[Congressional Record Volume 159, Number 155 (Monday, November 4, 2013)]
[Senate]
[Pages S7797-S7798]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. LANDRIEU (for herself and Mr. Manchin):
  S. 1642. A bill to permit the continuation of certain health plans; 
to the Committee on Finance.
  Ms. LANDRIEU. Mr. President, I wish to speak about a bill I plan to 
introduce in a few moments, and hopefully we will have a chance or an 
opportunity in the future to debate it because it is a very important 
fix, if you will, to the Affordable Care Act.
  We debated this bill for literally years--months in committee for 
hours and hours, in daylight and during the evening sessions. There 
were hundreds of amendments. This bill was built with Democratic input 
and support and Republican input. The Republicans did not vote for the 
bill, but they most certainly had a tremendous amount of impact in the 
amendment process.
  Building a new health care system for this Nation has been very 
difficult, but it holds a great deal of promise. The Affordable Care 
Act--and the easiest way to explain it--was somewhere between what some 
people on the left wanted, which was a government-run system, something 
like Medicare for all--it is appealing, but it is very expensive. We 
couldn't figure out a cost-effective way to provide that. Members on 
the right, the more conservative-leaning in this body, wanted to 
provide savings accounts. This works beautifully for people who have 
money to save in the account, but people who live paycheck to paycheck 
and have no money to save would never get any account to be able to 
provide for their health insurance.
  Between those two bookends, we debated for a long time about how to 
provide a market-based approach to insurance. No nation in the world 
has attempted this. This is a big effort, but it is an important effort 
because we are a developed nation. We need to have a healthy workforce. 
It is about as simple as that. We can't be No. 1 in the world and we 
can't be the strongest economic power in the world if our people are 
sick and weak. It is as simple as that. We can't be the strongest 
economic power in the world if our health care system is sapping so 
much money out of our economic power--19 percent of the GDP, when Japan 
is 8 percent. We can't expect to beat Japan in economics if we are 
paying almost twice as much for health care and getting less results.
  We had to change. We did, and we built a market-based approach, 
contrary to what all of the opponents of the Affordable Care Act say. 
We built a market-based approach that basically said that if people are 
over 65, they will be on Medicare. We are continuing to reform and 
strengthen Medicare. There are some very good parts of it, and then 
there are some weaker parts or difficult parts that need to be 
corrected. Over time we will continue to streamline, save money, 
provide better service, more choice, et cetera.
  People who are among the poorest members of our country--133 percent 
of poverty, which is an income of about $15,000 or less--potentially 
may not be able to find a good-paying full-time job or perhaps didn't 
receive the education others received, perhaps have some disability, 
they would go on Medicaid. Then everyone in between the lowest income 
and under the age of 65 is in a private health care system, which is a 
market-based system, with competition driving prices down.
  The idea would be that there would be 20, 30, 40 health care plans 
offered in every State. People could choose what they want with a 
minimum bronze, silver, or gold plan with many choices. That is the 
promise; that is the hope; that is the idea. The great promise of this 
is that if someone has cancer, they can't be dropped. If they have 
diabetes, they can't be turned away. Everyone is covered, the risk is 
spread, the price comes down, and the free market operates. We would 
never know that based upon the criticism we hear on television and 
radio all day long, but this is the truth.
  One of the important components of that bill that many of us talked 
about was the fact that if someone had individual insurance on the 
market, they could keep it. What is happening now, unfortunately, 
because of the grandfather provision in the Affordable Care Act, in my 
view--this may not be shared by everyone on the floor--it was not 
written as tightly as it should have been, as clearly as it should have 
been. The bill I am introducing today, Keeping the Affordable Care Act 
Promise Act, will clarify this grandfather clause in the Affordable 
Care Act so that it will clearly say that if a person has an insurance 
plan they like, if it is what they want and can afford, they can keep 
it. This bill, if it passes, will help anywhere from 5 to 7 million 
people who are getting notices in the mail every day like the one I 
will read into the Record, which was sent to someone in my State.

