[Congressional Record Volume 165, Number 86 (Wednesday, May 22, 2019)]
[Senate]
[Pages S3035-S3038]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Ms. BALDWIN. Mr. President, I rise today to speak about the ongoing 
threat from the Trump administration to healthcare and the guaranteed 
protections that millions of American families depend upon.
  President Trump has tried to pass repeal plans that would take 
people's healthcare away and allow insurance companies to charge more 
for people with preexisting health conditions or those insurance 
companies could deny them coverage altogether.
  When that repeal plan failed to pass in the Senate in the summer of 
2017, instead of working in a bipartisan way to lower healthcare costs, 
President Trump turned to truly sabotaging our healthcare system.
  What do I mean by that?
  The Trump administration made it harder for people to sign up for the 
Affordable Care Act coverage. They have done so by limiting the window 
of time when people can enroll. They have truly created instability in 
the healthcare market, and their sabotage has contributed to premium 
spikes that we have seen across the country, including in my home State 
of Wisconsin.
  The Trump administration has even gone to court to support a lawsuit 
in order to overturn the Affordable Care Act completely, and that, of 
course, would include protections for people with preexisting health 
conditions. They have essentially gone into court to ask the court to 
strike down the Affordable Care Act. Now, if they were to succeed, 
insurance companies will again be able to deny coverage or charge much 
higher premiums for the more than 130 million Americans who have some 
sort of preexisting health condition. The number with preexisting 
health conditions includes some 2 million Wisconsinites.
  What is the President's plan to protect people with preexisting 
health conditions? He doesn't have one, and I don't believe he ever 
will.
  In fact, he has acted in just the opposite vein. This administration 
has expanded junk insurance plans that can deny coverage to people with 
preexisting conditions, and they don't have to cover essential services 
like prescription drugs or emergency room care or maternity care.
  I ask my friends on the other side of the aisle to think about this 
for a moment. President Trump supports overturning the law that 
provides protections for people with preexisting health conditions at 
the same time he is expanding these junk plans that don't provide those 
very protections. If this isn't straight-up sabotage, I really don't 
know what is.
  When I was 9 years old, I got sick. I was really sick. I was in the 
hospital for 3 months. Now, I recovered, but my family still struggled 
because I had been branded with the words ``preexisting health 
condition'' and I was denied insurance coverage.
  That family and personal experience has driven my fight to make sure 
that every American has affordable and quality healthcare coverage.
  Today, because of the Affordable Care Act, those with preexisting 
health conditions cannot be discriminated against. They can't be denied 
healthcare coverage, and they can't be charged discriminatory premiums.
  I want to protect the guaranteed healthcare protections that so many 
millions of Americans now depend upon. I have introduced legislation 
along with my colleague Senator Doug Jones of Alabama to overturn the 
Trump administration's expansion of junk insurance plans.
  The entire Senate Democratic caucus, including the two Independents 
who caucus with us, have supported this legislation. They have signed 
on to this bill. The Nation's top healthcare organizations, 
representing tens of thousands of doctors and physicians, and patients 
and medical students, and other health experts have supported this 
legislation and endorsed it. Anyone who says they support healthcare 
coverage for people with preexisting conditions should support my 
legislation.


