[Congressional Record Volume 160, Number 17 (Wednesday, January 29, 2014)]
[Senate]
[Pages S562-S565]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. BARRASSO. Madam President, as someone who has practiced medicine 
in Wyoming for about a quarter of a century, and as medical director of 
the Wyoming health fairs to bring low-cost blood screenings to people 
all around Wyoming, I have been very involved in the health care issue 
and in actually helping to provide health care for people.
  It was ironic last night during the State of the Union Address to 
listen to the President talk about health care as if he had some 
understanding of how it all worked. It became evident to me, sadly, 
that the President put forth some bold proposals and then came out with 
a 2,700-page bill that I think many people who voted for never read, 
didn't understand, didn't know the harm it was going to do to American 
families, and then the President last night was talking about it in the 
State of the Union Address in ways that it is actually helping people. 
It may be helping some, but it is hurting many more. It is not just the 
Web site. The Web site is the tip of the iceberg. There is huge damage 
being done to families.
  Today I have a letter with me that just came in from a family in 
Wyoming to talk about how much this is harming this person's individual 
family. A man from Upton, WY, a small community, somebody who tries to 
get up every day, go to work, take care of his family, put food on the 
table. Yet his whole family is being harmed by this law the President 
has put into place, forced down the throats of the American people on a 
party-line vote.
  So let me start with the letter:

       Opening up my insurance letter today has lead me to write 
     you this letter. I'm usually the type of person that just 
     keeps trudging along--

  I think all of us have constituents who are like this--

     and take things as they come. I'm a longtime resident of this 
     beautiful state and graduated from the University of 
     Wyoming-- as so many people have done--
       I'm married and have 4 young kids from ages 9 to 3.

  He has four young kids ages 9 to 3. He said:

       We're a healthy and active family. Non-smokers. Go to 
     doctors for emergency care only. Go to the chiropractor and 
     dentist regularly. I have a high deductible insurance plan.

  It is a $10,000 deductible, which is high. He says he is paying $584 
a month for that. I wish the President of the United States would get 
letters such as this and read them and understand the impact he is 
having on people's lives and how much his plan is hurting American 
families.
  Justin writes:

       Now, due to the current healthcare climate, I'm going to 
     have to pay $945 a month.

  So he will be paying a lot more. He was paying $584, now $945 a 
month. He says:

       And they conveniently raised my deductible to $11,000.

  He had a $10,000 deductible, which is high. They have raised that, 
and raised his premiums from $584 to $945 a month. He says:

       How does Obama expect the middle class to stretch their 
     budgets every month to get healthcare coverage?

  That is what middle-class Americans want to know. How does this 
President expect the middle class to stretch their budgets every month 
to get health care coverage?
  He goes on:

       How can we get rid of ObamaCare?

  That is a question I was asked repeatedly around the State of Wyoming 
last week.
  This gentleman goes on to say:

       Every chance you get, please vote to repeal ObamaCare.

  The President last night ridiculed people such as Justin--ridiculed 
him--saying, Well, sure, vote over and over and over. This man from 
Wyoming is saying: Every chance you get, vote to repeal ObamaCare.
  He also said:

       Every chance you get please help the middle class.

  Every chance you get, please help the middle class. We are not seeing 
that from this President, this administration, and those who supported 
these policies which have hurt the middle class.
  He said:

       Thank you and I appreciate your leadership for the state of 
     Wyoming. Now I'll go back to working hard to pay my insurance 
     bill, (and probably some for the people that Obama is trying 
     to help.)

  Finally he says:

       Obama stated to the public that our premiums were not going 
     to rise. Thanks for listening to me rant.

