[Congressional Record Volume 164, Number 168 (Wednesday, October 10, 2018)]
[Senate]
[Pages S6755-S6758]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Mr. President, in addition to praising the water resources bill, 
which was a great bipartisan effort--there are some wonderful wins in 
there for Michigan--specifically at this moment, I want to speak about 
my deep regret that a little while ago, a very important resolution did 
not get the bipartisan votes necessary to pass on the Senate floor. 
That resolution, which failed, would have stopped the administration's 
short-term plan rule, which is gutting comprehensive healthcare and 
undermining people with preexisting conditions getting the healthcare 
they need and deserve.
  About half the families in Michigan have someone in their family with 
a preexisting condition. It could be anything from high blood pressure, 
to diabetes, to something like cancer or whatever other illness it 
might be. They are in a situation now, with these junk plans, as we 
call them, where they are going to be undermined, and they either won't 
be able to get any health insurance, or it will cost much, much more.
  I have often said that healthcare isn't political; it is personal. It 
is not political. We all care about being able to get the healthcare we 
need for ourselves, our children, our moms, and our dads. When a family 
has a child born with a seizure disorder, they aren't wondering whom 
their pediatrician voted for in the last election. When a single mom of 
two teenagers learns she has breast cancer, she is not concerned about 
who is up in the polls and who is down in the polls. When a senior is 
forced to make a decision between buying the medication that helps him 
breathe better or keeping his heat on, he is not interested in what is 
happening on Twitter.
  Healthcare isn't political--not to any person I represent or to me or 
my own family; it is personal, and it affects every one of our 
families, whether we are Democrats, Republicans, urban, rural, red 
States, and blue States. I wish we could come together and work on ways 
to provide more healthcare and reduce costs based on that premise--that 
it is personal, not political.
  When people tell me their healthcare stories, I can assure you that 
they don't start with their political affiliation because it doesn't 
matter; they simply want to know that the healthcare they depend on for 
themselves and their families will be there. That is why I am so 
concerned about the short-term, limited-duration insurance plans, which 
we are calling junk plans because that is what they are. They may be 
cheap, but they don't cover much, if anything, and you don't know until 
you get sick. Many of them are medically underwritten, meaning

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that insurance companies can charge whatever they like based on the 
applicant's health, their gender, their age, their health status.
  Remember when being a woman was considered a preexisting condition? I 
certainly do. These plans are coming back. They are coming back through 
these junk plans. One recent study found that none of the plans cover 
maternity care. As a member of the Finance Committee, I led the fight 
to cover maternity care and birth control services and other preventive 
services for women. That is pretty basic for the women of this country. 
And if, as a man, you think you didn't need it, well, just ask your mom 
whether she did.
  On top of that, these plans can exclude people with preexisting 
conditions or impose yearly or lifetime caps on care. As I indicated, 
it is estimated that half of Michigan families include someone with a 
preexisting condition--everything from diabetes, to asthma, to 
arthritis, to cancer. Under the Affordable Care Act, we didn't have to 
worry about people with preexisting conditions being covered--until it 
began to be undermined through these new administrative rules put 
forward by the administration.
  Louisa is a beautiful little Michigan girl who was born with half a 
heart. I was so fortunate to meet her and her parents earlier this 
year. Louisa didn't ask for half a heart. She and her parents didn't do 
anything to cause it. Louisa didn't have a choice. She needs 
comprehensive health insurance.
  Unfortunately, that kind of insurance is getting less and less 
affordable. Thanks to short-term plans and other health insurance 
changes, comprehensive health insurance will cost over 12 percent more 
next year in Michigan than it would otherwise cost, and it is only 
getting worse.
  Louisa should be able to focus on starting school, growing up, 
learning to drive, going to college, and having a family of her own, 
not whether she will pay more for insurance, if she can get it, because 
she was born with a preexisting condition.
  Louisa isn't alone. She is just one of the estimated 130 million 
people in our country with preexisting conditions. That is 130 million 
people who could be hurt either directly or indirectly by these short-
term junk plans.
  Perhaps you are incredibly lucky, and nobody in your family has a 
preexisting condition. These short-term policies are a good choice, 
then, right? Well, just ask Sam, who came to DC earlier this year to 
share his story.