                   Unanimous Consent Request--S. 1556

  Mr. President, as in legislative session, I ask unanimous consent 
that the Health, Education, Labor, and Pensions Committee be discharged 
from further consideration of S. 1556; that the Senate proceed to its 
immediate consideration; 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 Tennessee.
  Mr. ALEXANDER. Reserving the right to object, this is the latest 
Democratic attempt to raise the cost of healthcare paid for out of your 
own pocket by taking away an ability to provide lower cost health 
insurance that preserves preexisting condition protection and the 
essential health benefits. These short-term health benefits were 
available under President Clinton. They were available under President 
Bush. They were available under President Obama right until the last 
few months of his office, when he cut them down to 3 months long.
  President Trump has simply said that you may now have them up to a 
year and renew them for 3 years. If you live in Fulton County, GA, your 
insurance costs will be 30 percent less against the typical ObamaCare 
bronze plan and even more against the silver plan.
  This is the latest Democratic attempt to increase the cost of what 
you pay for healthcare out of your own pocket. Their next attempt will 
be Medicare for All, which, if you have health insurance on the job, 
will take that health insurance away.
  I object.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from Wisconsin.
  Ms. BALDWIN. Mr. President, I am certainly disappointed that my 
Republican colleagues have chosen to object to protecting people with 
preexisting conditions.
  It is my contention that some of the very opposite impacts, because 
of these junk plans, are occurring than what my colleague has recited. 
In fact, I hardly consider them insurance plans. Many have argued that 
they are not worth the paper that they are written on. They don't cover 
many essential benefits. They are not required to cover people with 
preexisting health conditions. They can drop people. They can charge 
outrageous prices. What we found--and the reason that the Obama 
administration went from yearlong plans to 3-month plans--is that they 
saw the distortion in the markets. They saw that people who had 
believed that they might not get sick--healthy, often younger people--
were availing themselves of these plans, making the Affordable Care----
  Mr. ALEXANDER. Mr. President, will the Senator yield for a question?
  Ms. BALDWIN. I would yield to one question, and then I want to wrap 
up my comments.
  Mr. ALEXANDER. Mr. President, is the Senator of Wisconsin not aware 
that the short-term healthcare plans do not change the law of 
preexisting condition?
  Ms. BALDWIN. Mr. President, these short-term plans do not have to 
cover preexisting conditions. I can tell you, as I have inquired--
  Mr. ALEXANDER. Mr. President, may I----
  Ms. BALDWIN. I yielded already for a question. But I want to say----
  Mr. ALEXANDER. She gave the wrong answer, Mr. President.
  The PRESIDING OFFICER. The Senator from Wisconsin has the floor.
  Ms. BALDWIN. It may not be to the Senator's liking, but I was going 
to tell you about the plans that I read the fine print on from the 
State of Wisconsin. Now that these short-term plans are renewable for 
up to 3 years, in these junk plans, you can see the fine print. Many 
times they start with this: We will not cover a preexisting condition. 
Every single one of them refuses to cover maternity care. That means 
none of these junk plans cover that essential benefit. Most of them 
don't cover

[[Page S3036]]

emergency room care. Most of them don't cover prescription drugs. So 
regardless of how the law impacts people who have other types of 
insurance, I feel strongly that these junk plans are very distorting of 
the market and not worth the paper they are written on for those who 
have chosen to take that route.
  Last fall, we heard all my colleagues across the aisle say, often 
repeatedly, that they support protections for people with preexisting 
health conditions. Today I just offered an opportunity for Democrats 
and Republicans to come together to protect people's access to quality, 
affordable healthcare when they need it the most, but there was an 
objection.
  I say to the American people that we must not lose sight of the fight 
right in front of us. We have a President who time after time has 
sabotaged our healthcare system, raised healthcare costs, and pushed 
these junk insurance plans that don't have to cover people with 
preexisting conditions. We have an administration that is asking a 
court to strike down the Affordable Care Act and its protections for 
people with preexisting conditions in their entirety.
  The choice for the American people could not be more clear. We want 
to make things better, and my Republican colleagues refuse to join us 
in this effort, which would be to prevent this administration from 
making things worse.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.


      Protecting Americans with Preexisting Conditions Act of 2019

  Mr. MURPHY. Mr. President, the House recently passed a piece of 
legislation called the Protecting Americans with Preexisting Conditions 
Act. The substance of this legislation would prevent a Trump 
administration rule from going into effect that would allow for States 
to license the kind of insurance plans that Senator Baldwin was 
referring to. These are plans that do not cover preexisting conditions 
or the essential healthcare benefits.
  I am going to offer right now a unanimous consent request to proceed 
to immediate consideration of this bill. I suspect it will be objected 
to. After an opportunity for Republicans to object, I will speak to the 
merits of this legislation. So let me start with a request to bring 
this legislation that will protect people with preexisting conditions 
and the essential healthcare benefits to the floor.


