabilities and I want
to talk about the rural, independent pharmacies that have suffered
because of implementation problems with the drug program.
I was not a member of this esteemed body when the Medicare
Modernization Act creating this program was enacted. I therefore have
no political stake in defending or criticizing the drug program. I have
every interest, however, in making sure that the program is properly
implemented and that our seniors and people with disabilities have
adequate time and accurate resources with which to make decisions about
what plans best meet their health care needs. I strongly support
Senator Bill Nelson's legislation extending the deadline for seniors
and people with disabilities to enroll in the program. I want to thank
Senator Bill Nelson for his commitment to ensure that seniors and
people with disabilities have adequate time and accurate information to
make wise decisions about their prescription drug insurance.
In less than 1 week, seniors will face the deadline for enrollment in
the prescription drug program. For many seniors and their family
members, selecting an appropriate prescription plan is a difficult and
challenging endeavor. I know firsthand how time-consuming and difficult
it is to navigate through the various plans to select the plan that
meets the needs of an individual senior.
Several weeks ago, I helped my 82-year-old mother select a
prescription drug program. In Colorado, there are over 42 plans to
choose from--each covering different drugs or formularies as they are
known, each with different monthly premiums; each with different
copayments, each with different drug prices, and each with different
participating pharmacies. I speak from experience--the process is
daunting.
My offices have been helping many Coloradans with questions on
Medicare prescription drug program. Often, individuals have called my
office in exasperation, trying to find a friendly voice to help them
through this process. My staff has assisted these individuals. However,
many seniors continue to put off signing up for the program because
they are confused and nervous. In Colorado, there are still
over 100,000 individuals who are eligible to enroll in the plans who
have not. Coloradans consistently tell me that they need more time to
make sure they review reliable accurate information to select the right
plan. They should have that time.
The complexity of the plans and the importance of the choice that
seniors and the disabled must make dictate that we allow them more time
to make these important decisions regarding their health. Beyond the
complexity of the program, seniors and people with disabilities need
more time because of the government's own inability to provide reliable
information and available help to navigate the choices they are being
asked to make.
Just this month the Government Accountability Office released a
report that highlighted the government's own shortcomings with respect
to the implementation of the drug benefit. The report highlighted that
the Medicare help-lines were not providing accurate information for
beneficiaries with questions about enrollment. Posing as seniors and
senior advocates, the GAO made calls to the Medicare help-line with
questions about how the program works. Astonishingly, the GAO often
could not get through to an operator!
When the GAO staff did finally get through to an operator, the
information specialists often could not answer their questions about
the drug benefit, could not help them with questions about specific
plans, and could not provide the detailed information that seniors need
to enroll. If the government that administers this program could not
provide timely, adequate information to beneficiaries, how can we hold
them to an artificial deadline? Our seniors and people with
disabilities deserve better. They certainly do not deserve to be
penalized.
Individuals who miss the approaching deadline will not have an
opportunity to enroll until November. In turn, they will face increased
premiums and co-pays. And these costs increase the longer the
individual waits. Seniors should not be punished for the government's
inability to provide them with information with which to make a choice
regarding their health. We need to help our seniors in this process, by
giving them the time and resources needed to make the best decision for
them.
I also want to speak in support of Senator Lautenberg's Pharmacists
Medicare Relief Act of 2006 to modify the Medicare drug benefit to
allow pharmacies to get timely payment from prescription drug plans. As
we all know, pharmacies operating in rural towns and communities, like
my hometown in Colorado, are important components of the community's
already fragile health care delivery system. Because rural residents
tend to be older and have more chronic conditions, pharmacy services to
rural residents are particularly important.
The Medicare drug program has threatened the very survival of some
rural pharmacies because of the manner in which the plans pay the
pharmacies. These pharmacies must pay their wholesalers on a weekly or
biweekly basis. Unfortunately, the prescription drug plans reimburse
the pharmacies every 6 weeks. The discrepancy in payment has seriously
affected the business of many pharmacies, and particularly pharmacies
in rural communities.
Fortunately, there is a simple fix: require the plans to reimburse
the pharmacies every 14 days. That is exactly what Senator Lautenberg's
legislation will do. This legislation would require the plans to pay
pharmacists within 14 days if the claims are submitted electronically,
and 30 days if the claims are submitted by paper. The legislation also
prohibits plans from cobranding Medicare beneficiaries eligibility
cards--which means that it bans brands or names of pharmacies from
being printed on the prescription drug cards, so that large pharmacies
cannot use this advertising advantage at the expense of small
operations.
These simple fixes will enable pharmacies in rural areas to continue
to serve beneficiaries. Our rural pharmacies and the seniors and
disabled people they serve deserve our best efforts to correct problems
with the drug benefit plan to enhance health care delivery. I urge my
colleagues to support this small but very important fix.
One thing that we can all agree on is that our health care system is
in crisis, and that crisis is harming health care providers and
patients who need health care services. It is clear that we need
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real reform. The time for enacting piecemeal legislation that chips
away at the massive health care problems is over. Our healthcare crisis
will persist long after this healthcare week in the Senate is over. I
pledge to put partisanship aside and work with all of my colleagues
toward real health care solutions.
