[Congressional Record Volume 156, Number 40 (Thursday, March 18, 2010)]
[Senate]
[Pages S1688-S1693]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTH CARE
Mr. CASEY. Madam President, I wished to review a couple points with
regard to where we are on health care. We are at a point now where, of
course, we are still awaiting action in the House--the other body, as
it is sometimes referred to in the Senate--so we have to allow the
House process to take place, and then, of course, we will be taking up
health care more directly or more definitively next week.
But I think it is important to put this issue into the context of
real people. We have a lot of discussions in the Senate and throughout
Washington on process and procedure and numbers and all that, and that
is important and relevant, but at the end of the discussion--the old
expression ``at the end of the day''--we have to be able to not only
talk to the American people, as we have over many months now--in some
cases many years--about what this legislation will do, but also we have
to be aware of what is concerning a lot of people, a lot of families.
I received a letter in the early part of 2009 from a woman in
Pennsylvania who lives in Berks County--kind of the eastern side of our
State, just north of Philadelphia, a couple counties north of
Philadelphia, Berks County--and the woman who wrote to me, Trisha
Urban, is someone whom I have come to know over the past couple years
because of the tragedy in her own life which relates directly to health
care.
Trisha Urban related to me, in a letter she wrote to me but also in
subsequent conversations, her story, which was the subject of a lot of
discussion and public notoriety in her home area. I wish to read
portions of the letter--not the whole letter but I think the relevant
parts of this letter. She talks about her husband, she and her husband
having all kinds of trouble with health care, which relates directly to
almost every major issue we are talking about. Quoting from her, she
said:
Like many Americans, we have difficulty with our health
insurance. My husband had to leave his job for 1 year to
complete an internship requirement to complete his doctorate
in psychology. The internship was unpaid and we could not
afford COBRA.
I will end the quote there for a second. We have had debates for
weeks on extending COBRA health insurance to those who are unemployed--
a safety net not only for Trisha Urban and her family, at that time,
but so many American families--millions of them--especially in the
midst of a terrible recession.
Picking back up on her letter:
Because of preexisting conditions, neither my husband's
health issues nor my pregnancy--
She talked earlier in the letter about her pregnancy.
--would be covered under private insurance. I worked four
part-time jobs and was not eligible for any health benefits.
We ended up with a second-rate health insurance plan through
my husband's university. When medical bills started to add
up, the insurance company decided to drop our coverage
stating the internship did not qualify us for the benefits.
I will comment on that section. In those few sentences, you have the
preexisting condition problem and the ``insurance company dropped our
coverage'' problem. This is information we have heard over and over in
testimony from real people about what insurance companies in America
are doing to these families. They are discriminating against families--
legally, apparently, under current law. That is part of why we want to
change what has been happening in America, change the law through
passage of legislation to deal with the question of protecting families
with preexisting conditions.
At long last--we have talked about this issue for decades but
certainly in the last couple of years and more intensively in the last
couple of months--this opportunity we have, this legislation gives us a
chance not just to talk and to pontificate about what is wrong with the
system but to act, to vote and to act to change the system to protect
families.
Again, we are talking about preexisting conditions, we are talking
about people, families who are going to work every day, paying their
premiums, doing their part of the agreement they have with an insurance
company. Yet, despite paying their premiums, despite doing what they
are supposed to do under the current system, they are being denied
coverage, they are being discriminated against because they have a
preexisting condition or, even more outrageously, their children are
being denied coverage because of a preexisting condition.
I have to ask myself--and I think a lot of Americans are asking this
question--why do we tolerate this? Why do we go from year to year and
say: it is terrible, insurance companies deny people coverage because
of preexisting conditions even though they have been paying their
premiums; it is terrible that insurance companies drop their coverage;
it is terrible that they put limits on the kind of care they will
provide, but they will put a dollar limit on it for a year or for a
lifetime? That is really terrible, but there is nothing we can do about
it.
That is basically what we have been saying for years. We complain
about the problem, and no one or not enough people here in Washington
are willing to take on the insurance company and say: No, you are not
going to do that any longer. We are going to make those practices
illegal.
We have a chance, and it is an up-or-down vote situation. We have a
chance over the next couple of days--I hope not weeks but certainly the
next couple of days--to decide these questions once and for all. We are
either going to stand up to insurance companies or we are going to
allow them to control people's lives in a way that is insulting to the
American people. It is damaging the ability for families to have
coverage and to have better health care.
I believe what insurance companies do on these discriminatory
practices is harming our economy long term. How can you be a productive
worker if you have to worry every day, even though you paid your
premium, whether an insurance company can discriminate against you,
against your family, and especially against your children?
That is what Tricia Urban was pointing to here, not because it was an
issue in Washington but it was an issue in her life, in the life of her
husband, and eventually having an impact on her own pregnancy. I pick
up the letter again, and I am quoting Tricia Urban again in the letter.
She talks about what the costs were for her and for her husband:
We were left with close to $100,000 worth of medical bills.
