[Congressional Record Volume 163, Number 130 (Tuesday, August 1, 2017)]
[Senate]
[Pages S4659-S4660]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               HEALTHCARE

  Mr. ALEXANDER. Mr. President, this afternoon, Senator Murray, the 
Senator from Washington State who is the ranking member of the Senate 
Committee on Health, Education, Labor, and Pensions, and I, the 
chairman of the committee, made a joint bipartisan announcement that 
the Senate's HELP Committee will hold hearings beginning the week of 
September 4 on the actions Congress should take to stabilize and 
strengthen the individual health insurance market so Americans will be 
able to buy insurance at affordable prices in the year 2018. We will 
hear from State insurance commissioners, from patients, from Governors, 
from healthcare experts, and insurance companies. Committee staff will 
begin work this week, working with all committee members to prepare for 
these hearings and discussions. That was the announcement Senator 
Murray and I made today.
  Now, in my own words, the reason for these hearings is that unless 
Congress acts by September 27, when insurance companies must sign 
contracts with the Federal Government to sell insurance on the Federal 
exchange next year, millions of Americans with government subsidies in 
up to half of our States may find themselves with zero options for 
buying health insurance on the exchanges next year, 2018. Many others 
without government subsidies will find themselves unable to afford 
health insurance because of rising premiums, copays, and deductibles.
  There are a number of issues with the American healthcare system, but 
if your house is on fire, you want to put out the fire. The fire, in 
this case, is the individual health insurance market. Both Republicans 
and Democrats agree on this.
  Our committee, the HELP Committee, had one hearing on the subject on 
February 1 and will work intensively between now and the end of 
September in order to finish our work in time to have an effect on 
health insurance policies next year, sold in 2018.
  I am consulting with Senator Murray to try to make these hearings as 
bipartisan as possible and to involve as many committee members as 
possible. I will be consulting with Senator Hatch and Senator Wyden so 
the Finance Committee is aware of any matters we discuss that might be 
within its jurisdiction. A number of Senators, both Democratic and 
Republican, have approached Senator Murray and me and said they would 
like to be involved. We are going to find a way for them to be involved 
and update them on our progress.
  In these discussions--the ones I am describing--we are dealing with a 
small segment of the total health insurance market. Only about 6 
percent of insured Americans buy their insurance in the individual 
market. Only about 4 percent of insured Americans buy their insurance 
on the Affordable Care Act exchanges. While these percentages are 
small, they represent large numbers of Americans, including many of our 
most vulnerable Americans. We are talking about roughly 18 million 
Americans in the individual market. About 11 million of them buy their 
insurance on the Affordable Care Act exchanges. About 9 million of 
these 11 million have Affordable Care Act subsidies, and unless we act, 
many of them may not have policies available to buy in 2018 because 
insurance companies will pull out of the collapsing markets. It would 
be like having a bus ticket and no bus coming through town.
  Just as important, unless we act, costs could rise, once again, even 
making healthcare unaffordable for the additional 9 million Americans 
in the individual market who receive no government support to help buy 
insurance, roughly 2 million of them who buy their health insurance on 
the exchanges but who don't qualify for a subsidy, and roughly 7 
million who buy their insurance outside of the exchanges. This means 
they have no government help paying for their premiums, their copays, 
and their deductibles.
  As we prepare for these discussions, I have urged again that 
President Trump temporarily continue the cost-reduction payments 
through September so Congress can work on a short-term solution for 
stabilizing the individual markets in 2018. These cost-sharing 
reduction subsidies reduce copays, reduce deductibles, and reduce other 
out-of-pocket costs to help low-income Americans buy their health 
insurance on the exchanges. We are talking about those who make under 
250 percent of the poverty level or roughly $30,000 for an individual 
or $60,000 for a family of four. Without payment of these cost-sharing 
reductions, Americans will be hurt. Up to half the States will likely 
have bare counties, with zero insurance providers offering insurance on 
the exchanges, and insurance premiums will increase by roughly 20 
percent, according to the American Health Insurance Plans.
  In my opinion, any solution that Congress passes for a 2018 
stabilization package would need to be small, bipartisan, and balanced. 
It should include funding for the cost-sharing reductions, but it also 
should include greater flexibility for States in approving health 
insurance policies which should reduce costs.
  Now, it is reasonable to expect that if the President were to approve 
continuation of cost-sharing subsidies for August and September and if 
Congress, in September, should pass a bipartisan stabilization bill 
that includes cost-sharing for 1 year--that is 2018--it is reasonable 
to expect that the insurance companies in 2018 would lower their rates. 
They have told us--in fact, Oliver Wyman, an independent observer of 
healthcare, has told us that lack of funding for cost-sharing 
reductions would add 11 to 20 percent to premiums in 2018.
  So if the President, over the next 2 months, and the Congress, over 
the next year, take steps to provide certainty that there will be cost-
sharing subsidies, that should allow insurance companies to lower the 
premiums they have projected they will charge in 2018. In fact, many 
insurance companies have priced their rates for 2018 at two different 
levels--one with cost-sharing and one without cost-sharing. So it is 
important not only that the President improve temporary cost-sharing 
for August and September but that we, the Congress, in a bipartisan 
way, find a way to approve it for at least 1 year so we can keep the 
premiums down.
  Now, this is only one step in what we want to do about health 
insurance and about the larger question of healthcare

[[Page S4660]]

costs so we will proceed step by step. A subsequent step will be to try 
to find a way to create a long-term, more robust individual insurance 
market, but for the short-term, our proposal is that by mid-September, 
we will see if we can agree on a way to stabilize the individual 
insurance market to keep premiums down and make affordable insurance 
available to all Americans.
  I thank the Presiding Officer.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. WHITEHOUSE. Mr. President, I am here to speak about something 
else, but let me take just a moment and thank my chairman for what he 
has done. I had the experience of serving on the HELP Committee with 
Chairman Alexander and Ranking Member Murray when we did the Education 
bill last year.
  Education is nearly as fraught a topic politically around here as 
healthcare is, and what we saw in a thoughtful, regular-order process 
that was developed under Chairman Alexander's leadership was a very 
considerable piece of work with real effect.
  Sometimes we agree on something on both sides of the aisle in this 
body because there is nothing to it. It is ``National Peaches Week'' or 
something, and everyone votes for that. But when it is something big 
and something consequential, that is where difficulties begin to 
emerge, and what the chairman was able to work in the committee was 
something big and something consequential on healthcare. To the end of 
my days in the Senate, I am going to remember that closing vote, when 
the clerk of the committee called the roll, and every single member of 
the HELP Committee voted in favor of the measure. It came out of the 
committee unanimously, and with that burst of energy, it came through 
the floor fine, and it passed the House without too many changes. It 
was just a remarkable piece of work. So I have seen what the HELP 
Committee can do under Chairman Alexander and Ranking Member Murray, 
and I am filled with confidence that the process can be terrific there, 
and I am filled with goodwill toward a successful outcome.
  I just think what the chairman has said is terrific, and I wanted to 
say a few words of appreciation.
  Mr. President, I ask unanimous consent to speak for up to 17 minutes 
in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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