[Congressional Record Volume 156, Number 165 (Tuesday, December 14, 2010)]
[House]
[Pages H8335-H8336]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
AFFORDABLE CARE ACT
The SPEAKER pro tempore. Under a previous order of the House, the
gentleman from Connecticut (Mr. Courtney) is recognized for 5 minutes.
Mr. COURTNEY. Madam Speaker, yesterday Virginia District Court Judge
Henry Hudson's decision striking down one provision of the Affordable
Care Act has generated a lot of noise in the last 24 hours.
Opponents of health care reform are celebrating as if the whole law
was struck down, even though Judge Hudson refused the Commonwealth of
Virginia's request to strike down the entire law and Judge Hudson
refused the Commonwealth of Virginia's request to stop implementation
of the health care bill which has been proceeding since last March.
Thank goodness the judge had enough common sense not to stop the
health care bill's important protections for families and patients that
have been implemented since last March, such as age 26 dependent
coverage which employers all across America have been implementing
since last July, giving families the opportunity to keep children
covered on their family's health insurance plan up to age 26; such as
protections like the elimination of insurance company rescissions of
coverage, the practice of denying claims after the fact, many times
after patients have had surgery or have had treatment; such as the $250
payments, which seniors who fell into the part D doughnut hole received
in 2010; such as the 50 percent discount for brand-name medications,
which seniors in the doughnut hole will start to receive starting on
January 1; such as the new Medicare coverage for annual checkups,
cancer screenings, smoking cessation, vaccinations for flu, which the
new health care bill will provide starting on January 1; such as the
early retiree reinsurance program, which employers all across the
country, private employers as well as public employers, are using to
stabilize age 55 and up retirement health benefits, including 96 plans
just in the Commonwealth of Virginia alone.
For all the crowing and boasting by opponents of health care reform,
there was less there than meets the eye. But there is no doubt that the
judge did strike down an important part of the bill, namely, the shared
responsibility provision, the requirement that nearly all Americans
carry health insurance, a provision which two other district court
judges, one in Virginia and one in Michigan, upheld as a proper
exercise of Congress' power to regulate interstate commerce.
Judge Hudson ruled that this provision doesn't ``fit within the
letter or spirit of the Constitution.'' Well, Madam Speaker, there is a
long, long history of Supreme Court cases which have held exactly the
opposite of what Judge Hudson wrote.
Indeed, Antonin Scalia, the leader of conservative forces on the U.S.
Supreme Court, himself, wrote that Congress has the authority to enact
a regulation of interstate commerce, and it possesses every power
needed to make that regulation effective.
Using Justice Scalia's interpretation of the commerce clause, it is
clear that this bill's provision to eliminate preexisting condition
exclusion, the practice by insurance companies for denying coverage for
people with cancer, high blood pressure, diabetes, chronic conditions,
which require a pooling mechanism which the shared responsibility
requirement was designed to accomplish, clearly fits within Justice
Scalia's definition of the commerce clause. In fact, we know this from
real-life experience.
Seven States tried to enact a guaranteed issuance law requiring
insurance companies to insure all people regardless of preexisting
conditions, and what happened was that rates went through the roof.
Only one State was able to implement a prohibition on preexisting
condition exclusions, that was the State of Massachusetts, which was
coupled with a shared responsibility mechanism. And, as a result,
insurance premiums fell in the individual market by 42 percent.
The impact on interstate commerce in terms of what is happening in
the health insurance market could not be clearer. In fact, the trade
organization representing America's health insurance industry back in
2008, after the election, made it clear that a shared responsibility
mandate requirement is essential to actually executing and performing
real reform in the insurance market. Allowing people to enter the
market and exit the market when they get sick and when they get better
is like insuring a burning building. And the fact of the matter is that
the judge's decision, despite the fact that conservative judges like
Antonin Scalia have recognized Congress' ability to regulate interstate
commerce, which the health insurance industry clearly falls under,
would allow for the Congress to set up the real mechanism to make sure
that its goal of eliminating preexisting conditions can actually take
place. And the health insurance industry knows over the last 5 years
the collapse that has been occurring within the marketplace because of
rising premiums.
I come from the State of Connecticut. We have Aetna, we have CIGNA,
we have United Health Care. These are the largest plans in the country
that are selling to employers, and they have seen the percentage of
their coverage across America decline, not since the passage of the
health care bill, but going back to 2005. And this measure is designed,
in fact, really just to stabilize that private health insurance market.
