[Congressional Record Volume 159, Number 161 (Wednesday, November 13, 2013)]
[Senate]
[Pages S7969-S7970]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          AFFORDABLE CARE ACT

  Mr. BLUNT. It has been less than 6 weeks since the President's health 
care initiative, the Affordable Care Act, was launched. The Web site is 
still not working, but the Web site will work. Actually, the Web site 
will be the easiest thing, in my view, that the administration will 
deal with as they try to solve the problems created by the act itself 
and, frankly, then the problems that were created by the Web site not 
working when we started.
  What we see happening already in these 6 weeks is that families are 
losing their current health care coverage, and certainly the cost, in 
example after example from my State of Missouri and across the country, 
appears to be going up at substantial levels for many families. A few 
families are lucky enough that they don't have much additional cost but 
not very many. A lot of families are simply losing the coverage they 
have had even though the President said, as we all have been reminded 
over and over in recent days: If you like your health care plan, you 
can keep your health care plan.
  Apparently, there are a whole lot of caveats on that that weren't 
said at the time, because people aren't able to keep their health care 
plan. The Associated Press reported that at least 3.5 million people 
have received cancellation notices. I heard somebody at the White House 
the other day say: These individual policies, that is only about 5 
percent of all the people in the country. Five percent of all of the 
people in the country are millions and millions of people. Even if 
there weren't millions of people, if someone is one of the 3.5 million 
families who were recently told their health care policy was 
cancelled--100 percent of their health care policies were cancelled 
because they don't have one right now--or at least they were told they 
won't have one sometime between now and the end of the year.
  As millions of people are losing their plans, we find out that only a 
few thousand people are signed up. Reports apparently show that fewer 
than 50,000 people have been able to successfully get through this 
system in 6 weeks, a period where the estimate was 500,000 people. So 
far we have 50,000 people signing up, not 500,000 people. We have 
millions of people losing their plans, even though everybody was told 
that if they like their plan, they will be able to keep their plan.
  It is estimated now that 7 million people were expected to get 
coverage by the end of March. Nobody, any longer, thinks that is a 
number that will come anywhere close to being achieved.
  The American people, obviously, would like the President to figure 
out how to live up to the promise that people can keep the health care 
they have if they like it. A lot of people are weighing in.
  President Clinton, in the last day or so, says we ought to figure out 
a way to keep the promise. This is not a real reach. This was not a 
promise made only one time and accidentally stated, this was a promise 
stated over and over again: If you like your health care plan, you can 
keep it. If you like your doctor, you can keep your doctor.
  We are finding that is not true. Whether it is President Clinton who 
said we should figure out how to keep that promise, or there are all 
kinds of bills being filed in both the House and the Senate that would 
keep the promise, what I think we are going to find out is there are 
many promises in the Affordable Care Act that aren't going to be kept.
  We already know this has a workplace impact that is not good. People 
are going from full time to part time. People are trying to keep their 
employee numbers under 50 so they don't have to comply with the law. I 
have heard from many Missourians who have seen their hours reduced, 
seen their health care premiums rise, seen their options of insurance 
limited and their policies being cancelled. They deserve to have the 
people who made this pledge now keep this pledge.
  Congressional Democrats voted for the law. And there are very few 
laws one could say congressional Democrats voted for the law. This is a 
law that not a single Republican in the House or the Senate supported.
  There were many alternatives available. High-risk pools would work 
better, medical liability reform, expanding the marketplace where one 
could buy across State lines, more reporting by healthcare providers of 
what they charge and what their results are.
  The idea that there were no other options, which is widely repeated--
that the people who don't want to follow the Affordable Care Act don't 
want to do anything--is simply not true. When I was a Member of the 
House of Representatives, I filed a handful of bills, none of which 
were more than 75 pages long, that would deal with these rifleshot 
things that would have made the best health care system in the world 
better. It wasn't perfect, but it was the best health care system in 
the world, and I think we are in danger of losing that.
  The President promised: If you like your doctor, you can keep your 
doctor. Over and over again, that is not the case. The largest insurer 
on the Missouri exchange, on the exchange that Missouri voters have 
access to, doesn't include the largest hospital system. That means 
thousands of patients won't be able to see the doctors or to go to the 
13 hospitals of the largest health care system from the company that 
was their likely provider. This was the largest insurer--and as of this 
moment, the largest insurer in our State, the largest health care 
system--not part of their plan. Your insurance company, hospital, long-
time doctor, all should be your choice, not the choice of some 
government-dictated health care plan. With only one other insurer 
selling policies in the region where this big hospital system is, 
people aren't going to be able to go there.
  Many States have this same problem. Many States have options that 
don't include many of their hospitals or many of their health care 
providers.
  People are beginning to look at this and not only be concerned about 
a violated pledge, but being concerned about somebody besides them 
interfering with a long-term relationship with the hospital people go 
to and the doctor they see. Patients across the country are seeing and 
are likely to continue to see narrower and narrower networks available 
to them as insurers will try to keep costs down.
  With all of the new mandates in the law, one of the things they can 
control is they can negotiate with the people who would be available to 
see patients under their plan. That is obviously what has happened.
  Smaller networks can require patients to travel farther. People are 
driving by the doctor's office that they went to for years to get to 
the doctor they now have to go to. People are passing by the hospital 
that their family may have gone to for generations to get to the 
hospital that now is the only hospital available in their area, 
available under the exchange. This is going to become the routine for 
Americans who aren't going to be able to keep the insurance they like. 
They are not going to be able to keep the doctor they like, and in many 
cases they won't be able to go to the hospital they like.
  Last week I told stories of several Missourians who had preexisting 
conditions and are going to lose those policies when the Missouri high-
risk pool goes out of existence.
  Another thing we suggested in 2009 was to look for ways to expand the 
high-risk pools and make them work even better. They were working 
pretty well. The problem was there was always a waiting list to get 
into the high-risk pool. This was a way to deal with preexisting 
conditions. In a State such as ours where 4,300 people are in the high-
risk pool, they pay about 135 percent of the normal premium. That is a 
little more than the normal premium, but they are getting insurance 
after they got sick. This is a high-risk