  I don't consider what we are hearing from my friend Justin from 
Upton, WY, a rant. I hear it as a cry for help due to a health care law 
the President and the Democrats forced down the throats of the American 
people against their will. Many people who voted for it never read it, 
didn't understand it, and I really have strong doubts the President 
himself understands the health care law, what is in it, and the damage 
it continues to do to middle-class Americans and families all across 
this country.
  Thank you, Madam President. I yield the floor.
  The PRESIDING OFFICER. The Senator from Missouri.
  Mr. BLUNT. Madam President, last night in the State of the Union 
Message, the President looked at the Congress again and said: You need 
to be for my plan unless you have another plan, and suggested once 
again that we have never had other plans. I don't know in a handful of 
minutes that I can do justice to the other plans out there, but I can 
tell my colleagues there were other alternatives that were filed in 
legislation and that were debated in 2009. Clearly, today's 
experiences, one of which has been shared by a family from Wyoming, 
would be different experiences if we had looked at those other plans.
  Let me very quickly respond to the President when he asked, What are 
your ideas, and remind him again of what the ideas were that were 
proposed by people who thought we had the best health care system in 
the world but thought it could be improved. Some thought there were 
people who did not have the access they needed and there were rules 
that could be changed to make a difference. Here is what some of them 
are.
  One idea is to allow small business health plans. Most people get 
their insurance at work and they like what they have. Eighty-five 
percent of the people who had insurance last year got insurance at work 
and well over 90 percent of them thought what they had at work was good 
and met their needs. For years we have talked about ways to try to 
expand that so people, whether their association is the farm bureau or 
some other group they are associated with, where they can, through 
small businesses or associated health plans, get their health care plan 
that way, so they too become members of a bigger group that competes 
for health insurance through that group.
  No. 2, expand coverage for young adults. The President said last 
night that 3 million of the people have been added of the--he thought 
maybe 12 million; I haven't seen that figure yet. A few days ago 
Senator Reid said it was 9 million people, and a third of the people 
who had been added did so by staying on their parent's health care a 
little bit longer. That was the most uninsured group. The only person 
who filed that legislation in the House as the principal sponsor was 
me--to let people stay on their insurance. We said age 25, not 26. So I 
suppose the President added that 1 year to it, or whoever wrote the 
Affordable Health Care Act. But if that is right--I got the bill out 
the other day here on the floor--it was 3 pages and 4 lines. If 3 pages 
have

[[Page S563]]

solved 25 to 33 percent of the problem, I guess maybe our side should 
have come up with 12 pages of legislation and solved the whole problem. 
This was not something that took 2,600 pages that nobody understood.
  If we had that debate today, it would be a much better debate, 
because people have begun to understand how dangerous it is to deal 
with the health care of individuals and families.
  Medical liability reform makes a big difference in how costs and 
insurance are impacted and how health care is done.
  Increasing insurance flexibility lets people buy insurance across 
State lines. This is something that was out there as a significant idea 
that didn't minimize the choices people have, it maximized the places 
people could look to find out what their family needed.
  As to preexisting conditions, we had a system that was dealing with 
that pretty effectively if a person could get into it--the State high-
risk pools. We talked about ways to expand those. Why would that be 
better than where we are now? If an insurance company, a government--if 
in some way an entity is making that high-risk pool better--they know 
they are dealing with individuals who had a preexisting condition. It 
is not necessary to try to structure everybody else's costs so they pay 
a lot more just in case people with a preexisting condition become an 
unreasonable part of an insurance group that an entity is trying to 
provide for. These programs have been closed as of December 31 in most 
States. And in every case we have been contacted on, people who had 
preexisting conditions, were in a high-risk pool, are paying more for 
insurance with less coverage and, in many cases, can't get their 
doctor. And these are people who had a preexisting condition so who 
their doctor was mattered to them. In many cases, they no longer can 
have that doctor.
  Clearly, I don't have time today to respond fully to the President. 
Whether it is high-risk pools that work better, wellness programs, 
preventing insurance companies from being able to cancel policies--that 
didn't require millions of taxpayer dollars; it just requires a rule 
that said they can't cancel a policy because somebody gets sick. The 
same as limits on coverage.
  As for encouraging health savings accounts, the Affordable Care Act 
eliminates one of the real tools that was working for families.
  As far as more transparency, how do health care providers do and how 
much do they charge to do it? What are their results and what are their 
costs?
  And income tax treatment so that everybody who buys insurance buys 
that with dollars that are treated the same way. If the biggest company 
in America can buy an insurance policy and have it nontaxed, have it 
tax deductible, so should the individual who buys insurance on their 
own.
  There are all kinds of alternatives out there that would work better 
that are not nearly as complicated and not nearly as expensive. The 
President needs to at least understand there are plenty of competing 
ideas. His ideas are not the only ideas that will work to make the 
system work better.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arkansas.
  Mr. BOOZMAN. Madam President, surprisingly, the President didn't talk 
much about ObamaCare, his signature achievement. The people of 
Arkansas, the people of America certainly are talking a great deal 
about it and they are writing a great deal about it also. The reason is 
because they are so concerned that health care has become an absolute 
mess.
  The President talked about a single mom who was able to resolve the 
problem of her preexisting conditions. I think we all agree that is 
something that was desperately needed. I am an optometrist, an eye 
doctor, and very much aware of the situations people have been put in, 
in the past. Although the reality is we can fix this problem--problems 
such as this--without creating a massive bureaucracy, without creating 
a situation where we have thousands of pages of regulations, and the 
reality is the unintended consequences of the situation we are in now 
with ObamaCare is that we have made it unaffordable. We have made it 
such that millions of Americans simply cannot afford the health 
insurance they are being offered.
  Let me talk about a few people who have written to me to talk about 
their situation. Jack from Springdale writes:

       I just found out recently from my current health insurance 
     provider that my current health insurance policy will be 
     discontinued effective the first of next year, and a 
     replacement policy will be approximately double which will be 
     around $1,200 per month. My question is, is this what 
     ObamaCare was supposed to do? And if not, what can be done 
     about it?

  Leonard and JoAnne write:

       This letter comes to you to ask for your needed support to 
     defeat/defund the Affordable Care Act in any way possible.
       We recently received notification from Health Advantage of 
     Arkansas that our 2014 monthly premiums increased $173.70 for 
     a total of $1,360.06. Our out of pocket max increased from 
     $3,000 to $5,000, the primary care physician co-pay increased 
     from $25 to $35 and the specialist co-pay increased from $35 
     to $70. If either of us has to visit the ER, that co-pay 
     increased from $100 to $250 dollars. The drug co-pay also 
     increased. We are insulted to have to pay for benefits such 
     as maternity, pediatric dental, and drug rehab which we have 
     no need for since we are in our 60s and do not use drugs or 
     alcohol. Health Advantage of Arkansas explained that these 
     changes to our policy and increased costs were due to 
     compliance to ACA.
       We have supported you in the past and would like to know 
     what your plan is to relieve Arkansans and other Americans 
     from these additional financial burdens imposed upon us by 
     the Affordable Care Act.

  Mary in Little Rock writes that she received a notice that her Medi-
Pak Advantage plan was canceled at the end of last year. She explains:

       I had no idea that Obamacare was going to also affect 
     Medicare. Now, to receive comparable coverage for 2014, I 
     will have to pay an additional $500+ in premiums. This 
     additional cost will definitely place an unfair burden on my 
     finances. What are you & the Senate going to do to correct 
     this situation?