Madam Speaker, in a few short weeks, new Members of Congress are
going to be sworn into office. They are going to be given a PIN that
gets them into the building, they are going to be given a voting card,
and they are also going to be given an opportunity to enroll in the
Federal Employee Health Benefit plan, a purchasing exchange which
Members of Congress can participate in, get a nice comprehensive
package of benefits, taxpayer subsidies, affordable rates. And on page
29 of this booklet, it makes it very clear that preexisting conditions
will not be imposed against them.
The people of this country deserve the same type of coverage. And it
is my hope, as the appellate courts review that decision yesterday,
that they will uphold the Affordable Care Act's provision to stabilize
the private health insurance market.
[Press Release, Nov. 19, 2008]
Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions
and Individual Coverage Mandate
Washington, DC.--Health plans today proposed guaranteed
coverage for people with pre-existing medical conditions in
conjunction with an enforceable individual coverage mandate.
Under the new proposal, health plans participating in the
individual health insurance market would be required to offer
coverage to all applicants as part of a universal
participation plan in which all individuals were required to
maintain health insurance.
Health plans also said that premium support for moderate-
income individuals and broad spreading of risk was necessary
to promote affordability and maintain premium stability in
the individual health insurance market.
To ensure that all Americans can access coverage, health
plans also reiterated their long-standing support for making
eligible for Medicaid every uninsured American living in
poverty and strengthening the Children's Health Insurance
Program.
``No one should fall through the cracks of our health care
system,'' said Karen Ignagni, President and CEO of America's
Health Insurance Plans (AHIP). ``Universal coverage is within
reach and can be achieved by building on the current
system.''
The announcement follows a nationwide listening tour
conducted by AHIP as part of its Campaign for an American
Solution. Concerns about coverage for pre-existing
conditions, continuity of coverage for those between jobs and
maintaining affordability for those with insurance were
raised repeatedly across the country.
[[Page H8336]]
``AHIP's Board of Directors is responding to the concerns
of the American people by offering a workable solution to
ensure that no one is left out of the health care system
because of their health, age, income or employment status,''
said Ignagni.
The new proposal builds on the series of comprehensive
reform plans that AHIP's Board of Directors began releasing
in November 2006. Further reform proposals addressing the
affordability, accessibility and quality of health care are
anticipated in the weeks ahead.
Summary of AHIP's Proposal to Guarantee Coverage for Pre-existing
Conditions and Promote Affordability in the Individual Insurance
Market:
Guarantee-issue coverage with no pre-existing condition
exclusions;
Establish an individual coverage requirement with an
insurance coverage verification system, an automatic
enrollment process and effective enforcement of the
requirement that all individuals purchase and maintain
coverage;
Promote affordability by: providing refundable, advanceable
tax credits for moderate-income individuals and working
families; and promoting tax equity whether coverage is
obtained through an employer or the individual market; and
Ensure premium stability for those with existing coverage
through a broadly funded reimbursement mechanism that spreads
costs for the highest-risk individuals.
Background on the Individual Market and Guarantee Issue
AHIP's survey of the individual market shows that
individually purchased health insurance is far more
affordable and accessible than is widely known. The survey
found that 9 out of 10 applicants undergoing medical
underwriting were offered coverage. The plans commonly
purchased by consumers provided substantial financial
protection and a wide range of benefits, including coverage
for behavioral health, prescription drugs and preventive
services.
Some individuals are unable to purchase individual health
insurance coverage in the private market because of their
health status. One approach taken by states to address this
issue has been the enactment of guarantee issue legislation
requiring health plans to offer coverage to all applicants.
These well-intentioned reforms have often resulted in severe
unintended consequences, including significantly higher costs
for all policyholders.
A report by Milliman, Inc. found that enactment of
guarantee issue laws in the absence of requirement that
individuals purchase coverage may incentivize people to defer
seeking coverage until they have health problems--a situation
which unfairly penalizes those who are currently insured.
According to the report, states that implemented these laws
saw a rise in insurance premiums, a reduction of individual
insurance enrollment and no significant decrease in the
number of uninsured. To learn more about the individual
market survey and the Milliman report, please visit
www.ahip.org.
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