       Thank you for your support of Vantage Health Plan, Inc. 
     ("Vantage'') over recent years. It has been our pleasure to 
     serve you and we hope that you have been satisfied as a 
     Vantage member.
       In light of recent changes in the health insurance 
     industry, Vantage will be discontinuing our offering of 
     Grandfathered Individual plans, effective January 4, 2014. 
     This discontinuance will affect your policy.
       Vantage is pleased to announce the availability of several 
     new individual products in 2014:
       Beginning in January 2014, you will have the option to 
     enroll into a new plan through the Health Insurance 
     Marketplace (or the Exchange). Members enrolling into 
     Individual plans through the Marketplace may be eligible for 
     premium and/or cost sharing subsidies.

  This is because everyone in Louisiana with a family income of up to 
$90,000 a year will have some sort of premium support, which will be a 
great help to many of our middle-class families.
  Continuing:


[[Page S7798]]


       Many of the Marketplace plans will provide you with more 
     generous coverage than your current Grandfathered Individual 
     plan. We invite you to visit Vantage online at 
     www.VantageHealthPlan.com/marketplace to review our Exchange 
     plan offerings. You may also enroll online at 
     www.Healthcare.gov, by calling (800) 318-2596 or by 
     contacting your agent or broker.
       In addition to the Exchange plan offerings, Vantage will 
     have several new plan offerings available outside of the 
     Exchange for 2014. These plans are similar to your current 
     Freedom or High Deductible plan. We will have more 
     information on those plan options later this Fall.

  This is the letter thousands of people are receiving. This letter 
should have never gone out. We said to people that if they have 
insurance they like, they can keep it. We didn't say that if they have 
insurance they like that doesn't meet the standards or that meets the 
minimum standards, they can keep it. We said and the President said 
over and over that if people have insurance and they like the insurance 
they have, they can keep it. That is my bill. That is the single focus 
of my bill. It is not to undermine the Affordable Care Act; it is to 
strengthen it and to keep our promise to the millions of Americans to 
whom we said if they have insurance, they can keep what they have. If 
they don't, there is a new marketplace where they and their families 
can go and choose among a variety of different plans.
  Depending on their income, they may have support from their community 
or from the government. If someone is extremely poor, we can provide 
options for them through Medicaid. It is not as desirable as through 
private insurance, but many Governors, including some Republican 
Governors, are being very creative with their Medicaid plans and 
actually changing them into more of a private-like insurance model. 
There is great flexibility in how Governors who have good hearts and 
good intentions are using their Medicaid dollars wisely.
  Having said that, having reread the grandfather clause, having looked 
at it very closely, I have determined that this is the best course to 
introduce this bill, which I will do later this evening to actually 
file it. Again, it has two simple directives:
  No. 1, all insurance companies shall continue to offer grandfather 
plans that were in effect prior to a certain date.
  No. 2, every insurance company that provided those grandfather plans 
has to explain to those policyholders how their current plan falls 
short of the new standard on the market and what might be available to 
them that is better, but they are not forced to buy it.
  So I hope we can debate this. Unlike many on the other side who want 
to tear the act down and repeal it, to defund it--they even took the 
whole Federal Government hostage and the whole economy of the United 
States hostage because of it--or that is what they tried to do. They 
failed, thank goodness, and the hostages have been released. The 
government is back up and operating. There are some of us who are 
sincere about supporting the concepts of this bill, the promise of this 
bill, which is extraordinary and historic. We recognize there are some 
pieces of it that need to be fixed or tightened or tweaked to make sure 
it is going to work in the future as we have said.
  Again, that is simply what my bill does. I am happy to introduce it. 
I have one cosponsor, Senator Manchin of West Virginia, but many others 
have expressed their interest in working with me, and I look forward to 
bringing this before the committee for full debate and hopefully to the 
Senate floor in some way in the near future for debate and hopefully 
for passage.
                                 ______