[Congressional Record Volume 163, Number 90 (Wednesday, May 24, 2017)]
[Senate]
[Pages S3118-S3121]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Healthcare Legislation
Mr. HATCH. Mr. President, I rise today to speak about the continuing
effort to repeal and replace ObamaCare. This effort has essentially
been going on since the day the bill was signed into law. I think most
of us on the Republican side recognize the overwhelming consensus
surrounding the
[[Page S3119]]
failures of ObamaCare as a major reason we currently find ourselves in
the majority.
As you know, the House passed the American Health Care Act, a bill
that would repeal and replace ObamaCare, earlier this month. This is an
important step in the process. Later today, we expect to hear from the
Congressional Budget Office about the House bill. The CBO score will
lay down an important marker for the repeal and replace efforts in the
Senate. It will allow us to work to ensure that the House bill fits
into the constraints of the reconciliation rules in the Senate, while
we continue to strive toward our own policy goals to implement patient-
centered healthcare and healthcare reforms that address cost and
promote choice and competition.
I am very interested in what they say. These changes are more
important than ever. Just today, we received a report from HHS that,
from the time ObamaCare took effect through 2017, there was an average
premium increase of 105 percent across the 39 States using
healthcare.gov. This is just one snapshot of the runaway costs of
ObamaCare, and it is just one of many examples indicating why we need
to act as quickly as possible to repeal and replace the misguided law.
As the Senate continues to discuss the policy matters related to this
effort, we will need to confront a number of different issues as we
work to provide enduring reforms for our beleaguered healthcare system.
As chairman of the Senate committee with jurisdiction over most of the
salient issues under discussion, I want to make my views on these
matters very clear.
First, it is my view that all of the ObamaCare taxes need to go. We
should not be treating the ObamaCare taxes as a smorgasbord, picking
and choosing which ones to keep and which to discard. I don't think
there is a single tax increase in ObamaCare that has enjoyed support on
this Republican side.
When all is said and done, the tax provisions of the Affordable Care
Act represented a trillion-dollar hit on the economy in just the first
10 years. That is nearly 1 percent of the projected gross domestic
product over the same period. In my view, it would be inappropriate,
after spending the better part of a decade railing against ObamaCare's
burdensome job-killing taxes, for us to then turn around and say that
some of them are fine so long as they are being used to fund Republican
healthcare proposals.
It is very simple. We need to repeal all of the ObamaCare taxes--the
medical device tax, the health insurance tax, the so-called Cadillac
tax, the taxes on healthcare savings and pharmaceuticals, and several
others. They all have to go.
Second, we need to fully repeal the individual mandate. There has
been some talk about keeping the mandate around temporarily, if nothing
else, to help shore up the new system. But as I said with the ObamaCare
taxes, Republicans have spent years condemning the individual mandate
as an unconstitutional assault on individual liberty. We have also
argued that it was ineffective and that it has failed to draw enough
younger and healthier consumers into the insurance market in order to
offset the cost of ObamaCare's draconian market reform mandates.
I don't see how we can now turn on a dime and say that the individual
mandate is now somehow acceptable because we are using it to prop up a
system that Republicans have designed. Like the taxes, the individual
mandate, in my view, needs to be repealed. Lastly, we need to resist
any temptation to alter the tax treatment of employer-provided health
insurance as part of this particular exercise. Don't get me wrong.
There have been a number of health reform proposals over the years that
have dealt with this issue, including a legislative framework that I
drafted, along with two of my colleagues. However, given the
limitations we face in this current exercise and the fact that we are
not starting from a blank slate but rather attempting to repeal a law
that has been implemented for a number of years, we should be wary of
the impact of pulling employer-sponsored insurance into this current
debate.
The purpose of this budget reconciliation exercise to repeal and
replace ObamaCare is to address costs in the individual markets. I
believe it is important that everyone, whether they are Members of
Congress, stakeholders in the business community, or living elsewhere
in the country, manage their expectations about the possible outcomes
of this process given the limitations we are facing.