Concerned with the upcoming financial responsibility of the
birth of our daughter and the burden of current medical
expenses, my husband missed his last doctor's appointment
less than 1 month ago . . .
Meaning less than 1 month prior to February of 2009.
Here is where she begins to close the letter. I am quoting again.
I am a working class American and do not have the money or
the insight to legally fight the health insurance company. We
had no life insurance. I will probably lose my home, my car,
and everything we worked so hard to accumulate and our life
will be gone in an instant.
If my story is heard, if legislation can be changed to help
other uninsured Americans in a similar situation, I am
willing to pay the price of losing everything.
You might be wondering what happened to her, what happened in her
life. Was it just a situation where they got dropped from their
coverage? That is bad enough. Is it a situation where they got dropped
from coverage and also were denied treatment or care or
[[Page S1689]]
coverage because of a preexisting condition? That would be bad enough
in and of itself. But, no, the story gets worse from there. She talks
about the day when her water broke and she is about to go to the
hospital to deliver her baby. The baby's name is Cora--just a little
more than a year old now. Here is what she says:
My water had broken the night before, we were anxiously
awaiting the birth of our new child. A half-hour later, 2
ambulances were in my driveway. As the paramedics were
assessing the health of my baby and me, the paramedic from
the other ambulance told me that my husband could not be
revived.
She walks out the driveway to get into the car to go to the hospital
to deliver her daughter Cora, and she sees her husband dead on the
driveway, largely because or maybe exclusively because he missed his
doctor's appointment for a heart condition because he was worried about
paying for the doctor visit.
This is not some screenplay or some theoretical story; this is real
life for people in America. We have to ask ourselves, on both sides of
the aisle--our friends on the other side have to ask themselves: Is
this good enough? Is this the best America can do, that we have to say
sorry to Tricia Urban; sorry that happened to you about a preexisting
condition, but we do not have the guts or the ability here in
Washington to stand up to insurance companies; sorry you were denied
coverage, but it is not going to change; sorry that a doctor's visit
might have cost too much at a particularly vulnerable point in your
life or the life of your husband; sorry that your husband died, but we
don't think we can be responsive to those situations.
Why do we tolerate this? Why do we allow insurance companies to
control our lives this way? This is not just another vote in
Washington. This is not just some discussion about reconciliation or
the House vote and all that other stuff. This is about real life, and
in the next couple of days we are either going to stand up to insurance
companies or we are not.
I think it is a whole set of questions Tricia Urban is asking. She is
asking me, she is asking all the Democrats in this Chamber and all the
Republicans.
Then there is another set of questions I have and I think a lot of
Americans have for our colleagues on the other side. They say they want
health care reform, but they are not willing to support what we are
trying to do. You say: OK, if they do not support what you are trying
to do, they probably have an alternative plan they have all come
together on and worked on for months and they are going to propose that
alternative; that is the American way.
They have an idea, we have an idea, we have a debate and vote, and
someone wins, right? That is not the case. I am still waiting--we are
all still waiting for Republican elected officials in Washington, House
or Senate, to tell us what their plan is, to tell us definitively what
they really want to do. Do they really want to be responsive to this
problem of a preexisting condition? Do they really want to stand up
against the insurance companies and say: No, you can't discriminate
against families any longer.
Oh, by the way, they are going to do just fine, those insurance
companies, because if our bill passes they are going to have 30 to 31
million more Americans covered. So they are going to do just fine.
Don't worry about the insurance companies, they will do just fine even
if we put a lot of protections in the bill.
We have to ask our Republican friends: You say you care about
covering Americans. Our legislation covers more than 30 million; how
about you? Their latest proposal covers 3 million Americans. That is
not even a serious attempt to cover Americans. We passed a bill last
year on children's health insurance where we are going from 4 million
children covered and, because President Obama signed the
children's health insurance reauthorization into law, we are going up
to 7 million. We have already proven we can cover more children with an
expansion of an existing program than the other side of the aisle is
going to cover in their entire health care plan. But there is not much
detail other than that. They say they want to cover 3 million. So it is
a choice: Shall we cover 31 million Americans and strengthen our
economy and give people the security of health care or give 3 million
coverage and pretend that is a serious proposal?
They say they care. They say they care on deficit reduction and
controlling costs. Yet they will not support a proposal that at last
count reduced the deficit by $130 billion. We are getting new
information that is just coming out today from the Congressional Budget
Office that number might still remain true from what it was in
December--$130 billion of deficit reduction over the first 10 years and
in the second 10 years maybe as high as $1 trillion or more. If you
care about deficit reduction, then why wouldn't you sign on to
something that would provide maybe the most significant deficit
reduction in American history in one piece of legislation?
They say they care about Medicare. We have heard that a lot over
there. They care about Medicare and all that. Then, when their proposal
comes out, they want to have vouchers for Medicare. Is that a serious
proposal?
