[Congressional Record Volume 160, Number 32 (Wednesday, February 26, 2014)]
[Senate]
[Pages S1141-S1144]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. MURPHY. Madam President, yesterday we received news that 4 
million people have now signed up in private health care exchanges all 
across the country. In addition, it was released that about 12 million 
people have called the call centers in January alone, and 1.1 million 
people signed up to receive health care through the Affordable Care Act 
during that time. Young enrollment--the group of individuals for which 
there has always been a question as to whether they are going to sign 
up for these exchanges--grew by 65 percent.
  It is time for this body to recognize the Affordable Care Act is 
working. It is working for people who have been desperate to get 
insurance. It is working for people who have been getting the short end 
of the stick from insurance companies, and it is working for millions 
of seniors all across this country who have been paying far too much 
for prescription drug costs and for preventive health care.
  We have known this from the very beginning in Connecticut. Despite 
the hiccups over enrollment in the fall period, States such as 
Connecticut that had made a commitment to making this law work, rather 
than undermining it, have seen the success from day one. Connecticut, 
at the outset, said that we were going to try to enroll between October 
1 and March 31 about 80,000 people. That was our goal. We just 
announced in Connecticut--a State that is working to implement the law, 
not undermine the law--that we didn't just hit 80,000, we didn't just 
hit 100,000, but we have enrolled 126,000 Connecticut residents in our 
health care exchanges and in Medicaid. Our projection is that we are 
going to enroll 150,000 people by March 31. That is nearly double our 
initial estimate. Last week, traffic on Connecticut's Web site rose 31 
percent, and the daily enrollments rose by 67 percent.
  The stories just keep on coming into our office about the lives that 
are being changed as people, for the first time in their lives, get 
access to affordable health care. People such as Susie Clayton, who has 
been dealing with a cancer diagnosis for over a decade--a crippling, 
preexisting condition that for most of her adult life has kept her out 
of the ranks of the insured. I have known Susie for probably two 
decades. Almost every single conversation I have had with Susie over 
those 20 years has been about her daily struggle to try to deal with 
her illness and her preexisting condition. Every single day, every 
single week, she has thought about whether she is going to be able to 
pay for her health care if she has a reoccurrence of her cancer and 
whether during that time she is going to have a job that provides her 
with insurance.
  Susie had been paying about $1,700 a month at last count for an 
insurance plan she could afford. Her life changed on January 1. She now 
is paying a couple hundred dollars a month in premiums. She finally 
gets to wake up every day not having to worry about whether she is 
going to be able to afford coverage, whether she is going to be able to 
see a doctor to deal with her very difficult diagnosis. With 4 million 
people now enrolled in these exchanges across the country, that story 
can be replicated over and over.
  A bunch of our Republican colleagues have come to the floor over the 
last couple of days--I was in the presiding chair yesterday listening 
to some speeches--regarding some new information about Medicare 
Advantage. Everybody knows by now that included in the health care bill 
was an end to the subsidies given to Medicare Advantage plans. The 
private sector in health care and in other industries always tells us 
they can do things more cheaply than the Federal Government--and a lot 
of times they are right about that--but it was exactly the opposite 
when it came to Medicare Advantage. We were paying private insurance 
companies 13 percent more than it costs the Federal Government to run 
Medicare. This was a source of enormous profit for the insurance 
companies. It didn't make sense to oversubsidize insurance companies to 
run a program the Federal Government itself was running for 13 percent 
less money. So we ended those subsidies, and part of the elimination of 
those subsidies has gone into effect.
  But the story that is being told on the floor today isn't true. The 
fact is that since the Affordable Care Act was

[[Page S1142]]

passed, even as we have been implementing these cuts to these overly 
generous, unjustifiable subsidies to insurance companies, Medicare 
Advantage enrollment has gone up by 30 percent. Thirty percent more 
seniors are now enrolled in Medicare Advantage, even as these cuts have 
been imposed. Premiums are down. Medicare Advantage premiums have been 
reduced by 10 percent.
  Over the course of the debate on the Medicare Advantage cuts, I heard 
Republican after Republican, when I was in the House of 
Representatives, come to the floor and tell us that the sky was going 
to fall when we ended these subsidies to insurance companies. I will be 
honest. A lot of them are in my State of Connecticut. Not only has the 
sky not fallen, it has risen, with 30 percent more seniors in Medicare 
Advantage with 10 percent less in premiums. To the argument I have 
heard on this floor that there will be less choices available to 
seniors because of these cuts going into effect, let's just be honest: 
The average Medicare beneficiary has 18 different Medicare Advantage 
plans to choose from--18 different plans. That is a pretty robust 
market.
