[Congressional Record Volume 160, Number 36 (Tuesday, March 4, 2014)]
[Senate]
[Pages S1264-S1265]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. BLUNT. Mr. President, I want to talk for a few minutes today 
about health care and more inquiries I have from the people I work for 
in our State about health care. Like we always do, I followed up with 
them to verify that I understand their account, and they don't mind if 
I at least mention their first name and where they are from as we talk 
about these problems.
  This morning I had a chance to speak to the American Federation of 
Hospitals about the challenges we face, and I mentioned the comment I 
made on the floor a few days ago, which was: If we were dealing with 
this health care debate today, in my view it would be a much different 
debate. Every Member of the House, every Member of the Senate, and 
almost every American who has been impacted in any way by the changes 
in health care understands this a whole lot better than we may have 
understood it 4 years ago.
  I was in the House in 2009 and was leading our effort to come up with 
the alternatives that were clearly out there that I think we could 
have, and, frankly, should have pursued. But at that time it was clear 
a lot of Members had not really thought about this, and in many cases 
people who worked thought about it even less. We had a situation that, 
in many ways, was an accidental development at the end of World War II 
where most people in America who had insurance got their insurance at 
work. If the people at work liked the insurance they had, of course, 
among other things, they hoped they would be able to keep it. Hopefully 
many of them will, but clearly many of them won't.
  The letters I have today are reflective of all kinds of challenges 
people are seeing. One of the things that was working very well in the 
almost 40 States that had it was the high-risk pool. The high-risk pool 
allowed people who had preexisting conditions a way to get insurance. 
They were in a pool that was pretty well defined. Not everybody with a 
preexisting condition had an ongoing cost. You might have a condition 
that was under control, you might have had a heart problem or cancer 
problem or another problem that stood in the way of your getting other 
insurance, but it didn't mean you had a lot of ongoing costs. It did 
mean the high-risk pool was a place you could go.
  In our State, the premium for the people in the high-risk pool was 
135 percent of what everybody else was paying. So you would take the 
average rate of what people were paying for insurance and add 35 
percent to that.
  Remember, these were people who everybody understood--including 
them--had a preexisting condition. They had a place to go. If the new 
plan would have reduced that 35 percent back to what everybody else was 
paying, that might have been a worthy goal, but that doesn't appear to 
be what has happened at all to the 4,000 people who left the Missouri 
high-risk pool when it ended because of the new law on December 31 of 
last year. There was a transition for some of them.
  I have a letter from Bjorn of Kansas City. He said his wife was 
previously insured under the Missouri Health Insurance Pool for 
preexisting conditions. In her case she had a back condition. That was 
canceled in the middle of 2012, and she was put in another high-risk 
pool that the law allowed to happen as a transition.
  The problem that created for them was it reset their $1,000 
deductible. They met the $1,000 in the high-risk pool, and they met the 
$1,000 deductible again in the second half of that year.
  The insurance they have been able to find costs them four times what 
they were paying before. It is not 135 percent of the old premium. I 
guess four times that would be 550 percent of the old premium. So 
somebody who was paying 135 percent of what used to be the normal 
premium for an individual is now paying 550 percent of what used to be 
the premium for the old individual. If that was the way to help people 
who had a preexisting condition, they better hope the Federal 
Government doesn't try to help them any more.
  Mark, from Parkville, says his two sons--young and healthy as they 
were, according to him--just had a 20-percent increase in the policies 
they had. The only reason they were given for the increase was that the 
new requirements of the Affordable Care Act meant their premium would 
go up. Mark said he lived out of the country for 2 years and was amazed 
to find upon his return that the cost for the same type of health 
coverage he had before he left went up from $250 a month to $1,000 a 
month.
  Bill, from St. James, MO, said his deductible went from $1,000 to 
$2,500.
  In Missouri, West Virginia, and lots of places, you and I know that 
if the individual deductible is $2,500, a family looks at that--that is 
just like not having insurance at all. If a couple of you happen to get 
sick that year, it is suddenly $5,000.
  I met with some Missouri hospital folks last week in St. Louis. They 
said their fastest growing uncollected debt was now among people with 
insurance. Why would that be? Because people with insurance suddenly 
have a deductible that is much higher than the average person with 
insurance used to have.
  The point they were making was that people can't pay $2,500 or $3,000 
or $5,000 or an even higher deductible, so that part of the bill 
doesn't get paid. That is the new growing debt that hospitals have.
  These people who have the high deductibles are insured for maybe lots 
of things they didn't used to be insured for, but they don't use any of 
the things they are now insured for that they didn't used to be insured 
for. Bill from St. James says:

       ObamaCare sure has not helped us.
       I work for a small business that has renewed my healthcare 
     and my deductible has risen from $1,000 to $2,500. My visits 
     went from a $20 copay to a $30 copay and specialists from $50 
     copay to $75 copay.

  He says he doesn't understand how he is helped by the new health care 
law.
  Carl, in Lee's Summit, MO, said he has type 1 diabetes and his 
deductible went up to $7,500. Again, for most families, a $7,500 
deductible is like not having insurance at all. If we could go

[[Page S1265]]

back to where we had the health savings account where you had a high 
deductible and you had your health savings account and that high 
deductible would kick in only if you had to pay the high deductible--I 
never saw a health savings account plan that would not be cheaper than 
these plans that cover a lot of things, but they cover a lot of things 
a lot of people don't need.
  Carl says:

       To keep our premium rates down my employer had to raise our 
     deductible to $7,500 with no prescription benefit until it is 
     met, so now instead of putting away $400 per month for my 
     retirement I have to spend it on insulin and diabetic 
     supply's.
       How is this ACA helping any honest working American who is 
     trying to take care of themselves and not rely on the 
     government?

  Carl's point is that the money he used to spend to prepare for his 
own retirement he now spends to pay for his insulin and diabetes 
medicine that used to be covered--until this year--by his policy.
  Christine, from Kansas City, said her husband's employer was forced 
to make changes in their insurance resulting in a deductible that went 
from $1,300 to $6,100.
  If this had been the way we would explain this, that somehow--let's 
assume we are insuring more people. There is no reason to believe that 
yet, but let's assume we are, but we are insuring more people with what 
I have here today--a $7,500 deductible, a $6,100 and a $2,500 
deductible.
  She says:

       Our deductible went from a manageable $1,300 to a 
     devastating $6,100.
       I recently sent in scripts for my Dr and I can't imagine 
     how much they will be. We were told they would be between $25 
     & $200 depending on the cost of the drug.

  Remember, they are all before you get the deductible.
  I have a letter from Fred from Columbia. He says that a drug company 
that makes one of his prescriptions no longer offers him a discount. 
The pharmacy told him it was because of the Affordable Care Act.
  I am perfectly willing to believe the Affordable Care Act has become 
an excuse for some things, and this may be one of them. I have not 
talked to the pharmacy in this case, but I do know these are problems 
other individuals are having because their insurance doesn't cover what 
it used to cover.
  Fred is a retired State employee and he said his plan doesn't offer 
as much coverage as it used to.
  Houston and Shirley from Peculiar, MO, have a supplemental health 
insurance. Their supplemental health insurance increased by $330 since 
the Affordable Care Act was passed. They said their policy increased 
$149--this is their supplemental policy.
  They say:

       Senator Blunt, we are on Medicare and have a supplemental 
     health insurance. Our monthly premiums were a little less 
     than $165 [prior to the ACA's passage in 2010], and now as of 
     January 1, 2014, is $498.40. Our premium has increased by 
     $149.55 a month.

  That is for their supplemental insurance.
  Just last week Medicare Advantage, which serves people in underserved 
areas--whether they live in the inner cities or rural communities--has 
had that competition reduced as well.
  I will say that if there were ever a time when we should take a 
second look at something--and the facts that every one of us have in 
our office suggest we take a look at it, and even demand we take a look 
at it--it is this policy that is hurting Americans and hurting 
families.
  If we had this debate again, the country, the health care providers, 
and the Congress of the United States would be a whole lot better 
prepared to talk about what needs to be talked about than apparently 
the Congress was prepared to talk about in 2009 and 2010.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.

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