  I think Mary asks a very fair question. What are we going to do to 
correct her situation and the situation of so many others? I think the 
answer is we need to repeal ObamaCare. We need to put in place a system 
that does take care of the problems we have but without the 
bureaucracy, without the tremendous expense, and make health care 
affordable for all Americans.
  I yield back.
  The PRESIDING OFFICER (Mr. Kaine). The Senator from South Dakota.
  Mr. THUNE. Mr. President, I appreciate the comments of my colleague 
from Arkansas and prior to him those of my colleagues from Missouri and 
Wyoming--we will be hearing in a minute from my colleague from 
Nebraska--all of whom are expressing sentiments that are conveyed to 
them by their constituents in their individual States about the very 
real and very personal impacts ObamaCare is having on them.
  Last night, in the President's State of the Union speech, he sort of 
glanced over that issue. It is kind of the equivalent of a driveby. He 
sort of acknowledged the law. He said it is not going to change and if 
Republicans have better ideas, then come forward with them.
  We just heard the Senator from Missouri, Mr. Blunt, list 10 or 12 
things that we think could be done that would be dramatically different 
and would be a dramatic improvement in a very different approach from 
what is included in ObamaCare, which is a heavyhanded, government-
driven solution to health care, which essentially puts the health care 
in this country, which is one-sixth of our economy, under political 
control here in Washington, DC.
  As a consequence, what we are seeing out there are higher premiums, 
higher out-of-pocket costs in the form of deductibles and copays, 
canceled coverages, and fewer choices when it comes to doctors and 
hospitals. That has been the real-world impact of the passage of 
ObamaCare. The President said when he was running for office he was 
going to reduce health care costs by $2,500 per family. We now know 
they have gone up, since he has taken office, by about $2,500 per 
family, and they continue to go up all the time.
  We hear consistently from our constituents in our individual States, 
and those stories that are being shared this morning are good examples 
again of the real-world impact of this law and why it is so important 
we go back, start over, and do this the right way, with reforms that 
actually address the issue of creating more competition, more choice 
for individuals, allowing market forces in the world of health care as 
opposed to having this overreaching government approach, which clearly 
has not worked.

[[Page S564]]

  The one thing I and many of us got up and talked about when ObamaCare 
was being debated was the fact that there was not anything in there 
that constrained utilization or that put downward pressure on costs. So 
costs keep going up. That keeps getting passed on. Taxes keep going up. 
They keep getting passed on. What does that mean? For middle-class 
families it means higher premiums and higher deductibles, higher 
copays, and in many cases fewer jobs because that is the impact it is 
having on the economy, and it worsens the very thing the President says 
he is most concerned about; that is, the issue of income inequality. 
Because when you are driving up the cost for consumers in their daily 
lives--and I would say health care for most people is a very 
significant cost and I would add energy to that--but those are a couple 
of things where we have seen policies that have made it more expensive 
for middle-class Americans to make ends meet. Health care is certainly 
an example of that.
  I would like to share a couple examples from my State. Of course, as 
has been mentioned earlier by my colleagues, we hear these stories in 
the form of emails, letters, phone calls coming into our offices. Lest 
anybody think what we do is done in a vacuum, these are not abstract 
issues. These are very real personal experiences that people across 
this country are having.
  This is a letter from a constituent in Harrisburg, SD, which is a 
growing community near Sioux Falls, SD. It is a growing, vibrant 
community. The letter says:

       My wife and I have been fortunate to have become small 
     business owners and entrepreneurs. So far, we have been 
     successful of living the American dream for the last 3 years 
     and have seen great success at what we do.
       Unfortunately, with ObamaCare, we are needing to make 
     choices I never thought we would have to make.
       Based upon the rates for health insurance, we would be 
     paying approximately $800 out of pocket per month. 
     Essentially, we are thrown in to make an additional house 
     payment per month, or face a penalty at the end of the year 
     and not have health insurance.

  This constituent goes on to say:

       Needless to say, I am very disappointed and upset right 
     now. I feel I am being taken advantage of because I am a 
     small business owner and wanted to live the ``American 
     Dream.''

  This next statement is from another constituent who is from Rapid 
City, and this is in the form of a letter regarding the President's 
broken promises. He says:

       Bottom line is the president lied to us. He said if we like 
     our policy we can keep it. He said we would be saving around 
     $2,500 a year. Wrong on both Accounts.

  He then concludes:

       When our policy expires it will be cancelled and we will 
     have to pay almost triple what we're paying now.