Mr. MENENDEZ. Mr. President, while Republicans proclaim this week as
Health Week on the Senate floor, it is quite the contrary in the homes
of millions of American families. Today, 46 million Americans have no
health insurance at all. And 1.3 million New Jerseyans have no health
insurance. Another 16 million or more Americans are underinsured,
meaning that they have insurance, but still do not have access to the
care they need. Complicating matters even more is the fact that the
average cost of family health coverage--$10,880--now exceeds annual
earnings for a minimum-wage earner.
So what does the Senate majority propose to do to solve the problem?
Nothing more than dust off the old playbook and make another run at the
same old play. They propose a medical malpractice bill that has been
defeated over and over again, that does not even really reduce costs
for providers or patients, and in the process actually reduces remedies
for patients. They propose a bill claiming to help small businesses,
but it actually hurts patients by removing existing coverage and
protections and exacerbates the problem of the underinsured.
So at the end of Health Week in the Senate, all we have to show the
American people is more of the same--the same 46 million with no
insurance, the same 16 million people with inadequate insurance, and
the same families working 40 hours a week to earn a living for their
family but still unable to afford quality health care for them.
Instead of leading us down a dead-end road, as Republicans have done
this week, we should be on the expressway to real health care
solutions--legislation such as the Stem Cell Research Enhancement Act,
legislation to extend the enrollment deadline for the new Medicare Part
D drug benefit, legislation to provide real solutions to the large and
growing number of uninsured Americans, and legislation to address long-
term care needs that will only become more pressing as the baby boom
generation ages.
The Republican proposals being considered this week never even
received a hearing or a vote in their committees of jurisdiction and
were destined to fail from the beginning. Is this really all the
majority party plans to address regarding the endless needs of our
health care system? I believe we can and must do better.
First, Alzheimer's disease does not boast a party affiliation.
Neither does cancer or diabetes or Parkinson's disease. Yet, potential
cures to these debilitating and fatal diseases are being ensnared in
political wrangling, posturing, and obstruction.
Today, almost 35 years after President Nixon declared war on cancer,
the Federal Government and Washington Republicans remain AWOL in the
fight against this fatal illness and a host of other debilitating
diseases. While we have made great strides in researching potential
vaccines and cures, our colleagues on the other side of the aisle
choose to tie our researchers hands.
The bottom line is this: When your life--or the life of a loved one--
is on the line, you never give up and you never limit your options--
never. You never lose faith, and you pursue every option, every sliver
of hope, of finding a cure.
This issue is about more than statistics, it is about more than
numbers on a fact sheet. These are real people. These are families.
These are mothers and fathers, sons and daughters, aunts and uncles.
These diseases cut through race, age, religion, country, and political
affiliation. We all suffer, which is why we must move beyond the usual
partisan posturing and fight for expanding research.
I had the opportunity to vote on this stem cell legislation in the
House of Representatives, where we had broad, bipartisan support. And I
believe that same bipartisan support exists in the Senate, which makes
it even more difficult to understand why we cannot come together and do
something meaningful for those who are suffering.
We have an opportunity to do what is right, and the majority has
again let that opportunity pass them by. This bill means so much more
than ending restrictions placed on stem cell research. This bill means
hope for the individuals challenged and fighting to live a life with
dignity.
Stem cell research has vast potential for curing diseases,
alleviating suffering, and saving lives. I know my colleagues recognize
the enormous potential of this research too, and it is time to clear
the way for discovering new cures and therapies and bring this bill to
a vote.
Another thing we cannot ignore is the fast approaching deadline for
seniors to enroll in a Medicare prescription drug benefit without being
penalized. We need to stand up for our seniors and extend the deadline
so that our seniors have time to choose the plan that is right for
them.
When the Federal Government rolled out the new benefit, and it did
not go as planned, States such as New Jersey stepped up to the plate
and provided emergency drug coverage to seniors and people with
disabilities in need. Now the Federal Government has a responsibility
to recognize its shortcomings and give our seniors a chance to enroll
without having to pay the price for the Federal Government's mistakes.
And the concerns go beyond just seniors' drug benefits. There is also
a grave concern that seniors and people with disabilities may lose
access to their local neighborhood pharmacies. Almost any senior will
tell you that they rely on their local pharmacist to help them when
they have complications with their drugs--whether it is interactions
between drugs or problems getting their medications.
I recently heard from Adolph Gonzalez and Alan Garcia who run the
North Bergen Pharmacy, which has been open and serving its customers
for the past 21 years. Unfortunately, since prescription drug plans are
not paying their claims in a timely fashion, pharmacies such as this
one are dipping into their line of credit, taking out loans and
scrambling to stay afloat. Unless things change, pharmacies such as the
one in North Bergen, NJ, are going to be forced to close their doors.