While the constraints inherent to the budget reconciliation process
may be inconvenient at the specific moment, they serve a number of
important purposes. Under this process, the Senate will need to reduce
the deficit by at least as much as the House bill. There is no way
around that. The process for determining what provisions of the House
bill will need to be changed is still ongoing. Of course, we will have
to take a good long look at the numbers we get from CBO later today.
Not only do we need to take into account the CBO numbers and the
budget rules, but we also need to consider what the best policy is,
and, at the end of the day, what approach is doable. We can do a lot in
this exercise, but we should not make this the be-all and end-all of
our healthcare reform effort.
As I said before, everyone should be managing their expectations at
this point. While we can and should be ambitious in our efforts, we
need to be realistic about the limitations that exist and be willing to
practice the art of the doable, to compromise, and to really recognize
what issues will need to be set aside for another day.
None of this is going to be easy, but I believe we are up to the
challenge. I look forward to working with my colleagues on these issues
and to finding solutions that will help us keep the promises we made to
our constituents.
I yield the floor.
The PRESIDING OFFICER. The Senator from Missouri.
Mr. BLUNT. Mr. President, I want to follow the comments made by the
President pro tempore of the Senate--the Senator from Utah--talking
about problems that people have and problems that grow every day with
their future look at healthcare and what it may mean for their
families.
This is a top-of-the-mind issue for families in Utah, or Missouri,
where I am from, or Montana, where the Presiding Officer is from, or
Massachusetts. Anywhere in the country, anyone who is looking at this
system and hoping to have a system they could rely on is finding that
it is just not working. This is a plan that clearly has failed. It was
a plan that gave all kinds of assurances, virtually none of which have
been kept.
In our State today, we got some bad news in Missouri about what that
health insurance exchange looks like next year. Blue Cross Blue Shield
serves 30 counties in our State. Another Blue Cross-related group,
Anthem, serves the rest of the State. But today, Blue Cross Blue Shield
announced that it is going to pull out of the exchanges next year. Some
31,000 people in 25 counties around Kansas City will have no insurer at
this moment who is willing to sell policies on the individual exchange.
This is devastating news for those families--maybe they are already on
their second or third insurance company in as many years--trying to
wade through yet another individual plan that tells them what might or
might not be covered. This is certainly a long way from the assurances
that you would be able to keep your plan and you would be able to
continue to see the doctors you like. It seems a long way from that
pledge. Remember that pledge? If you like your plan, you can keep your
plan. If you like your doctor, you can keep your doctor. It didn't turn
out to be that way at all.
In fact, in the five other counties that Blue Cross is leaving in our
State--and I don't say this with any disrespect toward that nonprofit
company--they are losing money. This system won't work, and that is why
we are down from multiple companies willing to offer insurance in all
kinds of counties around the country to now States, like Iowa, having
no insurance company at all that will offer an individual policy
anywhere.
In the five metropolitan counties in the Kansas area, they have three
competitors this year in those five counties. Humana announced in
February that they would be leaving next year. Blue Cross announced
today that they would be leaving. So 5 metropolitan counties at this
moment, at least, have only one company that will even offer
[[Page S3120]]
a policy, and 25 counties have no company that will offer a policy
based on that announcement. If you only have one choice, do you really
have any choices at all?
Under this plan, unless we go in a very different direction, the
choice is to buy the policy or pay the penalty. This exchange that was
promised where the average family would see their insurance costs go
down $2,500 a year--this is as far from that promise as you could
possibly get. Not only has your policy likely gone up more than $2,500,
but your deductible has gone up in even higher percentages than that.
Certainly, 30 percent of the counties in America right now only have
one company that will offer insurance. As I said earlier, our
neighboring State to the north, Iowa, has no company that will offer
insurance to anybody on the individual market. What kind of system is
that?
