[Congressional Record Volume 164, Number 74 (Tuesday, May 8, 2018)]
[Senate]
[Pages S2543-S2545]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Mr. ALEXANDER. Mr. President, for the sixth consecutive year, 
ObamaCare insurance rates are going up, and Democrats are already 
running around pointing fingers, trying to find someone else to blame.
  About 10 days ago, the distinguished Democratic leader came to the 
floor and warned that, very soon, health insurance companies will be 
announcing rates for 2019 in each State across the country. He said 
that many health insurance companies will propose rate increases.
  Today, several Democratic Senators held a press conference saying 
that insurance rates are going to go up in 2019. Well, they are exactly 
right. Insurance premiums are going to go up in 2019, just as they have 
for the 5 previous years of ObamaCare. But they are exactly wrong about 
who to blame.
  The Democrats wrote the bill. They wrote ObamaCare, and they voted 
for ObamaCare--every single one of them. Not a single one of us voted 
for ObamaCare. They wrote the bill. If they are looking for someone to 
blame, they should look in the mirror.
  Running around, pointing fingers, and trying to find someone else to 
blame is a little like selling somebody a house with a leaky roof and 
then blaming the new owner for the leaky roof. Democrats built the 
house with the leaky roof. They built these insurance markets--the 
individual markets, where no one can find insurance. They wrote the 
sloppy law. They failed to make the markets competitive, and they 
erased the ability of consumers to have choices. They didn't follow the 
law when they paid out cost-sharing payments that were designed to help 
low-income Americans pay for their out-of-pocket expenses, and--this is 
the very worst--when Republicans were prepared 1 month ago to stabilize 
these markets and, according to the Oliver Wyman healthcare experts, to 
lower rates by up to 40 percent over 3 years, the Democrats said no.
  President Trump asked Speaker Ryan and he asked Senator McConnell to 
put that bipartisan proposal in the omnibus spending bill that passed. 
The Republicans said yes, and the Democrats said no. So the rates are 
going up because Democrats wrote the law, and they said no to lowering 
the rates.
  What Democrats don't say--but every American should know very well--
is that health insurance rates didn't start increasing when President 
Trump took office 15 or 16 months ago. Insurance rates have been 
increasing since ObamaCare took effect more than 5 years ago.
  In 2010, there was a big discussion at the Blair House. I was invited 
to make the Republican case for President Obama, who stayed there all 
day and listened.
  I said: Respectfully, Mr. President, the Affordable Care Act will not 
work. I said directly to him that ObamaCare would send an unfunded 
Medicaid mandate to States. It did.
  I said: It will cut Medicare by one-half trillion dollars. It did.
  I said: There will be new taxes in it. There were.
  I said: It will mean that for millions of Americans, premiums will go 
up because when people pay those new taxes, premiums go up, and they 
will also go up because of the government mandates--and they have, for 
5 years. Now the Democrats are pointing out that their law, which they 
passed, will cause rates to go up for the sixth consecutive year.
  Back in 2010, I said: Our country is too big, too complicated, too 
decentralized for Washington, DC--just a few of us here--to write a few 
rules about remaking 17 percent of the economy all at once. That is the 
size of the healthcare economy. That sort of thinking works in the 
classroom, but it doesn't work very well in the big, complicated 
country which is the United States of America. Since the

[[Page S2544]]