I introduced legislation to address problems with the Medicare Part D
drug benefit and so have many of my colleagues. All of us recognize
that unless we start making important changes to improve the program,
seniors are going to see lapses in their care. We must be committed to
making sure that all Americans have a comprehensive drug benefit that
allows them to take the medication prescribed by their doctors,
provides them the information and flexibility to pick a plan that works
best for them without being penalized, and allows them to continue
visiting their local pharmacy.
Unfortunately, the majority party is not going to allow us the
opportunity to improve the Medicare Part D prescription drug benefit
this week. Our fight for seniors is one we are going to continue, but
one that has been overlooked this week in the U.S. Senate.
Second, the unproductive nature of this week is most insulting to the
46 million people across the country who have no health insurance at
all--1.3 million in New Jersey alone. No American family should be
forced to skip a trip to the doctor because they fear it will also mean
an unfortunate trip to the bank.
That is why I strongly support initiatives that will help small
businesses afford meaningful health insurance for themselves and their
employees; increase coverage for uninsured parents by extending the
State Children's Health Insurance Program, SCHIP; and help Americans
nearing retirement buy into Medicare--programs that have proven
successful in reducing the uninsured and providing access to quality
coverage.
In addition, I introduced the Health Care COSTS Act, which will help
hard-working Americans afford their health insurance when they are
between jobs by providing an ``advanceable'' tax credit for half the
cost of COBRA premiums. As I mentioned earlier, the average cost of a
family health plan exceeds a full year's earnings for a minimum-wage
worker, so there is no way most families can afford to continue to
purchase coverage if they lose their job and have to find another.
Instead of debating a bill that will preempt the important New Jersey
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State coverage protections--including coverage of cervical cancer
screening, contraceptives, home health care, mammography screening,
mental health parity, and prostate cancer screening, to name a few--and
protection against age discrimination in setting premiums, the Enzi
bill takes the high bar of health insurance for New Jersey, and lowers
it to a dangerously low level that strips away the coverage our State
fought so hard to get.
The choice before us this week--the Enzi bill or nothing--is a false
choice. This policy will result in reduced access to important health
benefits and substantially increase premiums for people who need
coverage most. It will allow insurance companies to cherry-pick the
most profitable patients and punish those who need coverage most. It
will allow companies to discriminate against older, sicker patients by
charging them 3 exhorbitant premiums for the care they get. It will pit
young versus old, the healthy versus the sick. These are false choices,
and we should not allow the majority to force us into making them.
What we should be doing is considering a bill that preserves State
benefits and prevents such cherry-picking. By offering small businesses
access to the Federal Employees Health Benefits Program, which has
provided extensive benefit choices at affordable prices to me, my
colleagues, and all Federal employees for decades, we can do just that.
By pooling small businesses across America into one risk and
purchasing pool like the Federal Employees Health Benefits Plan, the
new Small Employees Health Benefit Plan will allow employers to reap
the benefits of group purchasing power and streamlined administrative
costs, as well as access to more plan choices. That is why I support
the Lincoln-Durbin alternative. Unfortunately, the Republican
leadership has refused to let us have a full debate and up-or-down vote
on this proposal.
Finally, the challenge of caring for our aging population will only
increase as the baby boom generation grows older and our life
expectancy increases. We need to work now to address the challenges of
providing affordable long-term care, encourage future retirees to plan
for their own long-term care, and strengthen our existing programs to
address this growing need.
I have introduced legislation to do just that. This week we should be
supporting legislation that helps all families afford to care for the
ones they love while also preparing for their own long-term care needs.
While I am disappointed in the partisan nature of this week's debate,
it makes my commitment to fighting for the health and well-being of all
Americans that much stronger. I call on my colleagues to finally make
the health care priorities of the America people the health care
priorities of the Senate.
No longer should we avoid a vote on stem cell research, a vote on
improving the Medicare Part D prescription drug benefit, a vote for a
real solution to solve the issue of the uninsured, and a vote to help
our growing senior population age with dignity. At the end of so-called
Health Week in the Senate, we will have accomplished nothing for the
millions of Amerians who are uninsured or underinsured and struggling
every day to provide health care for their families.
Mr. BAUCUS. Mr. President, I rise today in support of the State
Health Insurance Assistance Program. I filed amendment No. 2917 to
increase resources for this important initiative.
The State Health Insurance Assistance program, known as SHIP,
provides one-on-one counseling and assistance to people with Medicare
and their families. Congress created the program in 1990 so that
Medicare beneficiaries could obtain free, unbiased and personal
assistance with their health benefits. Today, SHIPs operate in all 50
States, Washington, DC, and the territories.
Over the last 2 years, SHIPs have had the formidable task of helping
Americans understand the new Medicare prescription drug benefit. In all
States, SHIPs enlisted the help of thousands of volunteers--over 11,000
nationally--for a massive public outreach campaign.
SHIP counselors and volunteers--like Bobbie Roberts and Sue Bailey in
Billings, MT.--conducted public education programs at senior centers,
hospitals, assisted-living facilities, libraries, and other public
venues. They answered questions via telephone and in face-to-face
sessions. And they spent countless hours helping Medicare beneficiaries
choose and enroll in a drug plan that best meets their needs.
