[Congressional Record Volume 160, Number 132 (Tuesday, September 16, 2014)]
[Senate]
[Pages S5603-S5605]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTH CARE
Mr. MURPHY. Madam President, last week the House of Representatives
voted for the 53rd time to repeal or undermine all of--or aspects of--
the Affordable Care Act. This is beginning to sound like a broken
record. I was in the House of Representatives for a period of time, so
I had the privilege to vote on 30 or 40 of those different pieces of
legislation.
Republicans, of course, shut down the government a year ago because
of their pique over the health care law. There are those who still have
a desire to shut down the government again.
The other day one of our colleagues said they were hopeful that among
the
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Republicans priorities--should they increase their numbers in the
Senate this fall--would be, once again, to repeal the health care bill.
It is a story we have heard over and over despite an absolutely
overwhelming array of data points which tell us only one story, and
that is that the Affordable Care Act is working.
I don't deny that my colleagues can come down to the floor of the
Senate or House and tell stories of people who have had poor
interactions with the health care system. In fact, some people have had
poor interactions with the Affordable Care Act. But those are stories.
Data and information tell us something fundamentally different.
At the very least, I am glad that our Republican colleagues say they
are still focused on this very vague idea of repeal and replace. But
here is the problem: We have had 53 votes in the House of
Representatives to repeal the law and not a single vote to replace it
with anything of any substance. So it is one thing to just say you want
to replace the health care law, and it is another to actually put
together a plan to do it.
I wish to credit three of our Republican colleagues in the Senate.
They are the only ones who have outlined an alternative. It is only an
8-page summary, but it is important for people to know what it would
do. It would allow insurance companies to go back to their old ways of
imposing annual limits on coverage, charge women more than men, provide
little coverage for individuals with preexisting conditions, and
effectively charge millions of Americans more by capping the tax
exclusion for health care benefits. It is just an 8-page summary, but
it is not pointing the way to a better health care reality for
thousands of Americans.
Frankly, Republicans are not listening to what the American people
are telling us. Over and over polls tell us that the American people
don't want this law repealed. They want changes and so do Democrats and
Republicans, but they don't want to repeal it.
A recent poll from Bloomberg, which I think is the most recent on
this subject, found that two-thirds of Americans want the new law to
either be left alone entirely or given the chance to work with small
improvements. That is the reality of where people are in this country.
Why is there growing support for the law, and why is there
diminishing support for repeal? Well, because 10.3 million uninsured
Americans--as outlined by the New England Journal of Medicine--now have
insurance thanks to this law. The uninsurance rate among 18-to 64-year-
olds, which is our target audience, fell from 21 percent in September
of 2013 to 16 percent in April of 2014. I will say that again. In a 6-
month period of time, the uninsurance rate in this country dropped by 5
percentage points. That is an absolutely stunning achievement, and
there is only one reason for it--the Affordable Care Act. The people
who have this insurance are using it.
According to the Commonwealth Fund, nearly 2 in 3 newly covered
consumers who went to the doctor or filled a prescription said they
would not have been able to afford or access those services if it were
not for the new coverage.
In a moment I will talk about what is happening when it comes to
rates and health care expenditures. But the theory of the case is this:
If you get people insurance, they are going to use it for preventable
coverage rather than wait until their illness is so serious that they
go to the emergency room, which would require much more expensive
interventions. It is bad for them, and it is bad for the taxpayers and
ratepayers as well.
We are seeing record low rates of increase in health care spending.
Premiums--probably for the first time in my lifetime--are stable from
year to year, and that is because the theory of the case is actually
working out in practice. People are getting insurance, using preventive
coverage, not getting as sick, and as a result health care is costing
less.
The Kaiser Family Foundation said that in the 16 major cities they
surveyed, families will pay less on average to enroll in a health care
exchange in 2015 than they did in 2014. I don't mean they will have a
premium increase in 2015. They will actually pay less. The cost of the
plan in the exchange will be less in real dollars than they were in
2014.
I will talk about Connecticut in a second. We are an example of that
trend line.
It is not just the exchange that has stabilized. Employer-sponsored
coverage has stabilized as well.
I get it. There are outliers here. There are examples where health
care insurers are still passing along big increases to employers. So
the information I am giving is the average across the country. There
are always outliers on the high side--but also on the low side.
Kaiser's study also says that the average premium for family coverage
through employer-sponsored coverage care increased by 3 percent in
2014, tying 2010 for the slowest rate of increase on record for
employer-sponsored premiums. That is the reality of what is happening.
More people have coverage, and the growth of health care spending is at
a historic low. Medicare's 2019 budget is about $95 billion less than
it was projected to be 4 years ago.
We are saving $100 billion a year on just Medicare alone, and that is
on top of all the money that is being saved through relatively low
rates of increase on exchanges. That $100 billion--just to give you
some perspective, because I know it is hard to get your head wrapped
around what it means to save $100 billion--is greater than the total
amount of money we spend as a country on unemployment insurance,
welfare programs, and Amtrak combined. It is a lot of money to save as
a government.