ObamaCare exchanges opened in 2014, history has proved this--what I 
said--to be right.
  The Affordable Care Act has not worked the way Democrats promised. It 
certainly hasn't worked that way for Marty, a farmer in Tennessee who 
stopped me at a Chick-fil-A last December. She wanted to tell me that 
before ObamaCare her rates were $300 a month. She is in the individual 
market. She doesn't get a subsidy. She pays these rates herself. This 
year, it is $1,300. Next year, it will be more.
  Rates in Tennessee for people like Marty went up 58 percent this past 
year. That is a lot of money. People can't afford it. She is one of 
thousands of others in Tennessee who have seen their premiums increase 
176 percent since 2013, the year before the ObamaCare marketplaces 
opened.
  The Affordable Care Act hasn't worked for the 9 million Americans, 
like Marty, who purchased their health insurance in the individual 
market and received no government subsidy. They have been hammered by 
skyrocketing insurance premiums, and Democrats come to the floor and 
say: Well, they are going up for the sixth straight year.
  If I were them, I would want to keep it quiet. But, no, they are 
looking for somebody to blame. They don't want to look in the mirror. 
They wrote the bill. They are the reason the rates are going up. They 
have rejected any reasonable attempt to change the law. They will not 
even support changes that they are for--that they know aren't working.
  The Affordable Care Act does not work because it is too Washington, 
DC, focused. It has made insurance too expensive, and it is hurting the 
American people. So last year, Republicans tried to repeal the law to 
help make health insurance work again for people like Marty, the farmer 
I met at Chick-fil-A. We came up short.
  While I hope that Senators Graham and Cassidy can build a coalition 
to try again, there is still the urgent problem of skyrocketing 
ObamaCare premiums. It did not have to be this way. The Senator from 
Washington, Mrs. Murray--the lead Democrat on the Senate HELP 
Committee--and I last year announced that we would hold hearings to see 
if there were steps Congress could take to stabilize and strengthen the 
individual health insurance markets so that Americans could buy 
insurance at affordable prices in 2019.
  President Trump called me in August of last year, and he asked me to 
work with Senator Murray to try to come up with a temporary solution so 
people who were hurt by the skyrocketing ObamaCare prices would not be 
hurt while Congress concluded what to do in the long term. In 
September, our committee hosted four bipartisan hearings. We invited 
all of the Senators to come to meetings before the hearings. We had 
about half of the Members of the Senate involved in those meetings and 
hearings. Out of those meetings and hearings, we came up with three 
proposals that Congress could pass that would temporarily lower rates 
over the next 3 years, according to Oliver Wyman, one of the most well-
respected healthcare experts in the country, by up to 40 percent over 
those 3 years.
  No. 1, our proposal had 3 years of reinsurance grants at $10 billion 
a year so States could create funds to insure the needs of the very 
sick. You take the very sick out of the pool, care for them, and then 
you can lower the rates for everyone in the individual market. That is 
3 years and $10 billion a year. That was the first proposal.
  No. 2 is 3 years of cost-sharing reduction subsidies to help low-
income Americans pay out-of-pocket expenses. It is counterintuitive, 
but when you pay those expenses, you actually lower the deficit. You 
lower the cost to taxpayers because it lowers the premiums, and that 
lowers the subsidies. You actually save taxpayer money when you pay 
those 3 years of cost-sharing subsidies.
  No. 3, we took a provision that is in the Affordable Care Act called 
the innovation waiver--it was already there, and it wasn't working--and 
we agreed to streamline it so that it would work and the State might 
make an application and say we have a better idea.
  We said: You can't change the essential health benefits and you can't 
change the prohibition on lifetime limits. You still have to give 
people an offer of insurance if they have a preexisting condition. All 
of those provisions and protections were still in our bill, but that 
new flexibility would have allowed Iowa and other States to increase 
their choices and lower premiums. It would have allowed New York, 
Minnesota, and New Hampshire to do things their Democratic Senators 
said they badly wanted to do and their Governors said they badly wanted 
to do.
  There was new authority for a catastrophic insurance policy with 
lower premiums and higher deductibles that people could choose. That 
was in there too. This is the package that the Oliver Wyman expert said 
if you are a contractor and you are making $60,000 and your insurance 
is $20,000, it could reduce your premium from $20,000 to $12,000 over 3 
years. That was the package.
  Almost all Democrats liked those three ideas. The truth is, a lot of 
Republicans and conservative groups were skeptical about them because 
they said it would ``shore up ObamaCare.'' But the Congressional Budget 
Office said that if the scoring reflects the cost-sharing payments 
being paid, our proposal would actually save taxpayer dollars by 
lowering premiums and, therefore, lowering subsidies.
  So this would sound like a very good proposal; wouldn't it? It is 
something that at one point Democratic leaders said every Democrat 
could vote for, something that more than half of the Senate 
participated in--reinsurance, cost-sharing subsidies, and more 
flexibility without changing the basic guarantees of the Affordable 
Care Act. That sounds very much like a proposal that might come from 
the other side of the aisle, not the Republican side of the aisle. Yet, 
on the Saturday before we passed the omnibus spending bill, President 
Trump called Speaker Ryan and Senator McConnell and said: Will you 
please put that provision in the omnibus spending bill?
  They said yes. The Democrats said no.
  The Democrats have written this ObamaCare bill, which for 6 years has 
raised rates. Then, we come up with a proposal that every Democrat 
should like, and they say no. They will not even support changing one 
sentence of a law, even if it changes parts that don't work and that 
they are for.
  What was their reason? Here is their reason. They would not apply to 
our proposal the traditional Hyde compromise language regarding Federal 
funding for elective abortions. What that basically says is that there 
may be no Federal funding for elective abortions, but States may do 
what they want. That has been the compromise since 1976. Since 1976, in 
every omnibus appropriations bill, Democrats have voted for that. In 
fact, all those weren't omnibus bills. Some of them were different 
appropriations bills. Since 1976, in every appropriations bill, 
Democrats have voted for the Hyde amendment. In the omnibus 
appropriations bill that we passed a month ago, Democrats voted for the 
Hyde amendment more than 100 times in other proposals, but they would 
not vote to lower health insurance rates by 40 percent over 3 years.
  I will say that again. Even though they voted for the Hyde language 
every year since 1976 and voted for it 100 times in the omnibus bill, 
they would not vote for it. They would not vote for our proposal to 
lower rates even though it was bipartisan because they didn't want to 
apply that same compromise Hyde amendment to health insurance.
  Howard Baker, the Senate majority leader, once said that the essence 
of Senate leadership is becoming an eloquent listener. That means 
hearing and understanding what people have to say because what they are 
saying is not always what they mean.
  My conclusion is that, by their words and by their actions, what 
Democrats really were saying is this: We will not change one sentence 
of ObamaCare, even the parts that obviously are not working and even 
when most of the Democrats would support the policy and the changes.
  Given the Democrats' attitude, I know of nothing that Republicans and 
Democrats can agree on to stabilize the individual health insurance 
market. I know of nothing.
  No one regrets Congress's failure to reach an agreement on this more 
than