These folks deserve our thanks. They are truly unsung heroes who have
helped make the drug benefit a reality for millions of people with
Medicare.
And they did all this on a shoe-string budget.
The Centers for Medicare and Medicaid Services, CMS, operates the
Medicare Program. As such, CMS is responsible for providing funding to
the SHIP. But last year, in the midst of the largest Medicare expansion
ever, CMS provided SHIPs just $32 million to carry out their important
work. Thirty-two million dollars sounds like a lot of money. But when
you think about the workload the SHIPs faced, it is not much. In fact,
that $32 million translates to only 70 cents per Medicare beneficiary.
A five-county region in Montana about the size of Delaware received
about $8,500 in SHIP funds for the entire year. That is not enough. I
believe that the lack of sufficient resources for SHIPs goes a long way
toward explaining why enrollment in the drug program continues to lag.
I might also note that the $32 million CMS provided to SHIPs pales in
comparison to the roughly $300 million CMS spent promoting the new drug
benefit. That $300 million went to programs like the toll-free 1-800
Medicare hotline.
Last week the nonpartisan Government Accountability Office, GAO,
Congress's investigative arm--found major flaws with the Medicare
hotline. GAO found that the Medicare hotline failed to give seniors
correct information on one key question--which plan offered the lowest
costs for individuals taking a given set of drugs--almost 60 percent of
the time.
And what about some of the other funding devoted to promoting the
drug benefit? CMS spent some of the funds on a bus tour. In 2003 CMS
spent $600,000 to promote Medicare with a blimp at football games. And
other funding went to Ketchum Communications, which produced simulated
news reports on the drug program. In 2004, the GAO found that these
videos violated the government ban on publicity and propaganda.
We can do better. We can promote the drug benefit in more cost-
effective ways by appropriately funding SHIPs. Recent findings from the
Medicare Payment Advisory Commission underscore this assertion. A
recent study by MedPAC suggests that only 1 in 5 people used the
Medicare hotline and only 1 in 10 used the Medicare Web site to make
decisions about their Medicare drug coverage.
And even though this year's enrollment deadline is almost upon us,
the hard work is not over. Enrollment in the Medicare drug benefit is
still too low in many States. In Montana, 40 percent of people with
Medicare still don't have any form of drug coverage. A study released
yesterday by Families USA estimates that most people who haven't signed
up have low income and would qualify for the extra help that Congress
included in the drug benefit.
We need to increase SHIP funding to help meet challenges that lie
ahead. My amendment would provide $25 million for States to expand
their SHIP activities. Funds also would be available for innovative
programs in States where Medicare drug coverage is low. And funds would
be available to CMS to promote the existence and services of SHIPs.
As the new program evolves, many people with Medicare and their
families will have even greater need for a reliable source of impartial
advice. And more needs to be done to help low-income people enroll.
Many of us voted for the drug benefit because we believed it would help
people who need help the most. Let's make that happen in every
community in every State. Let's devote resources to a program that
works. Let's help thousands of volunteers help our seniors. Let's
increase vital resources for the State Health Insurance Assistance
Program.
Ms. MIKULSKI. Mr. President, I rise today to support America's small
businesses. I know how important small businesses are to the health of
the economy and to the communities that
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they serve. I know that small businesses are struggling to provide
health care for their workers. We should move to offer small businesses
reasonable solutions. I commend Senator Enzi for tackling such a tough
issue, but this bill would ultimately end up increasing the cost of
health care coverage for those that need it most.
We need to be talking about improving health care for all Americans
at any age and making the care more affordable for patients, as well as
employers. American families are feeling stressed and strained, facing
the ballooning cost of health care. Health care coverage is one of the
most important issues facing Americans who are worried they will lose
coverage, and won't be able to afford the care they need.
It is true having health insurance is crucial but it cannot be just
any health care packet; it must be a comprehensive packet. One of the
big problems with Senator Enzi's bill is allowing insurance companies,
instead of State-elected legislators who speak for their constituents,
decide the benefits that consumers should have when they purchase
health care.
The benefits I am most concerned about protecting are preventive
services. There is a reason that so many of these benefits mandated by
States are preventive service--they wouldn't have been included
otherwise. There is a reason Maryland guarantees access to
mammography--insurers were not covering it. There is a reason that
diabetic equipment and supplies are a guaranteed benefit--beneficiaries
were complaining that they couldn't get the supplies covered.
Imagine being diagnosed with diabetes--there are in fact 21 million
Americans who have received just this diagnosis. Then imagine being
told you must carefully check your blood sugar to keep your disease in
control--but your insurance company won't pay for this? The American
Diabetes Association estimates that it costs $13,243 for every patient
to manage their disease. This is what health insurance is for. Most
States have recognized the importance of guaranteeing coverage for
diabetes supplies and education and have passed laws that provide this
coverage to residents in State-regulated health plans. We must not undo
what these States have identified as important covered services.