  Sam is self-employed. He owns a small landscape design business. In 
2016, Sam was shopping for health insurance. He had been healthy, aside 
from some back pain. He told his insurance broker that he had been to 
the chiropractor a number of times and that the chiropractor had taken 
x rays but had not been able to make a diagnosis for his back pain. The 
broker assured Sam that as long as he didn't have a diagnosis, he would 
be wasting his money if he bought anything other than a short-term 
insurance plan. Sam took her advice, thinking he was signing up for a 
quality health insurance plan that would meet his needs.
  Fast-forward to 2017 when at age 28 Sam was diagnosed with stage IV 
non-Hodgkin's lymphoma. What he thought was simply back pain turned out 
to be an aggressive form of blood cancer. After 6 months of 
chemotherapy and radiation, Sam's cancer was in remission; however, his 
doctors told him that a bone marrow transplant was his only hope for a 
long-term cure.
  Then Sam heard from his insurance company. They refused to pay for 
any of his treatment--any of his treatment--even though he had 
insurance, including the bone marrow transplant, because they claimed 
the cancer was a preexisting condition even though his broker had told 
him that was not the case. Sam appealed this decision and endured nine 
additional rounds of chemotherapy to keep his cancer in remission. 
After months of waiting--months of waiting--his appeal was denied.

  Sam was left with no health insurance, no way to pay for a lifesaving 
bone marrow transplant and about $800,000 in medical bills, even though 
he had bought an insurance policy. Sam eventually was able to buy some 
real health insurance--the kind that covers you when you get sick--and 
get the bone marrow transplant he needed. He is healthy again, thank 
goodness, but his finances aren't.
  In his words: ``Instead of planning a life together with my 
girlfriend and a future for my business, I am kept up at night worrying 
about staying afloat, how to pay the next bill, how to avoid 
bankruptcy.''
  This is the story of too many people before the Affordable Care Act 
passed, requiring comprehensive coverage and requiring people with 
preexisting conditions to be able to get affordable coverage. As I said 
before, healthcare isn't political; it is personal. People with 
preexisting conditions deserve to know their insurance will be there 
when they need it. Families with a sick child deserve to focus on 
getting her better, not how they are going to pay the bill for the 
doctor, and small business owners like Sam deserve insurance that 
covers them while they are sick or hurt and doesn't leave them on the 
verge of bankruptcy.
  That is what we are talking about. These current plans undermine the 
capacity for people to be able to get real coverage. They are less 
expensive, but they don't cover much, if anything, and the problem is 
you don't know until you get sick. What we need and what everyone needs 
is the confidence that they are buying affordable insurance that will 
actually cover them and cover their families. Everyone deserves that 
kind of insurance. This isn't about politics; it is about protecting 
what is most precious--our families and our health. Unfortunately, 
because of the administration's actions, we are seeing tremendous 
rollbacks that are putting more and more power back into the hands of 
insurance companies that are making their decisions based on what is 
best for their profits, not what is best for families.
  I am very disappointed that we weren't able to stop that today, but I 
am going to continue to try, as are my Democratic colleagues. We are 
committed to doing everything we can to ensure that people in the 
greatest country in the world know they can have affordable healthcare 
coverage that actually covers their healthcare needs.
  Thank you.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan.
  Mr. PETERS. Mr. President, the topic of healthcare affordability 
should unite us as a common cause. We all need healthcare, whether 
young or old or male or female, rich or poor.
  Not one of us will go through life without experiencing a major 
health concern. Even if we have a clean bill of health today, we all 
face the prospect of accidents, illnesses, and the inherent universal 
health challenges of aging.
  The Affordable Care Act is not perfect, but it has moved us toward a 
shared goal of making healthcare more affordable for everyone. Most 
significantly, the Affordable Care Act prevents insurers from denying 
coverage or increasing premiums because of a preexisting condition. 
This critical protection has been widely and wildly popular, and 
rightly so. If you don't have a preexisting condition, you probably 
have a family member who does.
  The Affordable Care Act also requires plans to cover a full set of 
benefits that enrollees will realistically need over the course of 
their lives, and, overall, it encourages Americans to get their health 
insurance so that they will have the appropriate support when they need 
it the most.