In my State, we have 114 counties and the city of St. Louis in
addition to those 114 counties. At this moment, 97 of them have only
one company that will offer insurance. Unless things change
dramatically, in January, 25 of those 97 will have no company that will
offer insurance. Now, 77 counties--unless the one company offering
insurance decides it can't participate in that market either--would
have only one choice. I think it is likely that those 77 counties will
see some change in whether they have one choice or no choice.
Last week, I came to the floor to talk about Missourians who have
problems and who are seeing their out-of-pocket costs skyrocket under
this. Let me share another story about one of the several people we
heard from this week.
Holly is a cancer survivor. She lives in Southeast Missouri. She was
forced again this year to switch insurance policies when the insurance
company she had left the individual exchange, the ObamaCare exchange.
That left Holly with only one choice. Again, people in the vast
majority of our counties have the same option--they have one option.
Holly had one option, and that carrier didn't cover any of her four
cancer doctors. Now, remember, this is a cancer survivor who literally
has been in a fight for her life, and now she can't get a policy that
allows her to see the doctors in whom, in that fight for her life, she
developed confidence. So that means she can't see her oncologist under
any policy she can get. She can't see the radiation oncologist, the
surgical oncologist, and the reconstructive surgeon. None of those
people are now available to her.
This is in a world where Holly, you, me--all of us were told: If you
like your doctor, you can keep your doctor. Well, she liked all four of
her doctors, and she can't keep any of those doctors. We were told: If
you like your policy, you can keep your policy. If it weren't so
serious, looking back at that promise, it would be like it was some
cruel joke that somebody is coming up with that couldn't have been
further from the truth. When you are battling cancer and you lose
access to the doctors you know and trust, no reasonable person can
argue to you that the system we have is working. The status quo is
unacceptable. It is clearly unsustainable.
There is a lot of discussion about what kind of change we are going
to have. The ``why'' here is more important than the ``how.'' The
``why'' here is the most important part of this debate because the
reason we have to change is that the system we have is absolutely not
working.
Americans like Holly and all the families in the Kansas City area who
are certain to lose this year's coverage next year may or may not have
coverage at all. No company besides this one company that left was
willing to be there this year. They deserve better. That is why I am
going to continue to work with my Senate colleagues to give families
more choices to expand their access to the healthcare providers they
want and the kind of insurance coverage they would like to have.
This plan simply hasn't worked, it isn't working, and it is going to
get worse before it gets better. That is why we are debating how to
change it, not debating the effort that has totally failed. Now we need
to get in and figure out how to stabilize this marketplace and answer
those important questions for families all over this country who not
only don't have the coverage they want, but they also don't have access
to the healthcare they need.
I yield the floor.
The PRESIDING OFFICER. The Senator from Wyoming.
Mr. BARRASSO. Mr. President, I congratulate my colleague from
Missouri for the excellent comments he made.
I bring to the floor a report that came out last evening, which is
essentially the analysis that the Obama administration never wanted the
American people to see, and it has to do with ObamaCare from 2013 to
2017. This report that the Obama administration would love to hide from
the American people makes the point that my colleague from Missouri
just made.
In those years, from 2013 to 2017, once ObamaCare came into place,
premiums around the country in the States that are buying on the
Federal ObamaCare exchange went up 105 percent on average--more than
double. It more than doubled in 20 States, and it tripled in three
States: Oklahoma, Alaska, and Alabama. In Wyoming, it went up 107
percent in just 4 years. Tell me something else that has gone up by
that price in our lives anywhere over that short period of time. Those
are the numbers that are out today.
More than 7 years ago, the Washington Democrats wrote an enormously
costly and complicated healthcare law. They forced it through the
Senate, and they made lots of promises. They promised it would provide
care for less money. They promised that you could keep your doctor and
that you could keep your insurance. They promised that if you just
allowed Washington to have more control, everything would be better for
you. It hasn't worked out that way. These are the numbers we are
looking at today, and it looks as if prices are going to go up again
next year because of the mandates and the requirements of the Obama
healthcare law.