They have to answer some basic questions, and they have to
specifically answer the questions Tricia Urban is asking us because
Tricia Urban's story is a story we have heard in different forms all
over the country, certainly all over Pennsylvania. Maybe not every
story has preexisting conditions, limiting coverage, jacking up rates
so you can't afford to have coverage, and, tragically, a death in the
family. Maybe not every story is that substantial. But we have heard
stories over and over.
I also point to our businesses. I ask unanimous consent to have
printed in the Record an Associated Press--Pittsburgh Tribune Review
article from earlier this month, ``Health Tops Pennsylvania Business
Woes.''
There being no objection, the material was ordered to be printed in
the Record, as follows:
[From the Pittsburgh Tribune-Review]
Health Tops Pennsylvania Business Woes
state's small businesses also see the recession as a severe obstacle
(By Joe Napsha)
Pittsburgh.--Pennsylvania's small businesses say rising
health care costs, along with the recession and business and
personal taxes, are the biggest challenges they will face
this year, according to a recent survey
``It really confirms that in Pennsylvania, we need to zero-
in on health care costs and taxes,'' said Thomas Henschke,
acting president of the SMC Business Councils, a Churchill-
based trade association that conducted the Small Business
State Opinions survey in February SMC represents about 5,000
businesses throughout western and central Pennsylvania.
About 71 percent of the 250 businesses that responded to
the survey said health care costs were their biggest
challenge. More than 70 percent said that high business and
personal taxes were a moderate-to-severe challenge to their
business.
Increases in health care costs--ranging between 7 and 12
percent a year--are a ``huge problem'' for small business
that isn't being addressed by politicians in Washington, said
Peter Cady, president of Command Systems Inc. of Oakmont. The
company operates Advanced Mining Service, which repairs and
sells coal mining equipment.
``You can't pass those costs along. Nobody wants to hear
that your health care costs went up,'' Mr. Cady said.
In response to a 23 percent jump in health care costs four
years ago to cover about 55 employees, Command Systems moved
to a high-deductible insurance plan, which makes it partially
self-insured. Command Systems pays 99 percent of the
insurance costs for its employees, Mr. Cady said.
In addition to health care, the poor state of the economy
was cited as a severe challenge by about 45 percent of the
respondents
``Even before the recession, Pennsylvania was a very
difficult place to operate a business,'' compared to the
neighboring states, Mr. Henschke said.
The survey was released the same day that President Barack
Obama announced his latest version of health care reform.
``That's politics. This is reality'' Mr. Henschke said.
``Proposed reforms change daily, and you can't find
anything that is going to lower costs.''
Small-sized employers often believe they are overpaying for
health insurance for employees. But self-insurance for their
work force is really not available because the pool of
covered employees is ``too small to spread the risk out,''
said Vincent Wolf executive vice president of Cowden
Associates Inc., a. Pittsburgh-based health care benefits
consulting firm.
Health care costs are a major concern for businesses, which
is driving their need to make changes in health care plans,
said Lorin Lacy, principal for the health and productivity
practice at Buck Consultants Inc., a Pittsburgh-based human
resources consulting firm. Those changes include revising
[[Page S1690]]
cost-sharing between employees and employers and the use of
wellness programs, Ms. Lacy said.
COUNTY HEALTH COMPARISON
[Ranking (Out of 67 Pa. counties)]
------------------------------------------------------------------------
Environmental
County Overall and lifestyle
health factors
------------------------------------------------------------------------
Lackawanna................................ 51 19
Luzerne................................... 57 37
Monroe.................................... 46 40
Pike...................................... 6 20
Susquehanna............................... 41 31
Wayne..................................... 62 21
Wyoming................................... 43 46
------------------------------------------------------------------------
Source: County Health Rankings Study.
Overall health by county
1. Chester
2. Centre
3. Union
4. Snyder
5. Montgomery
6. Pike
7. Bucks
8. Lancaster
9. Cumberland
10. Franklin
11. Butler
12. Bradford
13. Warren
14. Columbia
15. Lebanon
16. Berks
17. Indiana
18. Westmoreland
19. Lehigh
20. Jefferson
21. Adams
22. Tioga
23. Lycoming
24. Potter
25. York
26. Northampton
27. Fulton
28. Juniata
29. Washington
30. Erie
31. Bedford
32. Somerset
33. Crawford
34. Clinton
35. Perry
36. Delaware
37. Huntingdon
38. Sullivan
39. Montour
40. Cameron
41. Susquehanna
42. Clarion
43. Wyoming
44. Beaver
45. Clearfield
46. Monroe
47. Dauphin
48. Mifflin
49. Allegheny
50. McKean
51. Lackawanna
52. Mercer
53. Forest
54. Venango
55. Northumber-
land
56. Carbon
57. Luzerrie
58. Armstrong
59. Elk
60. Schuylkill
61. Lawrence
62. Wayne
63. Blair
64. Cambria
65. Fayette
66. Greene
67. Philadelphia
Mr. CASEY. It is an article, so you will not be able to see it, but
the headline is ``Health Tops Pennsylvania Business Woes.'' The
subheadline is ``State's Small Businesses Also See the Recession as a
Severe Obstacle.''