  Let me just add that Republicans have voted for these cuts 
themselves. The Ryan budget, which has essentially been the budget 
standard for Republicans in both the House and in the Senate--endorsed 
by hundreds of Republican legislators--the Paul Ryan budget included 
the cuts to Medicare Advantage subsidies because Republicans have 
agreed with Democrats that there is no reason to subsidize insurance 
companies instead of subsidizing beneficiaries.
  So what happened when we decided to stop subsidizing Medicare 
Advantage? Enrollment went up 30 percent. Premiums went down 10 
percent. The average beneficiary still had the choice of 18 different 
plans. But we took that money we saved in padding the pockets of health 
care insurance companies, and we told seniors that when they show up to 
get a preventive health care visit, they are not going to have to pay 
anything out-of-pocket. So since the ACA has been passed, here is how 
much a senior has to pay for their annual checkup: Nothing. So 25 
million people have gotten free preventive care since the Affordable 
Care Act has been passed.
  What else did we do? We decided that this doughnut hole in the 
prescription drug bill, whereby people got coverage up front and then 
they had to pay for a certain amount of drugs themselves and then they 
got catastrophic coverage, didn't make sense. So we eliminated the 
prescription drug doughnut hole. It will be gone by 2020. It has been 
cut by more than half already. Since the implementation of the 
Affordable Care Act, the average senior has saved $1,200 in 
prescription drug costs thanks to the Affordable Care Act.
  So as I listen to my Republican colleagues come to the floor and 
complain about the cuts to Medicare Advantage--cuts, in fact, that many 
of them have supported--I think we have to ask ourselves: If we had a 
choice to provide a 13-percent subsidy to for-profit insurance 
companies or pass along $1,200 in savings to American seniors and 
eliminate the costs that many of these fixed-income seniors pay when 
they go in to get preventive care, what would we choose? This is really 
all about choices in this body. It is about choices in terms of where 
we put the money we spend on behalf of Medicare beneficiaries. To me, 
it is a no-brainer. To the American public, it is a no-brainer. Instead 
of subsidizing insurance companies, let's subsidize hard-working 
seniors, who have built this country, with $1,200 in drug savings and 
25 million people who have gotten free preventive health care.
  For Republicans who have come down to the floor and said they want to 
repeal the Affordable Care Act or that they want to repeal the cuts to 
Medicare Advantage plans, essentially they are saying they want to 
return billions of dollars to the insurance companies and take away 
that money from seniors in this country. I do not think that is a 
choice the American people are going to accept.
  This week a group of us in the Senate are launching the ACAworks 
campaign. Later today I will be joined by a number of my colleagues 
around the corner as we launch a new effort to make clear to the 
American people that now, with 4 million people enrolled, and millions 
of people saving money--notwithstanding the legitimate difficulties 
that were encountered in the first days of the Web site--the Affordable 
Care Act is working. It is working for millions and millions of people 
across this country who are finally getting care.
  We will be joined today, as well, by a couple of Medicare recipients 
who are glad they now have the protection when they get into the 
doughnut hole. They are glad they now get free preventive care. And 
they will take the choice any day of this Congress and this government 
investing in them instead of investing in big for-profit insurance 
companies.
  None of us deny there are bumps in the road as you rework one-sixth 
of the American economy, which represents our health care economy. None 
of us will deny there is no excuse for the fact that for the first few 
months there were a lot of people who were not able to enroll who 
wanted to. But now that the enrollment site is working, now that 
outreach efforts are up and running, record numbers of people are 
signing up for health care because there is an almost insatiable demand 
for quality, affordable health care that is now being met as the 
Affordable Care Act is working.
  I yield back the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. BLUMENTHAL. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BLUMENTHAL. Madam President, I want to begin by thanking my 
colleague and friend from Connecticut, Senator Murphy, for the very 
eloquent and powerful remarks he has just made, showing America the 
Connecticut experience with health care, which shows that the 
Affordable Care Act is working and is expanding opportunities for 
health care across the country. Once the myths are exploded, once the 
truth is told, Americans will appreciate how fortunate we are to have 
this reform in the way that health care is insured and delivered for 
the American people.
  There are bumps in the road, as Senator Murphy has just said. There 
will continue to be issues to be overcome in achieving success. But the 
enormous potential to make America healthier, to eliminate the anxiety 
and anguish Americans experience in seeking a quality of life that 
health care affords, is an opportunity and obligation we cannot shirk. 
