[Congressional Record Volume 161, Number 159 (Wednesday, October 28, 2015)]
[Senate]
[Pages S7568-S7570]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               OBAMACARE

  Mr. HATCH. Mr. President, it has been a while since I have come to 
the Senate floor to talk about the shortcomings of the so-called 
Affordable Care Act--a few months at least. The last time I spoke about 
ObamaCare on the floor, I spoke at some length about the ever-
increasing insurance premiums that had resulted from the law's 
draconian mandates and regulations.
  Sadly, as I rise to revisit this subject, things haven't gotten 
better for ObamaCare. In fact, if the Obama administration's own 
estimates are to be believed, things are actually getting much worse. 
As we all know, this Sunday, November 1, marks the beginning of the 
2016 open enrollment period for the ObamaCare health insurance 
exchanges. This is an important milestone for the health care law in 
large part because President Obama and his supporters have, since the 
day the law was passed, repeatedly promised that as Americans become 
more familiar with how the law works, the more they will grow to love 
it.
  ObamaCare proponents wrote off problems in the first year of 
enrollment as glitches that were to be expected as the country 
transitioned to a new health care system. Problems in the second year 
were similarly dismissed as necessary growing pains as everyone learned 
from the mistakes that were made the previous year. Now, as we approach 
the third year of enrollment, supporters of the President's health care 
law are running out of excuses. At this point, most reasonable 
Americans--including many who may have initially been huge supporters 
of this endeavor--expect the system created under the law to work the 
way it was designed to work.
  You know what? The law is working the way it was designed to work. 
The problem is, it is not working the way the designer said it would 
work. At the time the law was drafted, the architects of ObamaCare said 
they can impose all new mandates and regulations on the insurance 
market, requiring massively expanded coverage above and beyond consumer 
demand, claiming that any increased costs that resulted from these 
requirements would be offset when more young and relatively healthy 
consumers were forced to buy insurance or pay a fine. Of course, they 
only called it a fine when they were drafting the law and initially 
selling it to the American people. Now a few years and a Supreme Court 
decision later, we were all supposed to call that fine a tax, but I 
digress.

  My point is that those who drafted the President's health law and 
then subsequently forced it through Congress on a strictly partisan 
basis said their new system would expand health coverage for everyone 
without increasing costs. In fact, they went further. They claimed that 
it would actually bring costs down. However, due to the way the law was 
actually designed, it was never going to work that way.
  No matter how many ad campaigns the government charged to the 
taxpayers and no matter how many talk shows the President went on to 
encourage hip, young audiences to enroll in the exchanges, the numbers 
were never going to add up. This is true for one simple reason: For all 
the attention the drafters of ObamaCare paid to expanding coverage and 
remaking the health insurance industry, they did not do anything to 
reduce the actual costs of health care in America.
  The problems with ObamaCare are not due to bad marketing, they are 
the result of fundamental design flaws. Health care costs are the 
biggest barrier keeping participants out of the insurance market. 
Health care costs are among the main factors contributing to wage 
stagnation for American workers. And health care costs continue to be 
the single largest problem plaguing our Nation's health care system. 
Yet despite the obvious problems, health care costs were all but 
ignored when the so-called Affordable Care Act was being drafted, and 
the few provisions in the law that were aimed at bringing down costs 
were either poorly conceived, terribly implemented or both.
  For example, we had the Consumer Operated and Oriented Plan Program, 
or CO-OP Program, which was created

[[Page S7569]]