In Connecticut, insurance companies say they want an average increase
of about 24 percent; in Maryland, the average is 45 percent; and in
Oregon, 17 percent. Americans are again facing double-digit increases
in their ObamaCare premiums next year, just like this past year.
Some companies simply said: Hey, I am done. I am not going to sell
anymore. It is just not worth it.
That is what Aetna has done--pulled out entirely. The thing that is
so interesting about Aetna's decision is that they were one of the
major cheerleaders early on back in the beginning of ObamaCare. They
said: Oh yeah, we want to do this. We want to sell insurance all around
the country. Well, now they are pulling out of ObamaCare all across
America. What that means for people at home is that they have fewer
choices.
People living in two-thirds of the counties in this country--and in
every county in my home State of Wyoming--are down to fewer and fewer
choices. We have one choice of a carrier to buy from on the exchange in
Wyoming. In two-thirds of the counties, people have only one or two
choices. There are now places where people have no choices. Even if
they get a subsidy under ObamaCare, there is no place they can use it,
so it is useless to them.
The companies that remain--what are they doing to help try to control
costs? Well, they are cutting back on access to doctors and to
hospitals, as we just heard is the situation of the patient in
Missouri.
Democrats say that people have to buy the insurance anyway because
they say they put a mandate on it. Americans, like it or not, you have
to buy ObamaCare insurance. If you don't like it, we are going to fine
you. That is what the Democrats said. Well, in spite of the mandate, 20
million Americans said ``No, thank you,'' and about 8 million paid a
fine. Another 12 million got an exemption because there are actually 41
different ways you can get exempted from ObamaCare. People realize it
is not a good deal for them. They know ObamaCare has made insurance so
expensive that it is not a good value for their hard-earned dollars.
It is astonishing to hear Democrats now say that basically the
problem was that Washington didn't have enough control. We need more
government control, they are saying. There are a number of Democrats
who want a single-payer healthcare system. Some call
[[Page S3121]]
it Medicare for all. They can call it what they want--it means higher
costs and more Washington control over the healthcare American families
need.
The State of Vermont looked at this idea a couple of years ago. Even
in this very small, very liberal State, they dropped the idea almost
immediately. Why? Because they said it was too expensive.
That didn't stop other States from looking at it. Recently, this
occurred in the State of California. Democrats in California recently
offered a plan to have the State take control of all healthcare for
everyone who lives there. Universal healthcare for all, they call it--
doctor visits, hospitals, inpatient care, outpatient care, emergencies,
dental, vision, mental health, nursing homes, everything, cradle to
grave, universal health coverage.
So what do the stories in the California papers say about this? Well,
they did a budget analysis. The budget office of the State of
California did a budget analysis and said: What would such a thing
cost? They came up with a cost of $400 billion a year. That sounds like
a big number, but how do you put that in perspective? What else can you
do? Four hundred billion dollars. So they said: Well, let's compare it
to the budget of the entire State of California. The entire budget for
the State of California today is $190 billion, so the cost of universal
healthcare alone is twice the budget of the whole State of California.
That includes teachers, firefighters, police, everything. They are
proposing to spend twice the amount that they spend on everything on
universal healthcare.
So what do the Democrats say? Well, we will just have to raise taxes.
That is their answer to so much of everything. I guess they figure that
hard-working families in California would need to pay these taxes every
year--not just once but every year because that price tag is $400
billion each and every year.
Democrats have no good ideas on how to deal with this collapse of
ObamaCare. Republicans are offering real solutions. We are looking for
ways to bring costs down, to give people more freedom, and to give
people more control over their own healthcare. We are working to make
sure people can get the care they need from a doctor they choose at a
lower cost. We don't have that with ObamaCare.
The Democrats are pushing the exact opposite approach. They are
offering higher costs, higher taxes, more government control, more
government say in your family's life.
ObamaCare has failed. Republicans are committed to finding long-term
solutions to our Nation's healthcare needs.
Thank you. I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. CARPER. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. CARPER. Thank you, Mr. President. Good afternoon.