[Congressional Record Volume 163, Number 111 (Wednesday, June 28, 2017)]
[Senate]
[Pages S3821-S3823]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                   Unanimous Consent Request--S. 1462

  Mrs. SHAHEEN. Mr. President, I am very pleased to join my colleague 
from North Dakota, Senator Heitkamp, and appreciate all of the efforts 
she is making to try to address the challenges we are facing in the 
healthcare markets across this country. Like her and like so many of my 
colleagues who are going to be here, I have come to the floor this 
afternoon because we want to take urgent steps and we can take steps 
today to address the uncertainty in our health insurance markets. We 
can take steps today that can hold down premiums.
  I have heard Senators on both sides of the aisle who have expressed 
concern about looming premium increases in the Affordable Care Act 
marketplaces. We all need to understand, as Senator Heitkamp pointed 
out, what some of the causes of these premium increases are.
  Insurers regularly cite the Trump administration's refusal to commit 
to making cost-sharing reduction payments, also known as CSRs. These 
CSR payments were included in the Affordable Care Act in order to help 
Americans afford insurance once they had it. The ACA requires insurers 
to reduce deductibles and copayments for working families who are 
buying insurance in the marketplace. Because of the cost-sharing 
reduction payments, the CSRs, patients pay less for their care and the 
government reimburses the insurers.
  These reductions and payments are built into the rates insurers are 
charging for 2017. Yet the Trump administration has refused to commit 
to paying these reimbursements because of a partisan lawsuit that has 
been brought by House Republican leaders.
  Because of the radically uncertain landscape insurers are facing 
right now, many of them are doing one of

[[Page S3822]]