[[Page S7970]]

pool where that has to work, 135 percent. For somebody who didn't have 
insurance until they got sick or lost their insurance after they got 
sick, that was probably a whole lot better than they are going to do 
right now. They are finding out it is a whole lot better than they are 
going to do right now.
  One of the stories we received this week was from Pam in Oronogo, MO, 
just outside of Joplin. Pam says her oldest son Aaron was born with a 
medical condition where there was a buildup of fluid inside his skull. 
He had his first shunt surgery at age 18 months. Her family has a 
family business and held onto their insurance through the business as 
long as they could, because they knew that no one would insure Aaron if 
they lost their insurance. That is obviously not a reason we would want 
to see perpetuated.
  Aaron, however, was ready to go to the high-risk pool. After 10 
years, their premiums had increased to $2,000 a month with a $10,000 
deductible. They were able to get Aaron in the high-risk pool and they 
were reasonably comfortable with that.
  With the elimination of the high-risk pool--all of which close 
December 31 in every State in the country--Pam and her family have to 
go to the exchange for Aaron. The exchange has to take Aaron, because 
he can get into the exchange.
  The PRESIDING OFFICER. The time of the Senator has expired.
  Mr. BLUNT. I ask unanimous consent for 2 additional minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BLUNT. He can get into the exchange even if he had a preexisting 
condition. What they found in the exchange is Aaron can no longer use 
his neurosurgeon from Kansas City, the surgeon he has used for years 
now. They can't buy a catastrophic policy that would allow them to have 
some choice and pay some upfront costs on their own so they could have 
the doctor they are comfortable with. This is where they are. The 
insurance they had has gone away. The insurance they have doesn't allow 
them to see the doctor this young man has seen for years with a 
condition he has had his whole life.
  The President also promised that premiums would decrease, and that is 
clearly not the case.
  I look forward to Missourians continuing to let us know the 
challenges they are having. I look forward to being able to share those 
on the floor of the Senate in the next few weeks.
  One of my constituents from Independence discovered when his wife 
came home, their policy which has been costing $500 a month now is 
going to cost $1,100 a month. She is the office manager of an office 
with about 20 employees. Their insurance more than doubled.
  Unfortunately, these aren't the only cases I could talk about today. 
They are not nearly as limited as we would hope they would be. People 
are finding out that the Affordable Care Act that wasn't good for the 
workplace is now turning out to be not very good for health care.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from North Carolina.

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