to encourage the development of a nonprofit health insurance sector. 
Specifically, under the CO-OP Program, HHS dealt out $2.4 billion in 
loans to 23 nonprofit startup plans. Many of which were headed not by 
insurance or health care experts but by political activists with no 
actual business experience.
  Almost immediately we began to hear reports of mismanagement in the 
program and poor decisionmaking at the CO-OPs themselves. Earlier this 
year, the HHS Office of Inspector General reported that 21 of the 23 
CO-OPs that received loans under the program--loans that were supposed 
to last for 15 years, by the way--had suffered staggering losses. This, 
of course, was not surprising given the inexperience of many of the 
founders of the CO-OPs and the lack of oversight and accountability at 
HHS with regard to the program.
  While a nonprofit insurer may not be focused on avoiding losses, one 
would assume that, at the very least, staying in business would be a 
priority. Yet, over the last several months, 10 of the 23 CO-OPs have 
had to close their doors, with more failures expected in the near 
future. The latest CO-OP failure was announced just yesterday and took 
place in my own home State of Utah, hitting pretty close to home for a 
number of people in my State who are just trying to find affordable 
health insurance.
  Every time one of these CO-OPs fails, they leave patients and 
customers in the lurch. A failed CO-OP in New York that was called 
Health Republic and was considered by many to be a flagship for the 
loan program will leave more than 150,000 customers looking for new 
insurance when its doors close at the end of the year. And, of course, 
$2.4 billion is hardly chump change. Yet that is how much the American 
taxpayers have shelled out to these CO-OPs, and as of right now, it is 
unlikely that any of that money is ever coming back.
  Despite these obvious problems with ObamaCare, we hear a constant 
drumbeat from my friends on the other side of the aisle that the law is 
a smashing success. My friends and colleagues have gotten very good at 
cherry picking favorable data points to make these types of claims. 
They will cite an enrollment number out of context or a premium 
projection that is slightly smaller than one that came before it as 
evidence that ObamaCare is working and that the only problems with the 
health care system they so graciously gifted to the American people are 
the terrible Republicans who have dared to raise objections.
  I expect that as time wears on and the number of isolated-yet-
favorable data points continues to get smaller and smaller, more people 
will see this ruse for what it is. Case in point, earlier this month 
the Department of Health and Human Services released its latest 
projections for enrollment in the ObamaCare exchanges. For anyone who 
has an interest--political, financial or otherwise--in defending the 
Affordable Care Act, the numbers are not good, and I am being kind when 
I say that.
  The Obama administration projects that in 2016, roughly 1.3 million 
people will newly enroll in the exchanges. Now, 1.3 million may sound 
like a big number, however, as always, context is important here. When 
the law was originally passed in 2010, the Congressional Budget Office 
projected that we would see an increase of about 8 million enrollees on 
the exchanges in 2016 compared to 2015. Now HHS is predicting that 
enrollment will be less than a quarter of that projection.
  It gets worse.
  In 2010 CBO also projected that by the end of 2016, roughly 21 
million patients would be enrolled in plans purchased on the exchanges. 
Now, HHS projects that the number will likely be less than half of 
that, probably a little more than 10 million people. In other words, 
all the rosy claims and predictions we heard at the time the law was 
passed about the impact these new exchanges would have on insurance 
markets and premiums were based in large part on the assumption that 
twice as many people would enroll. Now, by its own terms, ObamaCare is 
becoming a bigger failure by the day.
  Unfortunately, I am not done.
  HHS also estimates that there are 19 million Americans who earn too 
much income to qualify for Medicaid but still qualify for ObamaCare 
exchange subsidies who still have not enrolled. According to their 
numbers, a little less than half of these people buy insurance off the 
exchange without getting subsidies, leaving more than 10 million people 
eligible for subsidies on the exchanges but still uninsured. The 
administration also says about half of that eligible-but-uninsured 
population is between the ages of 18 and 34 and that nearly two-thirds 
of them are in excellent or very good health.
  In other words, a huge portion of those refusing to purchase health 
insurance on the exchanges, even though they are eligible for ObamaCare 
subsidies, are the same young and healthy consumers that the Affordable 
Care Act was designed to coerce into the health insurance market in 
order to subsidize all of the new mandates and regulations imposed 
under this law.
  The exchanges are failing to attract the very customers they need in 
order to stay afloat. If they cannot attract more of this prized 
Democratic base, the ObamaCare exchanges--and with them the entire 
ObamaCare system itself--will collapse under their own weight.
  The question now becomes this: What is keeping these young and 
healthy consumers from enrolling on the exchanges? Why are millions of 
people opting to pay a fine and forego coverage rather than purchasing 
health insurance with the aid of a government subsidy? The answer, for 
anyone who wasn't listening earlier, is costs. According to a recent 
survey by the nonpartisan Robert Wood Johnson Foundation, the vast 
majority--nearly 80 percent--of uninsured Americans who have looked for 
insurance said that after weighing everything, they could not afford 
the purchase.
  Sadly, the cost problem is only getting worse. As we learned earlier 
this year, insurance plans in markets across the country have been 
requesting dramatic increases in their premiums, and those increases 
have been confirmed as the enrollment date has drawn closer.
  Just yesterday I had a number of representatives from hospitals in 
New York and around New York City say they cannot continue to handle 
all of the nonpaying emergency room customers. They don't know what to 
do, and they are in danger of losing the health care systems they have 
established.
  In Minnesota, for example, there are five insurance carriers on the 
exchange. In 2016, all five will be offering insurance policies with 
rate hikes in the double digits between 14 and 49 percent.
  In Oregon, premiums for the second lowest cost silver plan on the 
exchange, the benchmark plan, will go up by about 23 percent. In 
Alaska, that hike will be more than 31 percent. In Oklahoma, consumers 
on this benchmark plan will see an increase of more than 35 percent in 
their monthly premiums.
  My own State of Utah will not be immune to this trend, unfortunately. 
Last week, the Deseret News reported that on average insurance rates 
for plans on Utah's federally run exchange will be 22 percent higher 
next year.
  Keep in mind that these numbers only reflect premiums and do not take 
into account potential increases in total out-of-pocket costs, which 
can include things such as copayments or deductibles.
  In a sense, all of this creates a vicious, self-perpetuating cycle. 
The plans on the exchanges, even with the ObamaCare tax subsidies, are 
too expensive for millions of the young, healthy consumers whom the 
exchanges need in order to keep the costs down. As a result, not enough 
members of this valuable demographic segment purchase insurance, 
causing plans to become more expensive and leading more insurers to 
drop out of the marketplace.
  None of this should be surprising. From the outset, opponents of 
ObamaCare, including myself and many of my Republican colleagues, 
predicted this exact outcome. The cycle moves in only one direction: 
higher costs, fewer choices, and a health care system that offers 
poorer and poorer care to the American people. Absent some sort of 
independent and intervening action to bring costs down, there is no 
scenario in which this gets better. It will only get worse.