And what about mammograms? Breast cancer is the most common cancer
among women, accounting for nearly one of every three cancers diagnosed
in the United States. Over 40,000 deaths from breast cancer are
anticipated this year alone. Screening and early detection are critical
for decreasing the mortality rates of breast cancer. Our reduction in
cancer mortality depends on the increased use of mammography screenings
for early detection of this disease.
I have worked hard in Congress to ensure women have access to quality
mammogram care. I authored the Mammography Quality Standards Act, MQSA,
over 10 years ago. This improved the quality of mammograms by setting
federal safety and quality standards for mammography facilities. This
includes personnel, equipment and operating procedures. Before MQSA
became law, there was a patchwork of standards for mammography in this
country. Radiation levels used on patients varied widely, equipment was
shoddy, and physicians often didn't have proper training. I went to
work in Congress to set national standards, helping to make mammograms
a more safe and reliable tool for detecting breast cancer.
My own State of Maryland is one of the many States that mandates
insurers provide mammography screening. We know this saves lives.
Maryland also mandates insurers provide coverage for breast cancer
patients who participate in clinical trials, so we can work toward a
cure for breast cancer.
Covering services that prevent health conditions is not only sound
health policy, it is sound fiscal policy. By finding and treating
diseases early we will save the U.S. taxpayers millions of dollars. In
fact, it is the only real way to really decrease the cost of health
care in this country.
Knowing how important health insurance coverage is for small
businesses, I have joined 26 of my Senate colleagues to support the
Small Employers Health Benefits Program, SEHBP, which gives small
businesses affordable choices among private health insurance plans and
expands access to health care coverage for their employees. The SEHBP
would allow small businesses across America to band together for lower
health care prices by pooling their purchasing power and spreading
their risk over a large number of participants. Employers would qualify
for an annual tax credit to partially offset contributions on behalf of
low-income employees.
I came to the Senate to change lives and save lives. We need to
guarantee that more Americans have access to services that prevent and
treat chronic illness. Unfortunately, S. 1955 will not do this and in
fact this bill will compromise the coverage people already have. I will
continue to work toward a solution for affordable health care for
patients and employers. I will fight to make a difference. Together, we
can change lives.
The PRESIDING OFFICER. Who yields time?
Mr. ENZI. I reserve the remainder of the time.
Mr. KENNEDY. Mr. President, I believe we have 10 minutes. I yield 5
minutes to the Senator from Connecticut and I will yield myself the
remaining time.
The PRESIDING OFFICER. The Senator from Connecticut.
Mr. DODD. Mr. President, I thank my colleague from Massachusetts and
very quickly say to our good friend from Wyoming as well, I appreciate
his interest in the subject matter and his concern about it. I want to
point out to our colleagues why I am terribly disappointed with the
procedures we have been confronted with this evening dealing with this
legislation.
In committee we spent quite a bit of time and had some rather close
votes, tie votes on a number of amendments that were not adopted to the
underlying bill.
I raise two issues here in the very short time we have remaining.
First is the process itself. This is the Senate. This Chamber
historically is the place where debate occurs. To have a process here
this evening on an issue where we have dedicated the entire week to
health care and then to basically lock out any amendments that might be
offered to this proposal runs contrary to the very essence of this
body.
Whether or not you are impressed with the substance of this bill, if
you believe the Senate ought to be heard on a variety of issues
relating to the subject matter--when the amendment tree has been
entirely filled, then obviously we are dealing with a process that
ought not to be. Even if you are supportive of the bill, it seems to me
the Senate ought to be a place where we can offer amendments, have
healthy debate over a reasonable time, and then come to closure on the
subject matter.
I am terribly disappointed. I know there are relevant issues and
irrelevant issues. Members wanted to talk about things such as
extending the time on the Medicare proposal. It is going to expire on
May 15. That is not an unreasonable proposal, in a Health Care Week,
when you are debating these subject matters. My colleagues wanted to
talk about prescription drugs, to spend an hour or two out of the
entire week to debate whether we ought to have a different proposal
regarding prescription drugs. I don't think that is asking too much of
this body, for one small debate about an issue that is so important to
people. Even amendments designed to help small business would have been
prohibited from being offered here as a result of this process. I am
terribly disappointed that we are not going to have a chance to talk
about this bill in a broader context where Members could bring their
ideas to the debate.
The second issue deals with the substance itself. My colleagues ought
to take note. The key word here is preempts, because this bill preempts
our States--each and every one of us--from having the kind of health
care benefits that have been debated and discussed and adopted by our
respective States. We each have unique problems. I mentioned earlier
this week in this debate, Lyme disease is a huge issue in my State. It
originated and was discovered in the town of Lyme, CT. I live 2 miles
away from Lyme, CT. People in my State are deeply worried about that
issue. So the State of Connecticut in its wisdom adopted as part of its
health
[[Page S4458]]
care plan a requirement that insurance cover Lyme disease.
I recognize that may not be an issue in the State of some other
Member. But we ought to allow Connecticut and every other of the 49
States to decide how they can best serve their constituents, their
people, when it comes to health care coverage. This bill preempts my
State from deciding whether they can cover certain problems that are
unique to my part of the country.
