[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

[[Page S5604]]

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

[[Page S5605]]

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.

                          ____________________