[[Page S7570]]

  I know that some of my colleagues have some specific intervening 
actions in mind. For example, they would like to see the Federal 
Government not only regulate the products offered on the insurance 
market, but the prices as well. And when the inevitable happens--when 
no private insurance provider can remain profitable in an environment 
where both product and price are set by the government--these same 
colleagues will, of course, want the government to step in and provide 
a plan of its own. In fact, that was what was in many of their minds at 
the beginning--socialized medicine. They figured this would push us 
towards it, and it certainly will if we don't change course. Soon 
enough, because only the government will be able to provide health 
insurance without the pesky need to turn a profit, the government's 
health insurance will be the only available option.
  I don't want to imply base or bad motives on the part of those who 
supported health care--by the way, it was a totally partisan vote--but 
let's be honest about what is going to happen here. A vast group of 
people on the left are really hoping that the government can do it all, 
and the government will pay for everything. Somebody has to feed the 
government too.
  Well, in the eyes of many--including, I believe, a number of my 
colleagues here in Congress--the only way to end the downward spiral we 
are currently facing under ObamaCare is, as I have said, to create a 
single-payer health care system. In other words, socialized medicine--
where the government provides health care for everybody. We can imagine 
how the costs are going to go up when that happens.

  I made this very claim back in 2010 when the Affordable Care Act was 
passed, and left-leaning politicians and pundits said it was a paranoid 
scare tactic. But now, as ObamaCare's downward spiral is becoming more 
obvious, I suspect that my argument is seeming less farfetched by the 
day.
  Fortunately, the march toward a single-payer system is not our only 
option. We can take action right now to right this ship. We can control 
costs. We can take government out of the equation and give patients and 
consumers more choices.
  There are a number of ideas out there that would accomplish these 
goals. One of them, of course, is the plan Senator Burr and I have 
offered, along with Representative Fred Upton in the House. Our plan is 
called the Patient CARE Act. I have spoken about it at length a number 
of times here on the floor and elsewhere. While ours is not the only 
good plan out there, a number of respected health care experts have 
analyzed the Patient CARE Act and concluded that it would, in fact, 
bend the cost curve and make health care more affordable for everybody.
  Once again, the failure to bring down costs is easily the biggest of 
ObamaCare's many failures. Our plan would ensure that Congress does not 
repeat that failure.
  I am well aware that health care policy is a contentious topic around 
here. I know there are a myriad of views and no shortage of fierce 
disagreements on virtually all aspects of our failing health care 
system, but right now, it should be clear to everyone that the so-
called Affordable Care Act was grossly misnamed. The law has failed to 
make health care more affordable, and it has failed to correct far too 
many of the problems that have long plagued our Nation's health care 
system. The sooner more of our colleagues--particularly those on the 
other side of the aisle--recognize and admit this failure, the sooner 
we can begin to work together on a plan that will deliver real results 
for the American people and not continue on this spiraling downward 
path of moving toward socialized medicine where we have one-size-fits-
all medicine for the people in this country and, frankly, government 
running it. That has never worked, and it is not going to work in this 
country.
  We need to revamp this program, and we have needed from the beginning 
to do so. I hope people will listen. I hope the citizens out there will 
start to pour it on and let everybody know that this is a disaster and 
that there are ways we might be able not only to stop the disaster, but 
also to increase good health care, excellent health care for the 
benefit of our people.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Kansas.

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