And second, of course, we preempt the States when it comes to setting
any kind of rating rules. That is a critical issue because even if you
have a comprehensive plan, if you allow the industry to price those
products way beyond the reach of the average person, then de facto they
are eliminated. So we preempt them on what they can cover and we
preempt the States from determining what the prices ought to be for the
insurance products that will be sold.
I point out to my colleagues, not a single Governor has supported
this bill. Not a single attorney general, not a single insurance
commissioner. Over 200 health care organizations have said this bill is
flawed and it ought not to be approved.
We are urging our colleagues to reject this proposal. Listen, if you
will, to what a business organization in my State had to say about this
bill. The Connecticut Business and Industry Association represents
5,000 small businesses in the State of Connecticut. They said:
We believe that in Connecticut federally certified AHPs
would destabilize the small business insurance marketplace,
erode carefully crafted consumer protections and raise
premium rates for small businesses with older workforces and
those that employ people with chronic illnesses or
disabilities.
That is a business organization representing 5,000 small employers.
This is not an organization that says those words lightly.
For those reasons, for process and procedure, as well as preempting
state benefits and rating rules, this bill ought to be rejected. I urge
my colleagues to do so.
I yield the floor.
The PRESIDING OFFICER. The Senator from Massachusetts.
Mr. KENNEDY. Mr. President, I understand we have 5 minutes. Will the
Chair let me know when I have 30 seconds remaining, please.
I want to pay tribute to my two colleagues who are in support of
this, Senator Enzi and Senator Nelson. Senator Enzi and I, and
Democrats on our committee and Republicans alike, have worked very long
and hard on a whole range of different issues.
We have made important progress. We are going to continue to do so,
but we take exception on this issue.
I commend the staff as well for all of their good work and help and
assistance.
Senator Nelson, who has been enormously concerned about the problems
of small business, has talked about this issue with me and, I know,
with other Members here on different occasions. He was such a strong
voice when we were considering the Patients Bill of Rights legislation.
I always enjoy working with him, although we have a different position
on this issue.
We are in the last few minutes of this debate and discussion. In
these last few minutes, I want to join with those who have expressed a
certain amount of frustration in being unable to address maybe a
handful of different health care issues that I find are of concern to
the people of my State. In traveling around the country, people are
concerned about the prescription drug program. They are concerned about
the high cost of prescription drugs. They are concerned about the
problems small business has. But we do not believe the proposed
solution that has been advanced by Senators Enzi and Nelson is really
the best way. We have had a brief debate over this proposal and over an
alternative way that we think would be more comprehensive, more
realistic, and more expansive than reaching the 1 percent or 2 percent
of those who are uninsured and who, according to the Congressional
Budget Office, will be covered under the Enzi proposal.
The reasons the insurance commissioners have serious reservations,
the reasons the Governors and the attorneys general have taken
exception to this legislation, are very important and have been stated
again and again; first is this bill's effective preemption of a number
of the very important benefits that my State of Massachusetts and a
great number of the States in this country have been willing to write
into law, to provide protections for their citizens. These protections
are in the area of cancer, in the area of cancer screening, in the area
of mental health, in the area of diabetes, and well-baby care. State
laws have effectively been preempted. The people of my State will no
longer be assured of those kinds of protections, if this legislation
passes.
The second point, which has been raised again and again, is the
question of raising premiums. In the legislation we refer to this as
rating. In the initial Enzi proposal, it would have been possible to
have a 25-fold variation in the cost of insurance premiums--from $100
to $2,500--based upon your age, your past health history, or that of
your family. We know what would happen.
When you allow such variation, you are denying people an effective
health insurance program. That is what Blue Cross-Blue Shield says in
Massachusetts, my own State. They basically say that younger people
will be able to have insurance, but the older people and families who
have had health care challenges will be knocked off, unable to afford
it.
What will happen? These people will go to the public health clinics,
with the State having to pick up the cost. That is what Blue Cross-Blue
Shield in my State says. This proposal is a shifting of the cost.
In this very excellent letter, which I will ask to have printed in
the Record, Blue Cross-Blue Shield in my State has been ranked among
the top five plans in the Nation by U.S. News & World Report.
In this letter, Blue Cross-Blue Shield warns us about preempting the
State regulations of rating and benefit requirements. They say do not
do this. It will have a bad effect on our seniors. It will increase the
number of uninsured and transfer the costs back to the public. The
taxpayers will pick it up.
We believe Blue Cross-Blue Shield and the other organizations that
have been identified are correct. This bill should not pass at this
time. We are prepared to work with the Senators from Wyoming and
Nebraska to try to deal with these health care challenges.
I ask unanimous consent to have the aforementioned letter printed in
the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Blue Cross Blue Shield
of Massachusetts,
May 10, 2006.
Hon. Edward M. Kennedy,
Russell Senate Office Building,
Washington, DC.
Dear Senator Kennedy: On behalf of Blue Cross Blue Shield
of Massachusetts, I am writing to express our opposition to
S. 1955 (``the Health Insurance Marketplace Modernization
Act''). The legislation being considered by the United States
Senate will completely undermine the historic health care
achievements made by Massachusetts for which you played a
critical role.
