[Congressional Record Volume 163, Number 55 (Wednesday, March 29, 2017)]
[Senate]
[Pages S2100-S2101]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ALEXANDER (for himself and Mr. Corker):
  S. 761. A bill to amend the Internal Revenue Code of 1986 to allow 
individuals to receive a premium assistance credit for insurance not 
purchased on an Exchange, and for other purposes; to the Committee on 
Finance.
  Mr. ALEXANDER. Mr. President, the Health Care Options Act of 2017, 
introduced by Senator Corker and me, would address the emergency in the 
health insurance exchanges in Tennessee and in other States. This 
legislation would allow any American who receives a subsidy and has no 
insurance available on their exchange next year to use that subsidy to 
buy any State-approved insurance off the exchange.
  Second, the legislation would waive the Affordable Care Act 
requirement that these Americans--who, remember, have zero insurance 
options for their subsidies--have to pay a penalty for not purchasing 
the insurance.
  Third, the legislation would bring peace of mind between now and the 
beginning of 2018 to millions of Americans--some of the most vulnerable 
people in our country--who face having zero options of health insurance 
to purchase with their subsidy in the year 2018 because of the 
collapsing ObamaCare exchange markets.
  Here is why urgent action is needed. There are 11 million Americans 
who buy individual insurance now on the Affordable Care Act exchanges. 
Approximately 85 percent of them receive a subsidy to help them buy 
insurance. For those who don't like subsidies for people buying 
insurance, I would remind us that about 60 percent of insured Americans 
get insurance on the job, and the average tax break for people with 
employer sponsored insurance is about $5,000. What we are talking about 
is the 4 percent of insured people who don't get insurance on the job, 
who don't get it from the government and Medicare and Medicaid, and 
this subsidy gives them some money to help them buy insurance if they 
are mostly low income.
  While these 11 million make up only 4 percent of the total insured 
population in this country, this 4 percent is where much of today's 
political turmoil rests.
  In the Knoxville area where I live, the one remaining insurance 
company on the Affordable Care Act exchange has pulled out for the year 
2018. So it is a near certainty that there will be zero insurance 
options for 40,000 Tennesseans who live there and buy their insurance 
on the exchange. In other words, for approximately 34,000 Tennesseans 
living in Knoxville who rely on an Affordable Care Act subsidy to buy 
health insurance, their subsidies will be worth as much as a bus ticket 
in a town with no buses running.
  There is a real prospect that the same thing may happen to all 
230,000 Tennesseans who buy insurance on the exchange. As I said, 85 
percent of them rely on a subsidy to afford insurance; they just will 
not have any insurance policies to buy.
  The decision Friday by the House of Representatives to not vote on 
the health care bill changes nothing about the urgency of rescuing 
these 230,000 Tennesseans who buy insurance on the ObamaCare exchanges 
that our State insurance commissioner has told us are ``very near 
collapse.''
  While Congress continues its work to enact long-term structural 
health reforms, we must take immediate action to help these 230,000 
Tennesseans and millions of Americans in other States facing the same 
dire consequences.
  This is not just a problem for Tennesseans. Last year, 7 percent of 
counties in the country had just one insurer offering plans on their 
Affordable Care Act exchange. This year, that 7 percent has risen to 32 
percent of the counties in this country having just one insurer 
offering plans on the Affordable Care Act exchange. There are five 
States this year that have only a single insurer offering ACA plans in 
their entire State--Alabama, Alaska, Oklahoma, South Carolina, and 
Wyoming. And in nine States, there is only one insurer offering ACA 
plans in a majority of the

[[Page S2101]]

counties in the States: Tennessee, North Carolina, West Virginia, Utah, 
Nevada, Arizona, Mississippi, Missouri, and Florida.
  Next year, in 2018, we know the problem will be much worse. As more 
insurance companies announce their plans for the 2018 plan year, it is 
very likely that more counties across the Nation will face challenges 
similar to those in the Knoxville, Tennessee, area, where, again, 
having an ObamaCare subsidy will be as useful as having a bus ticket in 
a town with no buses running.
  Now, there is a solution to this. As I mentioned, the legislation 
that Senator Corker and I are introducing will do three things: First, 
it will allow Americans to use their Affordable Care Act subsidy--the 
money they are getting now--to purchase any health insurance plan 
outside of the exchange, as long as the insurance is approved by the 
State for sale in the individual market. That means Americans on the 
exchanges will have options to purchase insurance where the Affordable 
Care Act has left them with none. This option will be given to 
individuals who live in the counties where the Secretary of Health and 
Human Services certifies that there are zero options on the ACA 
exchange.
  Second, when the Secretary certifies that there are zero insurance 
options on the exchange, the legislation will waive the Affordable Care 
Act's requirement to buy a specific health plan or pay a fine of as 
much as $2,000 for a family of four. The law's individual mandate, in 
other words, will not apply to these individuals. And, of course, it 
shouldn't. They shouldn't be penalized for not buying insurance when 
there is no insurance to buy.
  The legislation's temporary authority would be in place only through 
the end of the 2019 plan year.
  Third, I hope that this legislation will provide some peace of mind 
for those Knoxville area residents and Americans in counties across the 
country trapped in collapsing exchanges.
  This is not a permanent solution. Congress has a responsibility to 
continue its work to solve this problem and to give more Americans more 
choices of lower cost health insurance.
  Long term, Americans should have the freedom to make their own 
choices about their family's health care needs. But in the short term, 
we must act on behalf of 230,000 Tennesseans, some of the most 
vulnerable citizens in our State, and millions of other Americans in 
other States who are likely to have zero choices of insurance in 2018.
  Earlier this afternoon, the Tennessee insurance commissioner, Julie 
Mix McPeak, who has testified before the Senate and made public 
statements that the Tennessee Affordable Care Act exchanges were in 
virtual collapse--what she means by that is no one will be selling 
insurance in them--issued this statement in support of the bill that 
Senator Corker and I have introduced. She said:

       This bill ``would definitely be helpful for Tennessee 
     consumers. We are in favor of any legislation that improves 
     consumer choice and provides access for Tennesseans. It is 
     completely unacceptable for our consumers to have a subsidy 
     but no ability to purchase insurance on the exchange. We 
     support any option that avoids that result.''

  I yield the floor.
                                 ______