  I will be the first to recognize that there is room for improvement 
in our healthcare law, but we need to be working together to fix it, 
not allowing the Trump administration to continue its relentless push 
to undermine the affordability of healthcare. Since the beginning of 
his administration, President Trump has taken every possible step to 
weaken consumer protections in health insurance, all the while 
misinforming the public about what the real impact will be on their 
daily lives. But Americans right now are feeling the impact. For too 
many hard-working families, health insurance and healthcare costs are 
still not affordable. Today, premiums are going up, healthcare prices 
are soaring, and the burden of cost is increasingly shifted to the 
patient.
  We should be focused on ways to strengthen our healthcare system so 
that it lowers out-of-pocket costs, removes barriers to healthcare, and

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incentivizes cost efficiency. But the flawed Trump administration 
policy the Senate voted on earlier today is a step in the wrong 
direction. It is a step toward terrible coverage for consumers who will 
not understand what their plan fails to cover until they need it.
  We are seeing yet another Trump administration effort to roll back 
parts of the Affordable Care Act that are actually working every day to 
help Americans. President Trump is creating a new loophole for some 
insurers to ignore the Affordable Care Act's central patient 
protections. This is moving us back toward a period where insurance 
companies could discriminate against Americans based on their 
conditions, such as diabetes, cancer, arthritis, and even pregnancy--
yes, even pregnancy. Millions of Michiganders rely on the Affordable 
Care Act's safeguards for preexisting condition coverage.
  Americans should have the power to choose their own healthcare, but 
unfortunately this administration has it backward. President Trump 
wants to give more power to insurers to not only choose who they cover 
but also what they cover.
  The Affordable Care Act's 10 essential healthcare benefits are truly 
just that; they are indeed essential. The list includes things like 
prescription drugs, hospitalizations, and preventive care. Before the 
Affordable Care Act, we saw insurance companies neglect to cover 
services like maternity care, substance abuse disorder treatment, and 
mental health care. These are all truly essential elements of any true 
plan.
  The Trump administration is allowing for risky plans that make 
insurance companies money while shifting costs to taxpayers and 
Michiganders who choose to cover these essential health benefits. The 
Trump policy will create a parallel market that targets only relatively 
healthy, less costly individuals, and that is why I am deeply 
disappointed by today's vote and the actions of this administration.
  The true message President Trump is sending to the public is that he 
wants you to be misinformed. He wants you to make bad decisions and buy 
these flawed plans, increasing the profits of insurers.
  American taxpayers will be left with the bill when patients find out 
that their insurance and all of the money they have put into that 
insurance over so many years simply does not cover their healthcare 
needs when they need it the most.
  No matter where you live, how much money you make, or what your 
health record looks like, no one should be forced to make the 
impossible choice between seeking medical assistance or paying the 
bills for other basic necessities. Regardless of what the health 
condition is or when it arises, all Americans deserve certainty that 
their decision to go to a doctor will not push them into bankruptcy.
  Let's be clear that any Member who voted to support the Trump 
administration's efforts to undermine the ACA casts a vote today 
against coverage protections for preexisting conditions and against 
affordable, quality healthcare for all American families.
  Thank you.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Nevada.
  Ms. CORTEZ MASTO. Thank you, Mr. President.
  I rise today to share the story of one of my friends, Jesse 
Kleinedler. Jesse and her husband own and operate one of Reno's most 
successful small businesses--the Under the Rose Brewing Company. They 
are also the proud parents of a beautiful baby boy. Jesse, her family, 
and their business are doing great. But when I met Jesse last year, she 
told me her path to this point in life had not been easy.
  In 2012, Jesse left her job at a large firm--and the health insurance 
it provided--to pursue her dream of starting a brewery with her husband 
Scott. About 1 year later, she learned that she was pregnant. During a 
routine checkup 9 weeks before her due date, Jesse's midwife advised 
her to see an OB/GYN. Jesse didn't feel sick, so she hesitated, but the 
midwife urged her to go see a specialist anyway.
