[Congressional Record Volume 160, Number 77 (Wednesday, May 21, 2014)]
[Senate]
[Pages S3202-S3204]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. BLUNT. Madam President, I want to talk a little bit about the 
continuing concerns we see in our office and hear from Missourians 
about what is happening with the implementation of the health care 
plan. The more people know about the path we are on with health care, 
the more concerned they appear to become.
  I know the White House has suggested that somehow the numbers would 
reflect that people have responded to this program in a positive way. 
When you take away the health insurance people have and there is only 
one place they can go to get the insurance they think they need, 
obviously they are going to go there, but that doesn't mean they like 
it.
  In fact, there is a new political poll that suggests nearly half of 
the American voters say they are for outright repeal of this law, and 
nearly 90 percent say it will be important to them in determining how 
they will vote this year.
  Another point in terms of why we want to start over again is 
everybody knows what the consequences are when you make a bad decision 
about people's health care in a way that I think most Americans would 
not have anticipated in 2009 and 2010. When you fundamentally get 
involved in issues that impact people and their families, such as 
health care, and do things that fundamentally impact the way their 
money is going to be spent, and that decision is made by the Federal 
Government instead of by that family whose only decision might be to 
pay a penalty or not have insurance at all or

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pay a whole lot more than they were paying, the government has involved 
itself in an area where the government should have looked for better 
choices, more options, more ways to seek coverage, and better ways to 
be sure you can have coverage if you had a preexisting condition. All 
of those, by the way, were proposed. These are not ideas that weren't 
out there a few years ago, but they would be taken much more seriously 
today if we did what nearly half of the American voters say we should 
be doing, and let's just see what would happen if we start all over.

  Several States have announced that their Web sites will not work. 
This includes Oregon and Massachusetts. There is a report that four of 
the failed State exchanges cost $474 million of taxpayer money, spent 
in Nevada, Massachusetts, Maryland, Oregon--just those four--for 
systems that then wouldn't work.
  Many of these systems around the country that now are being abandoned 
were put in place partially, if not totally, with grants from the 
Federal Government. If a State gets a grant from the Federal Government 
to do something and then it doesn't do it, every other grantee has to 
give the money back. A State can't say it is going to take millions of 
dollars from Federal taxpayers to put together an exchange and then 
announce it didn't work out very well and then have no obligation to 
give that money back. There was a time when there appeared to be great 
concern in Washington that States weren't putting an exchange in place. 
Now we find out that States with this particular plan, ill-conceived as 
it was, can't put a system in place apparently that works. The State of 
Oregon, one of the earliest advocates of adopting this system, my 
belief is and I have read, wasn't able to sign up one single person 
from October 1 until they abandoned their Web site just a few days 
ago--not one person.
  Subsidies appear to be incorrect. The Washington Post reported last 
weekend that 1 million Americans who have enrolled in the plan may be 
getting incorrect health care subsidies because the Web site was 
defective and didn't appropriately calculate what the subsidy would be. 
If people get too much of a subsidy, they have to pay it back. If they 
get too little of a subsidy, they may decide they are not going to take 
the health insurance available because they are not getting the 
assistance they had hoped for. Potentially hundreds of thousands of 
Americans are, according to that article, receiving bigger subsidies 
than they deserve and will be required to return the excess next year.
  Under Federal rules, consumers are notified if there is a problem 
with their application and asked to send in or upload pay stubs or 
other proof of their income. Apparently, only a fraction have done what 
they are supposed to do. Whose fault is that? If the government 
allocates the subsidy and if a person hasn't complied with the law, is 
that the person's fault or the government's fault? It is the 
government's job to comply with the law and to insist that people 
comply if they are going to be part of a Federal program. It is not a 
person's absolute obligation to say, I need to send that final piece of 
paper in, if the government is saying we are going to give you this 
subsidy. Don't worry about sending this in, we are going to do this 
anyway. But there will be a reconciliation moment where people find out 
their subsidy was more than they deserved and suddenly they have to pay 
it back.
  The processing centers. KMOV, a television station in St. Louis, 
recently broke a story regarding the claims of workers at a Wentzville, 
MO, facility that was one of a handful of facilities the Federal 
Government financed around the country to handle paper applications. 
Not only, on one side, did the applications not appear to work coming 
in on the Web site--the easiest thing one would have thought possible--
the easier thing, I guess, suddenly we find out, would have been to 
fill out the paper application and send it to one of these locations 
that was set up.
  Contract costs of over $1 billion, 600 people working at the 
Wentzville site, and the allegations from people working there are that 
there is just nothing to do. They are told to refresh their computers 
once every 10 minutes--hit the refresh button--so it appears they are 
doing something, so 600 people don't process more than one or two 
applications a month and that way everybody has a chance to process one 
application. My belief is these are the kinds of applications people 
would have assumed every individual would have easily processed dozens 
a day. Yet they are told not to process more than one or two a month 
because there just aren't that many people making applications at these 
centers.
  The television station KMOV did a Freedom of Information Act request 
to CMS on April 8. They are 2 weeks past the 20 days the government is 
supposed to have to comply. I wonder what would happen if a taxpayer 
had an EPA penalty and the taxpayer was a couple of weeks late in 
complying with whatever that penalty is.
  Last week I joined Senator Alexander, who is the ranking member of 
the Senate Committee on Health, Education, Labor & Pensions, in a 
letter to the CMS Administrator expressing my concerns and his concerns 
and requesting answers to a number of questions no later than the end 
of this month. Hopefully, they will do better complying with us than 
they did with the Freedom of Information Act and the St. Louis 
reporter.
  The full 5-year contract has a balance of up to $1.25 billion. The 
Wentzville facility reportedly employs about 600 people. We are now 
hearing from a couple of the other facilities that they have exactly 
the same problem. They are going to work, they have a library with 
books stacked on the table so people can read a book during the day so 
they can wait for what I guess they think eventually will be this 
onslaught of applications coming in, but so far it hasn't happened. We 
have passed October 1, November 1, December 1, January 1, February 1, 
March 1, April 1, May 1, and soon June 1. One would think these would 
be coming in because we are paying these people to do this.
  Frankly, people need jobs, so it is hard to fault them for showing up 
every day until somebody says: The truth is there is no work here for 
maybe 590 of the 600 employees; maybe we need to eliminate these 
particular jobs which were supposedly to help implement this system. 
Facilities in Missouri, Kentucky, Arkansas, Oklahoma--there are lots of 
indications that everybody is having the same experience.
  The American part of this company, Serco, is based in Reston, VA, but 
this is a British company. They were already in trouble with the 
British Government, I have read, for not providing the services they 
guaranteed to provide. It is amazing to me that to do the work to 
implement this program, we get a Canadian company to design the Web 
site, which is already in trouble with the Canadian Government for 
failure to do what they said they would do, but we hired that company 
anyway. One would think there would be American companies that aren't 
in trouble with anybody's government that could design the Web site. 
Then we got a British company that is in trouble with the British 
Government to operate these centers for the written applications. No 
wonder taxpayers are wondering, Who is minding the store? Who is 
managing the government? Who is doing this work that would make common 
sense anywhere else?
  I continue to hear from Missouri families every week about the 
problems they have. We talk to them and we verify these problems. We 
then try to find a solution, including going through the Affordable 
Care Act, trying to find assistance so they can afford to pay for a 
policy that costs more than they ever thought they would pay, but we 
are not finding those solutions.
  I have a few letters, one from a retired substitute teacher who is no 
longer able to work the substitute hours they were able to work because 
of the unintended consequences of the Affordable Care Act. Thirty 
hours, the law says, is when employers have to provide full-time 
benefits. Different companies had different rules in the past. If we go 
back to the 40-hour workweek, a lot of people would be working 35, 36, 
and 38 hours. Now they are working 25 and 26 and 28 hours.
  Another letter is from a student, Stephanie, in Jackson, MO. The 
schoolteacher was in Kansas City. Stephanie