  Those are examples from my State of South Dakota, and my colleague 
from Arkansas shared some examples from his State. I know my colleague, 
my neighbor from Nebraska, Senator Johanns, hears many of those same 
stories coming from his State. He represents people very much like 
those I represent in South Dakota who in many cases make their living 
the same way and are experiencing the economic consequences of a bad 
policy, a failed policy, a bad law that was rushed through here, and 
they now--the American people--unfortunately, are experiencing the 
adverse impacts of that in their own personal economic lives and, in a 
broader sense, on our economy nationally. Higher costs, canceled 
coverages, fewer choices in the form of doctors and hospitals, and 
fewer jobs for American workers whom we want to get back to work, that 
is the real-world experience.
  There is a better way. The Senator from Missouri talked about many of 
those ideas. I hope the President would work with us to repeal this bad 
law and start over in a way that makes sense for the American people 
and for our health care economy in this country.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Nebraska.
  Mr. JOHANNS. Mr. President, I wish to express my appreciation to 
Senator Boozman and Senator Thune for being down here this morning to 
talk about an issue that is extremely important and an issue we 
certainly are hearing a lot about in our Senate offices and hearing a 
lot about when we travel back to our home States; that is, the whole 
issue of ObamaCare.
  The President, of course, mentioned this in his State of the Union 
last night, and I think he truly hopes he can change the subject here. 
But the reality is he cannot because so many people are being hurt by 
this legislation.
  Over 4 years ago, when the health care law was being debated, there 
was one concern that dominated the discussion when we talked to our 
constituents back home. That concern was cost. They talked about the 
rising cost of health care and wanted to see what we thought in terms 
of this law's impact on that. But since this year's rates were posted, 
it has become absolutely obvious that this law did not hold true to its 
promise to reduce costs.
  Our Nebraska insurance director was asked to comment about this when 
the rates were coming out. He said: ``Basically, the rates are going 
up.'' No truer words could have been spoken.
  A CNBC headline read: ``Consumers say they're shelling out more for 
health insurance.''
  But it is not just those headlines or the opinion of our director of 
insurance. It is what is happening to real people in their lives.
  A father from just outside Omaha, NE, wrote a letter to me, and he 
said this: In 2013, his family's flexible spending account was cut from 
$5,000 a year to $2,500 a year as a result of the health care law.
  If there was one thing people appreciated, it was the flexible 
spending account. Why you would want to cut this does not make any 
sense, but that is what the health care law did to him. He goes on to 
say that his wife's employer-sponsored insurance premiums have 
increased by an incredible 50 percent and their deductible and maximum 
out-of-pocket costs--well, they have not gone down--have gone up too, 
and these increases have been the worst they have seen in 14 years of 
employment, all due to the health care law.
  His sons who are struggling to pay for college had their work hours 
restricted to 28 hours a week. Why? Because of the law. So as a result 
they are applying for more financial aid, they are going further in 
debt, and even taking on part-time jobs so they can stay in school.
  But that is not the only person who has written to me. A Nebraskan 
from the south central part of the State reports this: He spent 27 
hours trying to enroll on healthcare.gov only to find out he could not 
afford coverage, even with a premium subsidy. Under the best option, 
his deductible would increase by $7,000.
  To a middle-class family, $7,000 out of pocket is bankruptcy. They do 
not have it. It is not like that money is going to fall out of the sky.
  A young traveling nurse from northeastern Nebraska also faced sticker 
shock and reached out to me. Under a new plan, her premium more than 
doubled and her deductible went from $3,500 to $6,500. She wrote to me 
and said: ``This is not affordable when I have student loans to pay for 
and I'm trying to support myself.''
  It is possible some Nebraskans have temporarily renewed their old 
policy under the delay that was announced by the President, but that 
just means they have delayed the pain until next year, and we will see 
more of these stories of skyrocketing costs and deductibles.
  Let's face it. Americans did not get what they were promised when the 
law was passed. They expected a bill that would deliver on the promises 
and address the cost of health care. Instead, they are stuck with the 
very real consequences of a poorly crafted policy.
  I think it is time we show Americans we can do better. I believe the 
place to start is to repeal the law and start working on step-by-step 
solutions that draw down health care costs for American families.
  Those of us on the floor today are ready to tackle the challenge. I 
hope we find willing partners.
  I yield the floor, and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. GILLIBRAND. Mr. President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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