The quality is getting better too--because that is what this is
really about. It is about delivering a better quality of life and a
longer life expectancy to consumers. Hospital readmissions--you go in
for a surgery, you go back home, and then you have to come back in--are
dropping like a stone. Hospital-acquired infections--one of the leading
causes of death in this country--are dropping precipitously. Costs are
getting lower, more people have insurance, and the quality is getting
better.
Here is the Connecticut story. We have dropped the overall insurance
rate in the country by about 25 percent--unbelievable news over the
course of 6 months. Connecticut is double that. We cut our insurance
rate in half in Connecticut. We are a small State with 3.5 million
people and had about 285,000 uninsured individuals. Connecticut has
taken the 250,000 people and put them into either the Medicaid
expansion or the private health care exchanges and a little more than
half of those people were previously uninsured.
A lot of my friends on the other side of the aisle say: That is
great, but those numbers are illusory because over time people aren't
going to pay those premiums; they are just going to drop off the plans.
Well, here is Connecticut's experience: 80,000 people signed up for
private plans on the health care exchanges, and 78,000 are still paying
their premiums about 4 to 6 months in. Everybody is still paying their
premiums. And we know why. Because it is largely affordable and because
people need that health care.
People love the exchange and their interaction with the new plan in
Connecticut. Tomorrow the Connecticut exchange will release data
showing that about 83 percent of people who went through the exchange
to buy private health care were satisfied with their experience. Of
those who went through the program to get Medicaid expansion, over 90
percent were satisfied as well.
We are saving money. Medicaid in Connecticut is 2 percent lower this
year than it was last year. We have cut our uninsured rate by half. We
are spending less as a government. People are satisfied with it. Rates
are stable.
Here are the three plans in Connecticut that submitted rate increases
on the exchange, and, at least for our biggest insurer, they are also
going to be the rates of increase outside the exchange. Our biggest
insurer, Anthem, which is our Blue Cross Blue Shield: Rates are going
down by an average of .1 percent. ConnectiCare is raising its rates by
3.1 percent. Our other insurer on the exchange, Healthy Connecticut, is
reducing its rates by 8.5 percent.
Republicans have kind of moved the ball on this a little bit. They
now say the way we judge a successful ACA is that health care rates go
down from
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year to year--not that we are controlling the rate of increase but that
the Affordable Care Act isn't succeeding unless rates are going down. I
heard my colleague from Wyoming make this claim about Connecticut a few
weeks ago in which I was talking about rates going up by 1 percent and
the claim was made: Well, that is not good enough.
People have been used to 10-, 15-,
20-, 30-percent increases in premiums in Connecticut. They are pretty
happy with a .1-percent reduction. Frankly, they are pretty happy with
a 3.1-percent increase. That is because of the Affordable Care Act.
So there is all the data. There it is. That is just the tip of the
iceberg. Costs are going down, more people have insurance, and quality
is getting better. It seems as though we open the paper every week and
there is some new piece of good information.
I get it. This needs to be better. This needs to be perfected. The
law still has warts. The Senator sitting in the Presiding Officer's
chair is leading the fight to make this law work even better for
people. I look forward to being involved in that conversation. But that
is where the conversation should be--perfection, not repeal. And we are
reminded again that if Republicans were to win control of this body, at
the top of their agenda would be this same old fight--53 different
votes in the House of Representatives over the past several years--to
repeal the law without any real tangible plan to improve it.
This morning I met with a good friend of mine whom I have spoken
about on this floor before, but because she is here in town I wish to
speak about her one more time, and that is Betty Berger. Betty is here
with the American Cancer Society. We will see them all over the Hill
today in their light-blue shirts. Betty is arguing for a lot of things
to happen here, with research funding increases at the top of the list,
but she is also here to make a very personal case to protect the
Affordable Care Act.
Years ago Betty's family was faced with a terrible choice when her
son was diagnosed with cancer. In the 1-week period of time her family
didn't have health care insurance--her husband had one job and he
switched jobs--in the 1-week period of time between when he went from
the first job to the second job, the diagnosis of cancer came down and
it became a preexisting condition not covered by the new employer.
Betty's family was left to pay for their son's cancer treatments on
their own. They eventually lost their home, they lost their savings,
and they had to declare bankruptcy.
Unfortunately, Betty's story is pretty familiar. Half of all
bankruptcies in this country are due to stories very similar to
Betty's. A mistimed illness at a point where the family didn't have
insurance results in them losing everything.
The reality is that the Affordable Care Act makes sure that Betty's
story never has to be told again, that no family ever has to make the
choice between declaring bankruptcy, saving their home, protecting
their savings, or choosing to care for a loved one.
Let's talk about making this bill better, but let's recognize that
the data, the numbers tell only one story; that is, the Affordable Care
Act is working.
I yield the floor.
The PRESIDING OFFICER. The Senator from Wyoming.
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