If you are a small business owner in Pennsylvania, this survey shows,
you are worried about two things: the recession--no question about that
having an adverse impact; that is why the recovery bill and jobs bill
are so important to these small businesses--but also health care.
I am reading an excerpt here:
About 71 percent of the 250 businesses that responded to
the survey said health care costs were their biggest
challenge.
Health care costs. This is not a group of Democrats sitting around a
room in Pennsylvania saying: Let's pass health care. These are small
business owners in Pennsylvania. They might be Democratic, Republican,
Independent, or they may not have any affiliation. Their life is
running a small business and raising their families, and 71 percent of
those surveyed describe health insurance as their ``biggest
challenge.'' We do not need any longer to debate whether this is an
issue we have to deal with.
I want to walk through some of the basic provisions of what we have
put in place in the Senate bill, what the House has been wrestling with
all these months, and what President Obama has been trying to do. Just
a couple of quick highlights.
First of all, if we are successful in this opportunity to pass major
health care reform, other issues we have talked about for years but do
not get a lot of attention are going to be finally the law of the land.
Quality and prevention--the information and research on this is
irrefutable. If you insist on prevention and you make it free or very
low cost, that person is going to be healthier because they are going
to take steps that are preventive in nature. They are going to be
healthier, their family is going to be healthier, they are going to be
better on the job and the economy will be stronger. But also we are
going to strengthen our health care system in terms of costs. We are
going to reduce costs in a lot of ways, but one of them is prevention
and elevating the quality of our care. Sometimes people get the best
care in the world, but in some places that can be very limited.
The second point on cost and deficit. I mentioned that before. The
deficit reduction in the Democratic health care bill is $130 billion
over the first 10 years. We will see if the Congressional Budget Office
alters that.
But from what we are hearing today, some of the preliminary reports,
that number might hold up. Some thought that because of the passage of
time that number might go down $130 billion to $100 billion. But it is
a tremendous deficit reduction over 10 and over 20 years.
Protections. I talked about that before. I just want to highlight
that quickly. Basic protections for American families who have health
insurance coverage now, families going to work, paying their premiums,
and not protected. They think they are protected because they have a
policy, an agreement, and they are paying their premiums. They are
doing their part. Then some insurance company bureaucrat or some other
player in this marketplace comes to them and says: We know you are
paying your premiums; that you are holding up your end of the bargain.
But we, the insurance company, do not think you or your child should
have coverage. Sorry. You are out of luck.
Well, we are dealing with that in a couple of ways. First of all, it
is important for people to understand what will happen now and what
will happen later. If we get this bill passed, 6 months after the
President would sign it into law, it would be illegal for an insurance
company to deny a child coverage because of a preexisting condition.
That is a tremendous change in the first year--literally, after 6
months.
In that same time period and beyond that, if you are an adult,
technically you would not have the legal protection because you cannot
do all of this at once. So we had to decide, do we do nothing in the
short term or do we at least protect children. We are protecting
children in the first couple months of the bill. But even though
technically an adult would not have legal protection until 2014, they
will have recourse. They will have an option to say: I am an adult. I
have been denied coverage because of a preexisting condition. I can go
into a high-risk pool and get coverage.
So there is recourse in the first--actually, that is in the first 3
months for the adult. So that is a very important protection. We can
talk more later about that.
Finally, and I will begin to close, on children's health insurance--I
talked about that before--it is important to note what the bill does on
a great successful program, the Children's Health Insurance Program.
For example, in our State this is what children's health insurance
has meant. It has meant that we have been able to reduce our rate of
uninsured children down to 5 percent. It is still not good enough; we
still want to go lower. But our uninsured rate among children in
Pennsylvania is 5 percent. With regard to adults between the ages of 18
and 64, it is 12 percent, so more than double for the adult uninsured
prior to getting to the age of Medicare. That is more than double the
children's uninsured rate. That is good for children that we have made
progress--we need to make more--but it is bad for adults who have not
had a strategy to help them.
That is part of why we are trying to pass the bill. At long last we
are going to be helping many adults, tens of millions. The Children's
Health Insurance Program is extended under the bill for 2 years, until
September 30, 2015.
What the President wants to do as part of the so-called
reconciliation process is to maintain--he proposes to require States to
maintain eligibility for children's health insurance to 2019, not just
2015, 2019. He wants to fund it through 2016. I think that is a very
important change that the President has proposed and that we have a
chance to ratify in our debate.
There is a lot more we can talk about, but I am running low on time.
But I think the basic question for the American people is, Are we going
to have an up-or-down vote on health care?
Some over there who have used this process before for other measures
over many years seem to not want us to have an up-or-down vote on
health care.
I think the American people want that, even if they disagree with
parts of the bill. But the real question for our Republican friends is,
Will they be responsive to Trisha Urban? Are they just going to say
that preexisting conditions are a problem; I know recisions are a
problem, I know limits on coverage are a problem for you and your
family; I know that denying a child health care coverage because of a
preexisting condition is a problem, but we are not going to do anything
about it; the insurance companies were too strong; we could not beat
them; we are just going to go the way that so many have gone in
Washington.