I am proud to join with him in speaking this truth and clarifying for 
people across the country the great promise of this program.
  A lot of the promise still has to be fulfilled. A lot of the 
realization about that promise has to be educated. But we will succeed 
in that effort. I thank him and my other colleagues who are joining us 
in seeking to make America realize the great potential and promise that 
we have, and already the great accomplishments that have been made.
  Connecticut stands as a model for both the promise and the 
accomplishment in the 130,000 people who have already enrolled in the 
benefits for young people now permitted to stay on their parents' 
policies, and, indeed, the elimination of preexisting conditions as an 
obstacle to insurance.
  I know about many of these issues and obstacles from my time as 
attorney general when I fought insurance companies that denied basic 
opportunities and failed to fulfill their obligation and impose these 
kinds of obstacles. Now, hopefully, insurers will be a partner in this 
effort, and so will the medical community and business community across 
the country.
  So I look forward to continuing this effort and thank him for the 
exposition he has given, and my other colleagues who will join us later 
today.
  I want to focus on a group that particularly needs health care in 
this country, and that is our veterans. We are here to talk about the 
Comprehensive Veterans Health and Benefits and Military Retirement Pay 
Restoration Act of 2014--a measure that seeks to address 
comprehensively the challenges our veterans face today.
  There are more and more veterans. We are losing some of the 
``greatest generation.'' In fact, we are losing them tragically and 
unfortunately

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every day. But the next greatest generation needs the same benefits and 
services we have given to the ``greatest generation.'' The next 
greatest generation is serving right now and has served recently in the 
wars of Iraq and Afghanistan.
  We must be unwavering in our commitment to our veterans. We must 
determine that this big and broad bill is necessary to keep faith with 
them and to make sure we meet the diverse and urgent needs they 
present.
  We all talk in this body about our commitment to veterans. But all 
too often, our Nation has failed to keep faith. I have learned that we 
all have expressed here our admiration and commitment to our Nation's 
veterans. I have introduced, as have many of my colleagues, veterans 
bills based on input from my constituents. In fact, my very first piece 
of legislation as a Senator was the Honoring All Veterans Act.
  But the reality is this comprehensive approach is necessary. I thank 
Senator Sanders as chairman of the Veterans' Affairs Committee for 
recognizing that the needs of our veterans are interlocking, 
multifaceted, and manifold in the kinds of problems that are raised as 
they leave the military and enter the civilian world.
  Sometimes it is their medical records that cannot be transferred 
seamlessly from the Department of Defense to Veterans Affairs and 
Veterans' Administration facilities. Sometimes it is the failure to 
make their military skills transferable in credentials and licensing. 
And sometimes it is medical conditions, health care needs for post-
traumatic stress and traumatic brain injury, that make their wounds 
invisible, make them difficult to discern to the ordinary eye but are 
there deeply and enduringly unless they are treated properly. That is 
why health care for them is so important and why this bill expands 
opportunity for health care so dramatically.
  The health care needs of our veterans must be met through the 
provisions of this bill that expand health care opportunities and 
services. When I first came to the Senate, I thought--and I think 
reasonably--that a veteran needing health care could simply go to a VA 
hospital to receive it. But that is really not the case. On January 17, 
2003, the Department of Veterans Affairs announced that it would 
``temporarily'' suspend enrolling Priority Group 8 veterans. That 
temporary restriction stands today. So under existing restrictions, a 
veteran making as little as $33,577 or a family of five making a 
household income of $50,025 can be denied health benefits in 
Connecticut. There are an estimated 720,000 Priority Group 8 veterans 
who are not enrolled in health care. Tens of thousands of veterans 
apply each year for enrollment and are denied due to that means test.
  Simply put, the VA should have the capacity and resources to serve 
every veteran. That is why section 301 of this bill would allow 
veterans who lack that access, who do not have a service-connected 
disability, and who do not have affordable health insurance, to enroll 
in the VA's health care system.
  There are other health care provisions: section 305, which expands 
the provision of chiropractic care; sections 331, 332, and 333, which 
expand complementary and alternative medicine. Anybody who has not yet 
seen ``Escape Fire'' should view it to understand the stark ways that 
veterans have challenges in access to alternative treatments and why 
drug addiction and abuse can become such a problem. And there is 
section 334, expanding wellness programs. All of these programs are 
vital, as well as the expanded access to treatment for post-traumatic 
stress and traumatic brain injury, which, in my view, are at the core 
of the need for this legislation.