  Midway through her visit, the OB/GYN became concerned that Jesse's 
life was in danger. He diagnosed her with preeclampsia and rushed her 
to the hospital. Jesse's son was born a few hours later via emergency 
C-section. The doctors who delivered her baby agreed that had Jesse 
waited even 24 hours to see an OB/GYN, both she and her son would have 
died.
  In no uncertain terms, Jesse told me that she and her son owe their 
lives to the Affordable Care Act. Without the affordable coverage 
having been purchased on the Silver State Health Insurance Exchange, 
Jesse would not have been able to have seen a specialist, and she and 
her husband, certainly, would not have been able to have afforded the 
$1 million in medical costs Jesse's son incurred over the course of a 
months-long stay in the NICU.
  Jesse's son is now a happy, thriving toddler, but he has a medical 
issue that interferes with his growth. Jesse and Scott, her husband, 
fear that President Trump's efforts to roll back protections for people 
with preexisting conditions will make it impossible for them to afford 
their son's health insurance.
  Donald Trump has not yet been able to get the support in Congress he 
needs in order to repeal protections for people with preexisting 
conditions, but he has taken steps to circumvent the wheel of Congress 
and hack away at these protections bit by bit.
  In August, he signed an Executive order to expand access to what are 
called junk plans. These are health insurance plans that don't cover 
essential services like prescription drugs, emergency room visits, or 
maternity care. These plans are designed for short-term use only and 
don't include protections for people with preexisting conditions. That 
means, if you sign up for one of these plans and are a cancer survivor 
or are a pregnant woman or are a war veteran, you could be charged a 
higher rate. It also means you could be forced to pay tens of thousands 
of dollars out of pocket for the care you receive in an emergency.
  Junk plans come in all shapes and sizes, but none of them comply with 
consumer protections established by the Affordable Care Act. The Kaiser 
Family Foundation looked at junk plans in 45 States and found that 43 
percent did not include coverage for mental health services, that 71 
percent did not cover outpatient prescription drugs, and that not a 
single one covered maternity care.
  Junk plans appear to be cheaper than comprehensive health insurance 
plans--that is, until you read the fine print. Junk plans have low 
monthly premiums and astronomical out-of-pocket costs. President 
Trump's Executive order allows insurance companies to trick consumers 
into signing up for these plans. Consumers think they are getting a 
good deal, only to find out, as soon as they get sick, that their 
medical bills are not covered.
  The American Cancer Society Cancer Action Network says junk plans 
pose ``a serious threat to cancer patients' ability to access quality, 
affordable health coverage.'' It also says the present administration's 
rule will likely leave older and sicker Americans in the individual 
insurance marketplace, with few, if any, affordable health coverage 
choices and that patients who are living with serious conditions will 
be left paying more for the coverage they need if they can afford 
coverage at all.
  President Trump's Executive order to expand access to junk plans is 
not just an attack on our healthcare system, it is an attempt to send 
us back to the days when families like Jesse's could not afford the 
healthcare they needed. Jesse told me she owes her life to the health 
insurance she purchased through the ACA. Where would Jesse and her 
family be without it? What if she had not been able to afford a 
comprehensive plan? What if she had purchased a junk plan instead?
  There are 1.2 million Nevadans who live with preexisting conditions. 
That is nearly one in two. That number includes nearly 159,000 children 
and nearly 270,000 people who are nearing retirement. The junk plans 
rule directly threatens their healthcare.
  Heather Korbulic, who is the executive director of the Silver State 
Health Insurance Exchange, summed up the risk junk plans pose.
  She said: ``[Junk plans] are designed to basically take your 
preexisting condition and charge you more or tell you that you can't be 
on those plans at all.''

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  She continued: ``If they find that you've not disclosed a preexisting 
medical condition . . . then you're left high and dry with no 
insurance.''
  I don't want to go back to a world where Nevadans with preexisting 
conditions can't get the care they need or where insurance companies 
aren't required to cover basic services like maternity care.
  I was a proud cosponsor of Senator Tammy Baldwin's resolution to 
overturn President Trump's Executive order. In failing to pass this 
resolution, the U.S. Senate has done a profound disservice to families 
and communities all across the country. I will continue fighting to 
restore protections against junk plans, and I encourage all of my 
colleagues to do the same.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from South Dakota.