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in Jackson is trying to go to school and trying to do everything she 
can to pay her own way through school, but her hours have been cut at 
work. She was working in the past more than 30 hours to try to do what 
kids used to do. What is one of the solutions to not having a lot of 
debt when you get out of college? Work your way through school. What is 
one of the things the Affordable Care Act has made it harder to do? 
Work your way through school. So Stephanie, the student, says she is 
looking for a second part-time job now that would give her the hours 
she used to have in her other part-time job because of the consequences 
of the Affordable Care Act.
  Just a couple more examples. Rich from Portageville, MO, his rates 
have increased from $412 a month to $732 a month. Rick says he is 49 
years old. His policy covers him and his son who is 22 years old. They 
are both healthy, but their insurance went up $320 a month.
  Roy from Oak Ridge, MO, says his deductible has gone from $250 to 
$650, and if his wife wasn't a veteran and couldn't get her medications 
through the Veterans' Administration, they would have real health care 
problems.
  Just one last example. Rodney from New Franklin, MO, says his rates 
have jumped. He says: My health insurance for my wife and myself has 
jumped from $320 per month to over $700 per month, and now there is a 
$5,000 deductible, despite the fact that we are both in great health. 
It doesn't include eye or dental coverage. I am self-employed, Rodney 
says. So it makes a very big difference to him whether he can continue 
to pay well over two times what he was paying before, with a higher 
deductible.
  Problems with implementing the system appear to not be dealt with in 
the right way, and then what happens when people do get coverage. It 
turns out for them not to be coverage they can afford. Of course, 
whether they had a policy they liked, almost nobody has been able to 
keep the policy they had, particularly if they had it as an individual. 
I think we are going to see fewer and fewer people having the policies 
they have had at work.
  I will go back to the almost 50 percent of Americans who say: Why 
don't we start over and do this the commonsense way and solve these 
problems in a way that benefits families and their health care rather 
than benefiting more government employees and more government 
regulations?
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas.

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