[Congressional Record Volume 162, Number 12 (Thursday, January 21, 2016)]
[Senate]
[Page S153]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   VETERANS' ADMINISTRATION MODERNIZATION AND HEALTH INSURANCE CO-OPS

  Mr. BROWN. Madam President, earlier today I attended two hearings. 
One was held by the Senate Finance Committee on Consumer Operated and 
Oriented Plans, or CO-OPs, created by the Affordable Care Act. The 
other was held by the Senate Committee on Veterans' Affairs, where 
Secretary McDonald, a son of Ohio, detailed his plan to modernize the 
Veterans' Administration.
  Both of these hearings are a strong reminder of the importance of 
government in supporting public health and access to health care and 
services. We know the Veterans' Administration, with all its problems 
today, has provided extraordinary health care for millions of veterans 
all across our country for decades. It doesn't mean we sit back and 
don't make very important improvements that are necessary at the VA.
  When we learned that shocking wait times at the VA were delaying 
veterans from getting the care they have earned, we took action and 
passed a new law to invest in better care and provide more health care 
choices to veterans, but we can't simply act in times of crisis and 
then turn our backs on those who served in our Nation's military. It is 
our responsibility to make sure VA facilities in Ohio, Connecticut, the 
Presiding Officer's State of Iowa, and all over--it is important that 
these facilities across the country have what they need to provide 
state-of-the-art medical care for our veterans.
  I have been struck by my time on the Veterans' Affairs Committee--I 
am the only Ohio Senator to ever sit on that committee for a full term. 
I am struck by how there are a whole lot of Members of Congress who are 
always happy to appropriate billions of dollars to send our men and 
women to war, but then when it comes time to take care of them when 
they come home, these same Members of Congress are not nearly as 
generous as let's say they were in sending them off to combat. That 
needs to change.
  The same is true for health insurance CO-OPs or CO-OPs that face 
challenges. Twelve of these programs have failed. We can't sit back and 
let the remaining 11 CO-OPs meet the same fate. That is why I will 
continue to work with my colleagues to make sure CMS understands the 
importance and that they have the support and solvency they need to 
succeed.
  When it comes to providing quality health care, the Ohio CO-OP is a 
success story worth telling. InHealth Mutual in Ohio covers 
approximately 25,000 people, 25,000 lives. It has enrolled individuals 
in each of Ohio's 88 counties. InHealth is doing some wonderful work, 
and it has taken it upon itself to be a major player in the community 
and in enhancing public health in Ohio.
  One issue InHealth has chosen to highlight is health equity. InHealth 
is working to eliminate health disparities and is focusing on reducing 
barriers to care through its InHealth Cares Program.
  To that end, InHealth started a faith-based initiative called Project 
REACH to address health disparities. Three years ago at a Martin Luther 
King celebration, a Martin Luther King breakfast in Cleveland, a 
minister told us something we perhaps already knew, but he said it so 
poignantly. He said: Your life expectancy is connected to your ZIP 
Code. Think about that. If you are born in Appalachia in Southeast Ohio 
or if you are born in East Cleveland versus if you are born in the more 
affluent suburbs of Shaker Heights or Bexley or Upper Arlington, your 
life expectancy can literally be a difference of 20 years. Imagine 
there are places in Cuyahoga County--one only 8 or 9 miles apart from 
the other--where a baby born has a life expectancy of literally 24 
years less than a baby born in the more affluent suburb.
  But one of the things these CO-OPs can do is--by involving trusted 
members of the faith community and focusing on issues such as infant 
mortality, asthma, and diabetes, InHealth is successfully utilizing key 
community players to strategically improve access to care in minority 
communities across Ohio, but despite InHealth's current success, they 
continue to experience significant challenges.
  Earlier today, the Acting Administrator of the Centers for Medicare 
and Medicaid Services testified in front of our committee about the 
challenges facing CO-OPs. At the hearing, many of my colleagues 
expressed significant concerns about the closure of the 12 CO-OPs that 
have pulled out of the market as well as the viability of the others 
that remain. I share those concerns, and I urge the Acting 
Administrator of CMS, Andy Slavitt, to work with Congress and the 
remaining CO-OPs, such as InHealth, to ensure their future viability. I 
commend him on his performance at this morning's hearing. I hope the 
committee will take the appropriate steps to confirm him so he is no 
longer an Acting Administrator but has the real job.
  Congress and CMS must work together to find creative ways to ensure 
these CO-OPs that are negatively affected by the lower than expected 
risk corridor payments can find alternative ways to ensure financial 
stability.
  We should work together to improve the current risk adjustment 
calculation, which is currently designed to favor the larger, more 
established health insurance carriers over new and significantly 
smaller health insurance plans, such as the CO-OPS, and improve 
provider cost transparency in the market. They must work together to 
support the alternative ways for CO-OP small businesses like InHealth 
to raise capital.
  CO-OPs like InHealth in Ohio are putting customer service before 
profits in making a positive difference in patients' health and their 
pocketbooks. CO-OPs boost competition, they drive down prices for 
customers, and because they are locally run and operated by their own 
members, CO-OPs are invested in providing the best possible care for 
the communities they serve. CO-OPs like InHealth are working. We need 
to make sure they have the support they need to continue providing 
quality, affordable local insurance to thousands of people in my State 
of Ohio and across the country.
  I look forward to working with my colleagues on the Finance 
Committee, on the floor, and with CMS on these important issues so the 
existing CO-OPs--like InHealth--can continue to pursue innovative 
approaches to affordable comprehensive health insurance.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. MURPHY. Madam President, let me thank my friend from Ohio for his 
very constructive remarks on the success of CO-OPs. We have a CO-OP in 
Connecticut that has been providing very good quality care at very 
reasonable rates. It is part of what helps make our marketplace 
function, and I will look forward to working with him as we try to 
sustain the success of CO-OPs across the country moving forward as an 
element of the Affordable Care Act which, as I have said many times on 
this floor, is working.

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