At Blue Cross Blue Shield of Massachusetts, we are
committed to providing access to affordable, quality health
care to the citizens of Massachusetts. With over 2.9 million
members, we are proud to be ranked among the top five health
plans in the nation by U.S. News & World Report and the
National Committee for Quality Assurance.
As you know, S. 1955 preempts state regulations as to
rating and benefit requirements. In so doing, it seriously
destabilizes the small group market nationally and critically
disrupts states, like Massachusetts, that utilize community
rating. Under Enzi, medical underwriting is permitted as are
premium surcharges based on age, gender, geography and group
size. In Massachusetts, older and sicker individuals will
face increased premiums, as will the self-employed and
smaller businesses.
Despite its intended goal, the Enzi legislation will
actually lead to a rise in the uninsured in Massachusetts as
older, sicker workers lose coverage. According to a recent
study by the Lewin Group, there will be an increase of over
37,000 uninsured in Massachusetts with an associated rise in
uncompensated care costs of over $8 million. Needless to say,
this places a further strain on our health centers, community
hospitals, urban medical centers as they see increased
uninsured and unhealthy individuals.
The Enzi legislation takes a completely different tact to
increasing access to affordable insurance than the
Massachusetts health reform bill. The Massachusetts approach
seeks to pool risk and optimize coverage to benefit the
community. S. 1955 would lower costs for individual groups by
[[Page S4459]]
basing their rate on their own particular risk and minimizing
coverage. The Enzi approach may serve to increase access to
young and healthy small groups but does so at the expense of
older and sicker populations. From a philosophical and
practical standpoint, the two approaches cannot coexist.
The impossible dream, to which you so eloquently spoke, of
quality health care that will truly be available and
affordable for each and every man, woman, and child in our
state, will become just that--impossible--if S. 1955 is
allowed to pass.
We thank you for your ongoing efforts for our shared goals
of ensuring access to affordable, quality health care to the
citizens of the nation and our state of Massachusetts and
urge you to continue to vigorously oppose S. 1955 so that it
fails in the Senate.
As always, please do not hesitate to contact me.
Sincerely,
Cleve L. Killingsworth.
The PRESIDING OFFICER (Mr. Cornyn). The Senator from Wyoming.
Mr. ENZI. Mr. President, actions speak louder than words. People are
going to have a chance in a little while to show some action for small
business. Once in a while there is a moment when you have a chance to
make a difference.
Today, most of the Democrats appear to be willing to sacrifice that
moment to make a statement. They are saying we cannot give small
business anything until we have votes on stem cells, until we have
votes on prescription drugs, until we have votes on drug importation,
and to heck with the small businesses. What kind of an attitude is
that?
The Democrats' argument is: We are going to deny small business
anything until we get them everything. Of course, they are promising
everything in their bill.
Let us get this clear. The Democrats care so much about families
employed by small business that they are willing to keep them from
having any insurance until they find a way to provide everything they
think they need. Spare me the care. We have a lot of smokescreens. One
of the smokescreens is the process did not allow them to have votes.
I asked unanimous consent a little while ago, and I said I will
guarantee you a vote on Durbin-Lincoln. I will guarantee you debate on
Durbin-Lincoln. I will let that happen right after cloture.
The reason that has to happen is because of the process of the
Senate; otherwise, they only get a vote and they still block me from
getting a vote on this bill that has been worked out with the insurance
companies, with the insurance commissioners, and with the associations.
That is a smokescreen. There is going to be a vote on whether we care
to debate some more on small business. There can be amendments after
cloture. Amendments will allow you to cover everything that has been
mentioned over here, whether it is ratings or whether it is mandates.
Let me tell you that mandates is another smokescreen. Where this has
been done inside States, the companies that had the right not to have
mandates, it covers the ones that you mentioned. This is about being
able to have enough opportunity to expand across State lines where
there are 1,800 different mandates. You have to be able to get them
together so that small businesses can go together across State lines
and gather a big enough pool to effectively negotiate against insurance
companies.
Yes, there are some insurance companies that are writing letters
saying: Do not let them do this. There is a profit motive. I can't
blame them for that. But what the small businesspeople are really
asking for on that is the same thing that big businesses have. We
already excluded big business from all of the mandates and the
oversight by States. We are not going that far.
We even have some provisions in there, and I am sure with some
amendments there would be some mandates in there. Here is where the
savings come in for these small businesses. I am extremely excited
about this.
The cost for administration for a small business policy is about 35
percent. If you check with Wal-Mart, which is excluded from everything
and gets to have their own plan, their cost of administration is 8
percent. The savings are in the administration. That is 27 percent
which they save.
For every 1 percent of savings, insurance brings in 200,000 to
300,000 people into the market.
There are 27 million uninsured small businesspeople and employees out
there. They are like families.
I was talking to Senator Harkin. He was telling me about a small
businessman he knows. These small businesses are kind of interesting.