I do not think that is going to be a good enough answer for Trisha
Urban
[[Page S1691]]
and her family and for millions of Americans.
Finally, the question is, If you are not for our bill, if you are
going to vote against it, what are you going to do about this? What are
you going to do if you vote against covering 31 million Americans? What
are you going to do? Are you going to cover three? Is that a serious
proposal?
If you say you care about Medicare, are you going to support--which
is the Republican proposal--having vouchers for Medicare? If you say
you care about deficit reduction, you are going to vote against the
bill that cuts the deficit by $130 billion, and let's say that number
goes down, the worst we could do is $100 billion. But the estimates
might hold up in the next couple of days. We will see what the
Congressional Budget Office has.
So I think Republicans in the Senate and the House have to answer
those basic questions, not necessarily my questions or our questions
but the questions that Trisha Urban and others across our country and
every single State, the millions of Americans who have been denied
coverage because of a preexisting condition.
Notice I said millions over the last couple of years, according to
one estimate, one survey. They have some questions to answer over on
the other side of the aisle. We will see what their answer is, and the
answer will be the vote. How you vote on this will be one answer to all
of those and many other questions.
So I hope we can have some conversions on the other side; that they
will see that it is important to cover Americans, it is important to
provide the kind of security and protection to families who are paying
their premiums every day and not being given the protections they
deserve. I hope our friends do that.
I hope they do not just spend all of their time debating the finer
points of process in the Senate. People really do not care about what
the procedure is in Washington in the Senate. They want to know are we
going to have, at long last, real protections for real families, or
will the insurance companies win again.
This is not complicated. That is one of the basic questions they are
asking us to answer for them.
I yield the floor and suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. CASEY. I ask unanimous consent that the order for the quorum call
be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. CASEY. Madam President, I know I have less than 2 minutes, but I
wanted to add a couple of things to the Record. One is an article from
the Los Angeles Times of February 4 of this year, headlined ``Anthem
Blue Cross Dramatically Raising Rates for Californians With Individual
Health Policies.''
I ask unanimous consent that article be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[From the Los Angeles Times, Feb. 4, 2010]
Anthem Blue Cross Dramatically Raising Rates for Californians With
Individual Health Policies
(By Duke Helfand)
Anthem Blue Cross is dramatically raising rates for
Californians with individual health policies. Policyholders
are incensed over rate hikes of as much as 39%, which they
say come on top of similar increases last year. State
insurance regulators say they'll investigate.
California's largest for-profit health insurer is moving to
dramatically raise rates for customers with individual
policies, setting off a furor among policyholders and
prompting state insurance regulators to investigate.
Anthem Blue Cross is telling many of its approximately
800,000 customers who buy individual coverage--people not
covered by group rates--that its prices will go up March 1
and may be adjusted ``more frequently'' than its typical
yearly increases.
The insurer declined to say how high it is increasing
rates. But brokers who sell these policies say they are
fielding numerous calls from customers incensed over premium
increases of 30% to 39%, saying they come on the heels of
similar jumps last year.
Many policyholders say the rate hikes are the largest they
can remember, and they fear that subsequent premium growth
will narrow their options--leaving them to buy policies with
higher deductibles and less coverage or putting health
insurance out of reach altogether.
``I've never seen anything like this,'' said Mark Weiss,
63, a Century City podiatrist whose Anthem policy for himself
and his wife will rise 35%. The couple's annual insurance
bill will jump to $27,336 from $20,184.
``I think it's just unconscionable,'' said Weiss, a member
of Blue Cross for 30 years.
Woodland Hills-based Anthem declined to say how many
individual policyholders will be affected or what a typical
increase will be under the new pricing, which will vary from
one individual to another. But the company defended its
premiums, even as it tried to strike a sympathetic tone.
``We understand and strongly share our members' concerns
over the rising cost of healthcare services and the
corresponding adverse impact on insurance premiums,'' the
company said in a statement.
``Unfortunately, the individual market premiums are merely
the symptoms of a larger underlying problem in California's
individual market--rising healthcare costs.''
About 2.5 million Californians have individual insurance
policies, accounting for a small portion of the state's
overall insurance market. By contrast, nearly 21 million
people in California are covered by health maintenance
organizations.
Individual policies are often the only option for those who
are uninsured, self-employed or do not receive health
coverage through employers.
Insurers are free to cherry-pick the healthiest customers
in the lightly regulated individual market. They can raise
rates at any time as long as they notify the state Department
of Insurance and prove that they are spending at least 70% of
premiums on medical care.
The size of the individual rate increases prompted state
Insurance Commissioner Steve Poizner recently to call for a
review of Anthem's charges.
``Commissioner Poizner is very concerned by these large
rate increases,'' spokesman Darrel Ng said.