                  Unanimous Consent Request--H.R. 986

  Mr. President, my motion is as such: As if in legislative session, I 
ask unanimous consent that the Senate proceed to the immediate 
consideration of Calendar No. 90, H.R. 986, Protecting Americans with 
Preexisting Conditions Act of 2019; 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 Tennessee.
  Mr. ALEXANDER. Mr. President, reserving my right to object, section 
1332 is the innovation waiver that is part of the Affordable Care Act, 
passed by the Democratic majority. That act includes protection for 
preexisting conditions. Using the flexibility granted under section 
1332 does not change anything about preexisting conditions. So it is 
misleading to the American people to suggest that it does.
  This is another Democratic attempt to make it more expensive, to cost 
more for what you pay for healthcare out of your own pocket by taking 
away flexibility from the States to find a less expensive way for you 
to afford healthcare and, at the same time, not changing the 
preexisting condition protection that is provided by the Affordable 
Care Act. This is the latest attempt to do it, but the boldest attempt 
to raise the cost of your healthcare is Medicare for All, which if you 
have insurance on the job, as 181 million Americans do, would take that 
insurance away from you.
  I object.
  The PRESIDING OFFICER. Objection is heard.
  Mr. MURPHY. Thank you, Mr. President. Again, I share in Senator 
Baldwin's disappointment that we can't move immediately to this 
legislation. This isn't a political game. These are individuals all 
across the country who are relying on us to make sure that they are not 
subject to the abuses of the market. They are relying on us to make 
sure we don't return to the days in which insurance companies could 
prevent you from getting healthcare simply because you were sick or 
return to the days when you bought an insurance product and then it 
didn't turn out to ultimately be insurance.
  Let's be clear. The waiver that the President has allowed States to 
take advantage of would absolutely--it would by definition of the 
rule--allow for States to waive the preexisting condition requirement. 
The rule itself says that the innovation that happens at the State 
level does not have to comply with the essential healthcare benefits 
requirement. It says in the rule that you do not have to comply with 
preexisting conditions requirements. That is the reason that they are 
so cheap. So I am at a loss as to why we have Republicans on the floor 
saying that preexisting conditions will be protected under this rule. 
That is not true. The rule says that States do not have to comply with 
the preexisting requirement. It says that States do not have to cover 
essential healthcare benefits. That is why these junk plans are 
attractive, because they aren't actually insurance, and they are only 
insurance for people who are at the time very healthy.
  We have to get on the same page here. We have to be reading from the 
same script. The fact of the matter is, the definition of the rule 
allows for protections for people with preexisting conditions to be 
discriminated against.
  I am sorry that we weren't able to bring up this piece of legislation 
because healthcare insurance should be healthcare insurance. And what 
we worry about are two things. First is that by allowing for the 
marketing of these junk plans, you are going to have all sorts of 
people who today aren't sick jumping into those plans, coming off of 
the plans that protect people with preexisting conditions. The people 
who are going to be left behind on those regulated plans are people who 
are sick, people who have preexisting conditions. So you are, all of a 
sudden, bifurcating the insurance market. You are going to have a 
market for people who are currently healthy, and then you are going to 
have a market for people who are sick or have ever had a preexisting 
condition.
  You do not have to be an actuary and you don't have to have taken 
classes in healthcare insurance economics to know that when that 
happens, rates skyrocket for people who have a preexisting condition--
for the millions of people around this country who have had a serious 
diagnosis at some point during their life.
  So as you sell these junk plans, there is no way but for costs to go 
up. That is on top of the increases we saw last year. Last year, 
insurance companies priced in the costs of Trump administration 
sabotage. They priced into their premiums the attacks on our healthcare 
system from the Republican Congress.
  In many States, we saw insurance plans pushing 60 percent, 40 
percent, and, in some cases, 80 percent increases in premiums. Now on 
top of that, for sick people, for people with preexisting conditions, 
the rates are going to be even bigger because of the flight of those 
without preexisting conditions into marketplaces set up specifically 
for them.
  The second thing we worry about is that these junk plans market 
themselves as insurance, but they aren't. Here is a list of things that 
I would generally consider to be covered under my insurance plan.
  If I bought an insurance plan, if I handed over a check to the 
insurance company, I kind of think that if I go to the emergency room, 
I am not going to have to pay for it out of my pocket. I am thinking to 
myself: Well, you know what, if I need prescription drugs, they are 
going to cover some of that. Well, if I have a mental health diagnosis, 
doesn't insurance cover my head as well as the rest of my body?
  These are the things that I would assume that insurance covers, but 
these junk plans don't cover these things.
  Junk plans do not cover trips to the emergency room. Junk plans often 
don't cover hospitalizations. They don't cover prescription drugs. 
Almost none of them cover maternity care. Your checkups might not be 
covered

[[Page S3037]]

under a junk plan. Preexisting conditions will cost you more. 
Contraception isn't going to be in lots of these plans. They are not 
required to cover lab services or pediatrics. Mental health isn't going 
to be in many of these junk plans. As for rehab services, if you get 
injured, you are not going to find those in some of these plans. And if 
you have a chronic disease, there is nothing in the law that requires 
treatment for those to be covered.
  So all of a sudden, as for the things you thought insurance covered, 
they don't cover it, and you have been paying a premium for years. 
Then, when you finally need access to the system, it is not there. That 
is what these plans can do. That is what the law and the Trump 
administration rule allows States to license as insurance. And that is 
why we are on the floor today, to ask--to plead--to our colleagues to 
bring legislation before this body, either Senator Baldwin's 
legislation or Representative Kuster's legislation that has already 
passed the House, that would stop these junk insurance plans from being 
sold all around this country, which will trick many Americans into 
believing they have insurance when they don't and will dramatically 
raise the cost of care potentially in many States for people who have 
serious preexisting conditions.