  Section 342 would require the VA to contract with outside providers 
to establish a program of supportive services to family members and 
caregivers of veterans suffering from mental illness. All of these 
invisible conditions have such dramatic consequences in the 
employability of veterans and their ability to give back and continue 
to contribute to this Nation, as so many of them wish to do.
  The needs of our veterans are also pressing in disability claims. The 
need to end the backlog is, again, one of the areas addressed directly 
in this bill. The backlog of disability claims at the Department of 
Veterans Affairs has become a chronic problem. The VA is making 
progress. There is no question that the numbers are better today than 
they were. But there are still veterans such as Army veteran Jordan 
Massa in Connecticut, who served in Afghanistan, and Marine veteran 
David Alexander, who was deployed in Iraq, who had to wait too long and 
suffered as a result. We need to keep faith with those veterans.
  I understand and I applaud Secretary Shinseki, who has committed to 
tackling this problem. But some 389,000 claims are still backlogged. In 
Connecticut, about 48 percent of the claims are backlogged, meaning 
that 48 percent of claims made by our veterans take more than 125 days 
to be resolved. Each of these veterans has an individual story, a 
record of service, a record of suffering. Be it in today's wars or 
conflicts past, a record of service and sacrifice is exemplified by 
every one of them. These individuals may now be looking for employment, 
perhaps, to support a family. We need to keep faith with them.
  This legislation aims to decrease the backlog further through an 
accelerated appeals process and getting the VA the information it needs 
to decide these claims. It brings in local governments to help with the 
claims. And it helps veterans who have misfiled documents in the claims 
process to seek a better route to what they need and deserve.
  The bill also would require regular reports to Congress on efforts to 
eliminate the backlog. Accountability is so critical--accountability on 
backlogs, on all of the issues that underlie the failure to process 
these claims as quickly as they should be. And the backlog must be 
eliminated.
  Employment programs are also addressed in this bill. So are the 
traumatic effects of sexual assault. The bill is multifaceted and 
comprehensive, as it should be. To address the diverse and urgent 
needs, it must be big and broad because the needs and challenges of our 
veterans are big and broad.
  The reality is that 1 million men and women will leave the military 
over the next 5 years. One million patriotic and brave men and women 
will be separating from our Armed Forces. Becoming veterans, they will 
need services and benefits that they have earned, and they will need 
them at the time they leave, not at some distant point in the future. 
We owe it to them now to keep faith.
  I have submitted amendments that would address some of the other 
issues.
  For example, the need to recognize that post-traumatic stress is not 
only a condition that afflicts our current military men and women and 
veterans but also past veterans, even though it was undiagnosed and 
untreated at the time. Changing their status so as to recognize post-
traumatic stress for the veterans of past wars is a need that we need 
to address.
  I will make sure those veterans of past wars, whether it is Vietnam 
or Korea or any of those conflicts in our history, receive a second 
look at their discharge. That is the purpose of the amendment. That is 
the purpose of legal action that has been brought by the Yale veterans 
clinic. I will continue to support it.
  We can go further as well to enhance our veterans' health by 
including the Toxic Exposure Research and Military Family Support Act 
in this measure. I have an amendment that will do so. Many veterans 
were exposed to toxic chemicals such as Agent Orange and their needs 
are only beginning to be addressed.
  In addition to the harmful effects to those individuals, there are 
also impacts on their children. For many years those who were exposed 
to Agent Orange were told there was no evidence that their symptoms 
resulted from that. Now that we have evidence Agent Orange is toxic, we 
need to include the longer term effects on their children and their 
families. The amendment I have offered would address those issues.
  Even if none of those amendments I have proposed are adopted during 
this process, this measure stands on its own as a historic step 
forward. It is, indeed, a historic recognition of the obligation and 
opportunity we have at this point in our history to make sure we leave 
no veterans behind and keep faith with our veterans, address their 
needs in a

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big and broad bill that reflects the urgent and diverse issues and 
challenges they face. I am proud to support it.
  I thank my colleagues on the Veterans' Affairs Committee who have 
approved many of the parts of this bill by unanimous vote or 
overwhelming bipartisan majorities. This cause should be truly 
bipartisan. Let's move forward and move America forward addressing the 
needs and challenges of its veterans as we have an obligation to do. We 
must keep faith with our veterans and leave no veterans behind.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. SANDERS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Coons). Without objection, it is so 
ordered.

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