Poizner directed his department to retain an ``independent
outside actuary to examine Blue Cross'' rates'' to ensure
that the company spends at least 70% of the premiums on
medical care, as required by state law, Ng said. Anthem said
it had already hired an actuary who found that the rates were
sound.
Anthem is not the only health insurer imposing double-digit
rate increases. Competitors such as Blue Shield of California
and Aetna also have raised premiums significantly in recent
years, insurance brokers said. But they said the impending
Anthem increases are the largest they have seen.
``Do they really think they are going to keep clients this
way?'' asked Bill Robinson, a Palm Springs broker who has
informed his Anthem clients that they will face increases of
as much as 39% on March 1.
Anthem sent letters to agents a few weeks ago informing
them of the March 1 increases and followed up with similar
notices to policyholders last week.
That's when Mary Feller of San Rafael learned that the rate
for herself and her husband will jump 39%, or $465 a month,
driving the couple's annual premium to $19,896 from $14,316.
Feller, 56, said the premium for her 26-year-old daughter
also will rise 38%, costing the family an additional $1,572 a
year.
As a result, starting March 1, the Fellers' health
insurance bill will surpass the family's monthly mortgage
payment on their home north of San Francisco.
``It's breathtaking,'' said Feller, an entertainment
journalist. ``We're going to have to cut back somewhere else.
This kind of stuff strikes fear in the heart.''
Feller said she was troubled by another part of the Anthem
letter. Besides detailing the premium increase, it said:
``Anthem Blue Cross will usually adjust rates every 12
months; however, we may adjust more frequently in accordance
with the terms of your health benefit plan.''
She and others voiced anger about the increases as Anthem's
parent company, WellPoint Inc., sees big profits. Last week
the company announced an eightfold increase in profit for the
last three months of 2009, a surge attributed largely to the
sale of subsidiaries.
Broker and insurance industry analysts said the California
rate increases will leave individual policyholders with few
good options: Anthem subscribers such as the Fellers can
switch to a company plan with a higher deductible. Or they
can try to switch insurers, a dicey proposition because
carriers in the individual market can reject applicants who
have preexisting medical conditions.
``It's putting people's backs up against the wall,'' said
Shana Alex Lavarreda, director of health insurance studies at
the UCLA Center for Health Policy Research. ``They are
finding new ways to create new problems for consumers.''
The insurer said it had a team of workers to help customers
balance costs and insurance.
``Anthem offers a variety of health benefit plans,'' the
company said, ``and we are dedicated to working with our
members to find health coverage plans that are the most
appropriate and affordable for their needs.''
Mr. CASEY. Basically, many Americans have heard these stories and
experienced the pain of these health insurance premium increases. But I
am going to read quick portions of it:
[[Page S1692]]
Anthem Blue Cross dramatically raised rates for
Californians with individual health policies. Policyholders
are incensed over rate hikes of as much as 39 percent.
Going on to say: Anthem Blue Cross is telling many of its
approximately 800,000 customers who may buy individual coverage--people
not covered by group rates--that their premiums will increase 30 to 39
percent.
Finally, I ask unanimous consent to have printed in the Record a
series of statements contained in a 3\1/2\-page summary entitled ``GOP
on Reconciliation.'' This is a series of statements that Republican
Senators have made over the years with regard to this process they are
complaining about and think that we should not be able to use, even
though they supported it in the past. It is interesting reading which
we do not have time to highlight.
There being no objection, the material was ordered to be printed in
the Record, as follows:
GOP on Reconciliation
gregg
Gregg 2005: ``What's Wrong With Majority Rule?'' During a
floor debate on drilling in the Arctic National Wildlife
Refuge (ANWR), Senator Gregg said, ``We are using the rules
of the Senate. That is what they are. Reconciliation is a
rule of the Senate set up under the Budget Act. It has been
used before for purposes exactly like this on numerous
occasions. The fact is, all this rule of the Senate does is
allow a majority of the Senate to take a position and pass a
piece of legislation, support that position. Is there
something wrong with majority rules? I don't think so. The
reason the Budget Act was written in this way was to allow
certain unique issues to be passed with a majority vote. That
is all that is being asked for here. . . . The point, of
course, is this: If you have 51 votes for your position, you
win.'' [Congressional Record, 3/16/05]
Gregg 2008: Reconciliation ``One Tool of Significance''
Budget Committee Can Use. ``Reconciliation, as we know--those
of us who work here--is the one tool of significance which
the Budget Committee has. It allows us to change how
entitlement programs are funded and slow their rate of
growth--that was the purpose of reconciliation--and do it
without the changes being subject to the filibuster rule. It
is a vehicle basically directed on the purposes of the
Senate.'' [Gregg Floor Statement, 3/13/08]
Gregg 2005: Republicans Used Reconciliation to Avoid
Democratic Opposition to ANWR Drilling, Passing Medicaid
Savings. ``The ANWR language has been a source of controversy
all year, and along with Medicaid savings, was one of two
principal reason for attempting to pass a reconciliation bill
this year, according to Senate Budget Chairman Judd Gregg, R-
N.H. Either provision on its own could not have survived a
Democratic filibuster without the protection of budget
reconciliation, Gregg said.'' [CQ Today, 12/19/05]
Gregg 2005: Mocked Democrats' Use of the ``Byrd Rule'' to
Slow Reconciliation Bill, Said Democrats ``Enforcing Minutia
Over Policy.'' ``Anybody who knows the Byrd rule knows it's
an extremely arcane and incredibly complex piece of precedent
that we deal with. And we had received estimates from CBO
which said that all three items which points of order were
made against scored . . . But the point here, of course, is
there are so many rules in this institution that go to
minutia on instances, that if you are using rules to enforce
minutia over policy, you can have a pretty massive unintended
consequence. Now in this case, I think it's intended, but the
consequence of promoting minutia by use of the rules is that
Katrina money isn't going to go out, people aren't going to
see doctors because doctors aren't going to get paid, and
students aren't going to be able to get student loans and
it's potential that the welfare program won't have the funds
it needs in order to continue to go forward. That's the
consequence of promoting minutia in this instance.''