They go to church with the same people who work for them. They go to
watch baseball with the same people who work for them. Their kids are
in the same little league. They go to the same organizations. And this
small businessman said: I have to tell them that I can't afford the
insurance anymore. And I still want to live with them. I want my family
to have insurance, but that is not going to happen.
This is an opportunity to make a difference, to offer amendments to
perfect the bill in whatever way the majority of people think needs to
be done. Anything else is a smokescreen.
I gave them an opportunity to vote on Durbin-Lincoln. I gave them an
opportunity to vote on this, but it was an assurance that we would get
to vote on both, so small business would get a vote. There is going to
be a vote on small business.
There are hundreds of people around the Capitol right now who are
with small business who are saying: We need the opportunity to have a
better health care plan. Some of them will get insurance for the first
time; some will get a better health insurance plan.
As an accountant, I have to remind you that this is not a case of
subtraction. This insurance plan is an addition. We are bringing in
newly insured people. Anybody who votes against cloture needs to go to
their dry cleaners tonight to pick up their laundry and look that
person in the eye and say: I do not think you deserve health insurance
because you might not demand enough for yourself. So you know what? I
saved you from yourself. Can you say that to the mom and pop running
the business down the street from your home? Can you say that they do
not deserve health insurance? As you go home today after you leave the
Hill, think about the people around you, the regular people--the cab
driver, the worker at the dry cleaners, the person in the neighborhood
restaurant, all of those people you may not notice who really make the
world operate. Many of them do not have any insurance. Some may even
own that little restaurant around the corner and still not be able to
afford the insurance. I am not talking about deluxe insurance; I am
talking about any insurance.
So please overlook the smokescreen and vote to have some more debate
and amendments and a vote on a small business health plan.
I yield the floor and yield the remainder of my time.
Cloture Motion
The PRESIDING OFFICER. Under the previous order, the clerk will
report the motion to invoke cloture on the pending modified substitute
amendment to Calendar No. 417, S. 1955, Health Insurance Marketplace
Modernization and Affordability Act of 2005.
The legislative clerk read as follows:
Cloture Motion
We the undersigned Senators, in accordance with the
provisions of rule XXII of the Standing Rules of the Senate,
do hereby move to bring to a close debate on the pending
modified substitute amendment to Calendar No. 417, S. 1955,
Health Insurance Marketplace Modernization and Affordability
Act of 2006.
Bill Frist, Johnny Isakson, Sam Brownback, John Thune,
Thad Cochran, Wayne Allard, John Ensign, Richard
Shelby, Larry Craig, Ted Stevens, John McCain, Lamar
Alexander, Norm Coleman, Judd Gregg, John E. Sununu,
Pat Roberts, Craig Thomas.
The PRESIDING OFFICER. By unanimous consent the mandatory quorum call
has been waived.
The question is, Is it the sense of the Senate that debate on the
modified substitute amendment to Calendar No. 417, S. 1955, the Health
Insurance Marketplace Modernization and Affordability Act of 2005 shall
be brought to a close?
The yeas and nays are mandatory under the rule.
The clerk will call the roll.
The assistant legislative clerk called the roll.
Mr. McCONNELL. The following Senator was necessarily absent: the
Senator from Pennsylvania (Mr. Specter).
[[Page S4460]]
Mr. DURBIN. I announce that the Senator from West Virginia (Mr.
Rockefeller) is necessarily absent.
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The yeas and nays resulted--yeas 55, nays 43, as follows:
[Rollcall Vote No. 119 Leg.]
YEAS--55
Alexander
Allard
Allen
Bennett
Bond
Brownback
Bunning
Burns
Burr
Chambliss
Coburn
Cochran
Coleman
Collins
Cornyn
Craig
Crapo
DeMint
DeWine
Dole
Domenici
Ensign
Enzi
Frist
Graham
Grassley
Gregg
Hagel
Hatch
Hutchison
Inhofe
Isakson
Kyl
Landrieu
Lott
Lugar
Martinez
McCain
McConnell
Murkowski
Nelson (NE)
Roberts
Santorum
Sessions
Shelby
Smith
Snowe
Stevens
Sununu
Talent
Thomas
Thune
Vitter
Voinovich
Warner
NAYS--43
Akaka
Baucus
Bayh
Biden
Bingaman
Boxer
Byrd
Cantwell
Carper
Chafee
Clinton
Conrad
Dayton
Dodd
Dorgan
Durbin
Feingold
Feinstein
Harkin
Inouye
Jeffords
Johnson
Kennedy
Kerry
Kohl
Lautenberg
Leahy
Levin
Lieberman
Lincoln
Menendez
Mikulski
Murray
Nelson (FL)
Obama
Pryor
Reed
Reid
Salazar
Sarbanes
Schumer
Stabenow
Wyden
NOT VOTING--2
Rockefeller
Specter
The PRESIDING OFFICER. On this vote, the yeas are 55, the nays are
43. Three-fifths of the Senators duly chosen and sworn not having voted
in the affirmative, the motion is rejected.
Mr. McCONNELL. I move to reconsider the vote, and I move to lay that
motion on the table.
The motion to lay on the table was agreed to.
____________________