two things: Some are pulling out of the ACA marketplaces altogether, 
and others are dramatically increasing premiums. The end result is 
fewer choices and higher costs for American families.
  Last year in my State of New Hampshire--and Senator Hassan is here. 
We represent New Hampshire, and we have been very concerned about what 
is happening right now. Last year, the insurance markets were stable, 
and health insurance premiums increased an average of just 2 percent--
the lowest annual increase in history. Today is a radically different 
story, in large part because of the uncertainty this administration is 
causing by refusing to guarantee insurers cost-sharing reduction 
payments. What we are seeing is that those insurance companies are 
protecting themselves by raising premiums on patients.
  The same thing is happening in other States. In some cases, insurers 
are filing two different sets of rates--a set that is premised on the 
administration continuing to make cost-sharing reduction payments and 
an alternative set with higher premiums to account for continuing 
uncertainty and the possibility that this administration will stop 
making those payments.
  Unfortunately, the Trump administration continues to send mixed 
signals to insurers, and of course it has threatened to stop paying 
cost-sharing reduction payments altogether. If this were to happen, 
insurers could immediately exit the markets for breach of contract.
  So we are kind of in this perverse limbo situation. The 
administration creates uncertainty by refusing to commit to continuing 
the CSR payments, and the insurers protect themselves by exiting the 
markets or raising rates. And it is the premium holders, the families 
out there, who are hurt by this political football that the 
administration seems to be intent on continuing.
  That is why I have introduced the Marketplace Certainty Act, which is 
a bill to appropriate funding for the cost-sharing reduction payments 
in order to make good on our commitment to help working families with 
their deductibles and cost sharing.
  I believe that the House Republican leaders' lawsuit has no merit but 
that the chaos it has caused by allowing the Trump administration to 
waver on these promised payments requires that we act now.
  I am pleased to be joined in this legislation by Senators Baldwin, 
Blumenthal, Cardin, Carper, Coons, Kaine, Hassan, Heitkamp, Cortez 
Masto, King, Leahy, Markey, Wyden, Stabenow, and I am sure that by 
tomorrow, we will have even more Senators on this bill.
  We could pass it right now. Right now, we could end this manufactured 
crisis. We could immediately restore certainty and stability to the 
health insurance markets for all of our constituents. That would be 
good for the Republicans, and it would be good for the Democrats. 
Mostly, it would be good for the families out there who are 
experiencing this uncertainty.
  We could do this. It would give us the breathing space we need to 
come together on a bipartisan basis to improve the law, to strengthen 
what is working and to fix what is not. In poll after poll, that is 
what the American people want us to do. They want us to stop the 
partisan bickering. They want us to work together. They want us to make 
commonsense improvements so that this law works for every American.
  Mr. President, at this point, I ask unanimous consent that the Senate 
proceed to the immediate consideration of S. 1462, the Marketplace 
Certainty Act; that the bill be considered read a third time and 
passed; and that the motion to reconsider be considered made and laid 
upon the table with no intervening action or debate.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Wyoming.
  Mr. BARRASSO. Mr. President, reserving the right to object, I just 
had an opportunity to read the legislation of the Senator from New 
Hampshire. It appears that the legislation was just filed today. 
Instead of giving the American people time to read the bill, the Senate 
is being asked to pass the legislation now. At a minimum, shouldn't the 
American people have at least a day to read the proposal?
  Putting that aside, this bill seeks to address another major failure 
of ObamaCare. That is what they are trying to do here. As a doctor, I 
want insurance to be affordable for patients all across the country. 
This bill confirms what we all know--that ObamaCare is not affordable.
  The Senator is well aware of the large premium increases in her own 
State. It is not just the premiums that are skyrocketing. This week, I 
spoke to a woman in Wyoming. She told me that the deductible under her 
ObamaCare plan is so high that her husband refuses to go visit the 
doctor. She said that it is $6,500 for her and $6,500 for him and that 
he will not go to a doctor with that kind of a deductible. According to 
supporters of ObamaCare, this person is actually covered under 
ObamaCare, but as a doctor, I see things differently in that healthcare 
must be more affordable for everyone.
  The Senator's proposal seeks to throw more money at a systemic 
problem with ObamaCare. Instead, we should be passing bills that 
actually bring down the cost of care.
  When the Senator mentions the CSRs, I will point out that absolutely 
every payment has been made--every one--all the way up until today.
  People also talk about the sabotaging of the market. To me, the 
sabotaging of the insurance companies and the insurance market in this 
country has been because of ObamaCare's mandating that people buy 
insurance--buy more than they want, more than they need, and more than 
they can afford in so many cases, and it is insurance that provides 
very hollow opportunities to actually use the insurance.
  Again, I appreciate the acknowledgment that ObamaCare is clearly not 
working; however, our focus should be on policies that make healthcare 
more affordable to all Americans.
  I object.
  The PRESIDING OFFICER. Objection is heard.
  The Democratic leader.
  Mr. SCHUMER. Mr. President, I ask unanimous consent that we get our 
full amount of time and that the time my friend from Wyoming uses be 
from the Republicans' time at some point later.
  The PRESIDING OFFICER. There is no order for divided time.
  Mr. SCHUMER. Oh. So we have as much time as we need?
  The PRESIDING OFFICER. There is no order.
  Mr. SCHUMER. I thank the Presiding Officer.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, while I am disappointed, I am not 
surprised that my colleague from Wyoming has objected to our effort to 
move forward. He is objecting to ending the uncertainty we have 
experienced, which is forcing insurers to raise rates because of the 
uncertainty with which this administration is administering the 
Affordable Care Act. They have been very clear that they want 
marketplaces to implode so that the act does not work for people. 
Senator Barrasso is objecting to a commonsense step to stabilize the 
insurance marketplaces.
  This is not going to be the last word because this is a commitment we 
made to American families. The instability here in Washington is what 
is causing the instability not only in insurance markets but in the 
country at large.
  We are approaching the Fourth of July, which is next week. When our 
Founders declared independence on July 4, 1776, Benjamin Franklin 
warned that we must all hang together or we will all hang separately. 
It is no different today. We all need to come together. We need to work 
across the aisle. We need to improve the healthcare system so that it 
works for all Americans. That is our goal. That is why we are here on 
the floor today, and we need to start by making sure the insurers have 
some certainty so that they can keep rates low for American families. 
We will be back, have no doubts about that.
  The PRESIDING OFFICER. The Senator from Missouri.
  Mrs. McCASKILL. Mr. President, I have to say that there are a lot of 
things my friend from Wyoming could have said in his objection, but to 
lecture us about bringing out a bill that people have not had a chance 
to read or study is rather rich at this moment in our legislative 
journey on healthcare. I do not know if he thought that through before 
he said it, but I can assure you

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that when it came out of his mouth, all of us on this side were saying: 
You have got to be kidding me. Really? It was just a little much.
  I know we are all talking around the obvious, and that is that we 
need to fix the healthcare system in America so that people do not have 
to go into their pockets as often, so that insurance is reliable, and 
so that the markets are more stable. We are going to have a lot of 
opportunity, I hope, to come together and do just that. I hope my 
friend from Wyoming and my other friends on the other side of the aisle 
will be part of that.