[Republican Press Conference, 12/21/05]
Gregg 2005: Reconciliation is the Mechanism that Deals With
Entitlement Spending, Tax Policy. ``The letter asks that we
indefinitely postpone reconciliation, reconciliation being
the mechanism by which we address the entitlement spending
and tax policy here at the Federal level. It is an outgrowth,
of course, of the budget process.'' [Gregg Floor Statement,
9/7/05]
GRASSLEY
Grassley 2003: If a Broad Energy Bill Lagged, He'd Favor
Attaching Energy Tax Credits to the Budget Reconciliation
Legislation. ``The result is an energy bill much like the one
lawmakers sought to finish in the final weeks of the 107th
Congress that is composed largely of energy-related tax
credits. . . . But if a broader energy measure lags, Grassley
said, the tax package could be accelerated by also attaching
it to reconciliation. 'If we weren't going to move an energy
bill, then I would want to do that,' he said.'' [CQ Weekly,
1/17/03]
Grassley 2003: Aimed to Use Budget Reconciliation to Pass
President Bush's Economic Stimulus Plan. ``The Finance
Committee plans four hearings on Bush's economic plan in late
January and early February. Grassley is aiming to use a
budget reconciliation measure as a vehicle and hopes to have
a stimulus bill completed by April.'' [CQ Daily Monitor, 1/
16/03]
Grassley 2003: Planned to Move a Tax Package Through Budge
Reconciliation Legislation, Said Some GOP Senators Would
Oppose the Measure. ``Lawmakers and aides in both chambers,
including Grassley, said a tax package probably will move as
a fiscal 2004 budget reconciliation measure protected from
Senate filibusters. 'We're still going to have to have a
bipartisan agreement,' Grassley said. 'We won't keep all 51
Republicans together. I wish we could. But don't forget,
we're going to have to work with Democrats to get something
we can agree on.''' [CQ Weekly, 1/10/03]
Grassley 2001: Said Republicans Would Have to Use
Reconciliation to Get the Bush Tax Cuts Passed, Would Protect
Legislation from Filibuster and Limit Debate. When asked by
Paula Zahn, ``As you know, House members have been
criticized, particularly Republicans, for sailing, at least
the rate cut portion of this bill, through the House so
quickly. As Senate Finance Committee chair, how much debate
will you allow?'' Grassley responded, ``Well, we're going
to--in the Senate of the United States, if we do this under
the reconciliation process--and that's probably the way it
will have to be done in order to get it done at all--and
that's a limit of 20 hours of debate. It's almost the only
process in the Senate that does not have unlimited debate and
cannot be filibustered. So we will probably adopt the budget
the first week of April, get it through finally, and
compromise the last week of April, and then go to the taxes
during the month of May. But it will be the expedited
procedure.'' [Fox News, 3/8/01]
Grassley 2001: If Tax Cuts Were Divisive, They Would Have
to Be Passed Through Reconciliation. ``Many observers expect
the Senate to take up the tax issue as part of the budget
reconciliation process. Under Senate rules, debate is limited
under the reconciliation process, preventing any individual
senator from holding up the process with a filibuster. If
there is a strong bipartisan consensus, the Senate may be
able to move ahead with a separate bill that could move
through in relatively short order, Grassley said. `On the
other hand, if you're going to have it be very divisive--even
if it's a bipartisan bill it could still be very divisive--
then it would demand to be part of the reconciliation
process,' which could stretch into May or June, Grassley
said.'' [CBS Marketwatch, 1/26/01]
MCCONNELL
McConnell 2005: Republicans Would Use Budget Process to
Extend Tax Cuts Because They Could Not Reach the 60 Votes
Needed to Make Permanent Changes Outside of the Budget
Process. ``Well, we're going to try to extend a number of the
taxes through the budget process that we're involved in this
week. That's the good news. The bad news is you can't make
these taxes permanent through the budget process, which is
why we have what is perceived by a lot of people as the
bizarre situation with regard to the death tax, where it
phases down over a period of time, goes away for one year and
then comes back. We are working on the death tax separately,
hoping to come up with a proposal that could get to 60 votes,
which we would need if we did it outside of the budget
process. So we haven't given up on trying to get a major
permanent improvement, if not total repeal, of the death tax.