[[Page S2545]]

I do. I ran for the U.S. Senate because I wanted to achieve bipartisan 
results on important issues. I have often been able to do that, but I 
literally struck out here.

  When Democrats blocked these proposals from being included in the 
omnibus in March, I said: ``Now let's look down the road . . . 
insurance companies will announce their rates for 2019 . . . and rates 
will continue going up instead of going down.''
  They are right about that. Already in the last few days, it has been 
announced that rates will go up in 2019. Millions of Americans will be 
hearing more about that. The Democrats could have worked with us to 
lower premiums by up to 40 percent. They instead chose to cling to an 
unworkable law, to skyrocketing rates, and to reject any change that 
would have temporarily reduced rates, even though the President and the 
Republican leaders were willing to support ideas that the Democrats, as 
a matter of policy, almost unanimously support.
  For relief, we will have to turn to the Trump administration and to 
the States. I am encouraged by Labor Secretary Acosta's proposed rule 
on association health plans. It would help some self-employed 
Americans, like Marty, the farmer, and employees of small companies to 
buy the same kind of insurance with the same lower cost and the same 
protections that roughly 160 million Americans who work for large 
employers have today. In other words, if you work for IBM, you in 
effect get about a $5,000 average tax break because of the way the tax 
law applies to employer insurance. We would like to give the same 
opportunity to the self-employed and to people in small businesses.
  The Trump administration has also proposed a rule that would reaffirm 
the role of States in regulating short-term health insurance and that 
could provide a coverage option for Americans who are uninsured because 
plans in the Affordable Care Act markets are too expensive. Neither of 
these changes require the approval of Congress.
  I am talking with Secretary Azar and Seema Verma, the Administrator 
of the Centers for Medicare and Medicaid Services, about other 
administrative actions they can take to give States more flexibility 
within the current law to help lower health insurance premiums, 
especially for the 9 million working Americans who do not receive a 
Federal subsidy in the individual market.
  Those are the ones who are getting hammered. Those are the one whose 
rates we could have reduced by up to 40 percent over the next 3 years, 
but the Democrats said no.
  I will be encouraging Governors and State insurance commissioners to 
do everything they can to repair the damage caused by the Affordable 
Care Act, but my own efforts as chairman of the HELP Committee will 
turn to other pressing healthcare issues, including the opioid crisis, 
overall healthcare costs, electronic healthcare records, prescription 
drug prices, and the 340B program.
  Contrary to the Democratic leader's speech, this is not a crisis of 
Republicans' making. Democrats should look in the mirror. The last 5 
years and the upcoming 6 years of premium increases are the fault of a 
law designed, drafted, and voted on exclusively by Democrats.
  Last year, Republicans freed Americans from the individual mandate 
requirement, which was a tax on the poor that forced many Americans to 
buy insurance they couldn't afford or didn't meet their needs. We tried 
to provide even more freedom from this unworkable law, but, as I have 
detailed, Democrats said no.
  If you have an insurance premium that is going up 40 percent next 
year, on top of the more than 105 percent increases since 2013, you can 
thank the Democrats. If you would like greater choice and an 
opportunity for lower premiums, you should support Republicans.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wisconsin.