The other taxes that you mentioned we hope to extend for an
additional period of years through the budget process.''
[Kudlow & Company, 3/15/05]
HATCH
Hatch 2001: Important to Pass a Budget So Senate Could Do a
Reconciliation Bill to Pass President Bush's Tax Cuts. ``The
important thing is, is that we got a budget through the
Senate. The House has passed the tax cut of $1.6 trillion.
Now that that budget's through, I think we can do a
reconciliation bill that'll have an overwhelming number of
senators and Congresspeople voting for this $1.3 trillion to
$1.6 trillion tax cut. And that's critical for our economy,
critical to this country.'' [Fox News Network, 4/16/01]
ROBERTS
Roberts 2003: Majority Rules. On the Senate floor, Pat
Roberts said, ``If we do not end this business and get to the
business of the Nation, and understand there is a majority
and a minority and that the majority rules, we will open up a
wound further that will not heal without significant price
and scar, not to mention public ridicule for our
institution.'' [Congressional Record, 1/14/03]
COLEMAN
Coleman: ``Principal of Majority Rule.'' On the Senate
floor, Norm Coleman said, ``The fact is that what happened
here is that my colleagues followed the history and tradition
of this body and said they would make sure they got a vote
because that is what the Senate is called upon to do, advise
and consent. There is a principle of majority rule, a
principle, again, espoused in this document, in this
Constitution, of the United States.'' [Congressional Record,
11/12/03]
KYL
Kyl: Reconciliation Is a Perfectly Legitimate Legislative
Process. On Hugh Hewitt's radio show, Senator Kyl discussed
reconciliation and said: ``Reconciliation is a perfectly
legitimate legislative process to deal with budgetary
matters. It is a, it is the one exception to the general
rules of the Senate
[[Page S1693]]
that was created about thirty or forty years ago, and Robert
Byrd was one of the people that helped to create it, to deal
with budget matters where you didn't want a filibuster to
prevent the balancing of the budget, in effect. I mean,
there's one thing you have to do. You have to be able to
either increase your revenues or reduce your spending in
order to balance the budget, theoretically. So they made that
one exception to the policy of the Senate, which otherwise
would have required sixty votes to do the big things. Now
that process is available for those kinds of monetary-related
subjects. And it has been used many times. That's true. The
Bush tax cuts were done as, through reconciliation, for
example. Now there have been a couple of other examples where
they ventured outside of pure monetary issues. They shouldn't
have. I wasn't there. I don't know why or how they did it.
But in any event, it is not available for large, substantive,
comprehensive kinds of legislation like this health care
bill. It doesn't work, it's not suitable, and it certainly
isn't appropriate.'' [Hugh Hewitt via Think Progress, 2/25/
10]
Kyl: Only Takes 51 Votes To Extend the Bush Tax Cuts. In
2005, Senator Kyl said, ``the bottom line is in the Senate,
to do anything permanently, it takes 60 votes because that's
what it takes to break a filibuster. So if you don't have 60
votes, you've got to do the best you can. The best we can do
right now, I suspect, is not to make all these tax cuts
permanent but to extend them out as far as we can. If we had
a five-year budget this year, for example, we could extend
these tax cuts out through the year 2010. For example, that
would mean that with dividends and capital gains, we need to
take those two 15 percent rates and carry them forward two
more years, so that they would include not only 2008 but also
2009 and 2010. And we can do that with some of the other
rates as well. So with a five-year budget, that's doable. . .
. And I would hope that--that only take 51 votes to
accomplish, so I would hope that we would do that.'' [CNBC,
2/14/05]
CANTOR
2005: Cantor Hoped Congress Would Engage in Budget
Reconciliation Every Year. ``I would again say, though, that
obviously reconciliation is a two-part process; that we are
focusing on reducing spending on this one. And again, a first
step in a process that I hope we can engage in every year,
that we would cut the size and growth in the entitlement
programs, at the same time reform these programs to promote
the efficiency that the taxpayers expect.'' [Republican Press
Conference, 11/8/05]
2005: Cantor Praised His Colleagues for Passing Budget
Reconciliation Legislation. ``Well, I too am here to also
thank the entire team, from the speaker on down, for all that
we did for America last night. And I think what is really
telling, though, is the fact that we were able to vote and
pass a reconciliation spending package, and unfortunately, we
did it by ourselves. The fact is not one member from the
other side of the aisle participated in doing what it is the
whip just said, which was reform--beginning the process of
reforming government. And I think it does demonstrate that
the other side remains stuck to their old tax-and-spend ways
and has not even presented--did not even present last night
an alternative. I think that's very telling.''
Mr. CASEY. I yield the floor and suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. DORGAN. I ask unanimous consent that the order for the quorum
call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
____________________