  I am not surprised at the objection to both of our unanimous consent 
requests. Nevertheless, I am disappointed in it. We will continue to be 
down here on the floor for as much time as it takes to try to rally the 
whole of this body to protect people with preexisting conditions, to 
fight back against the sabotage of the Affordable Care Act and the 
healthcare system by this President. Hopefully, one day we will be 
successful.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan.
  Ms. STABENOW. Mr. President, I am proud to be here on the floor today 
to join with Senator Baldwin and Senator Jones on their resolution with 
Senator Murphy. I have to say to Senator Murphy, before he puts that 
down, I have to look at that list and tell you that, before the 
Affordable Care Act, I would get calls like this, and I am sure you 
did, too.
  Someone calls me and would say: I paid into healthcare all my life 
and never gotten sick, and then I finally needed surgery. What do you 
mean it only pays for 1 day in the hospital? Well, it never paid for 
more than 1 day in the hospital, but they didn't know it because they 
didn't get sick.
  So folks buy the junk plans--and thank you for the list--but they buy 
the junk plan being healthy and then will never know that it doesn't 
cover those things unless they get sick. When they find out, it will be 
too late.
  So that is why we are here because we know that healthcare isn't 
political. It shouldn't be political. It is personal for every one of 
us. It is personal for ourselves and our families. It affects all of 
us, whether we are Democrats, Republicans, Independents, vote, don't 
vote, urban, rural from any State in the Union.
  In fact, when people tell me their healthcare stories, they don't 
start by telling me their political affiliation. They talk to me about 
what has happened to them, what has happened to their mom and dad, what 
has happened to their children. Political affiliation doesn't matter.
  People in Michigan simply want to know that the healthcare they 
depend on will be there for them and be affordable for them and their 
family today and into the future, and that is the fight that we have as 
Democrats. We will continue that fight.
  Unfortunately, they have reason to be worried about the rise of 
short-term, limited duration insurance plans. They should be worried 
about what these plans don't cover--junk plans, as we are calling them. 
As Senator Baldwin said so well, they are junk. They don't really cover 
anything. They make you feel good, as long as you are healthy, that you 
have got insurance, but then you find out, when you get sick, that your 
child is not covered or you are not covered.
  The fact many of these plans are medically underwritten, which means 
that the insurance company--by the way, junk plans are about putting 
decisions back in the hands of the insurance company, instead of you 
knowing that you and your doctor can decide what you need and that it 
will be covered. The insurance companies can charge whatever they want 
based on somebody's health, gender, age, or other status.
  Remember when being a woman was considered a preexisting condition? I 
do. These plans are bringing that back. One recent study found that 
none of these plans that have been approved by the Trump administration 
so far cover maternity care--none of them. We fought hard--I fought 
hard--as a member of the Finance Committee to make sure that women's 
healthcare and maternity care were covered. Our healthcare is as basic 
a healthcare as any man's healthcare and ought to be covered the same.

  I want to repeat this. We have a maternal health crisis in this 
country, and the administration is pushing plans that don't cover basic 
coverage for women. On top of that, these junk plans can exclude people 
with preexisting conditions--yes, they can--and impose yearly or 
lifetime caps on care.
  Remember when you had to worry about how many cancer treatments the 
insurance company would pay for? Now, there aren't caps so that you can 
decide and your doctor can decide with you on what it takes to put you 
in remission and put you on a healthy path. It is estimated about half 
of Michigan families include somebody with a preexisting condition--
about half--with everything from heart disease to asthma to arthritis. 
I met with some of them earlier this month during the National Brain 
Tumor Society's Head to the Hill event.
  Tiffany, who is from Livonia, was just 17 years old when she was 
diagnosed with a brain tumor. Since then, her tumor has reoccurred six 
times. She has been through seven surgeries, chemotherapy, and 
radiation treatments. The location of her tumor means that Tiffany has 
also lost some of the use of her left arm and hand. Tiffany doesn't 
have a choice. Her life depends on having comprehensive health 
insurance. Unfortunately, that kind of insurance is getting less and 
less affordable.
  So when our Republican colleagues come to the floor and say that we 
just want to raise prices, let me tell you what has really happened in 
the last year. The sabotage by the Trump administration, the 
unravelling of the Affordable Care Act, the junk plans, now the 
instability and going into court to try to totally repeal the 
Affordable Care Act, all of that instability--everything that has been 
done--means that comprehensive health insurance costs have gone up 16.6 
percent this year, so somebody buying insurance is paying an average 
16.6 percent more than they did last year because of all of this effort 
to sabotage, undermine, and unravel the healthcare system.
  Tiffany should be able to focus on getting the treatment she needs 
and living her best life possible, not how she will pay for the 
insurance she needs. We all know Tiffany isn't alone. It is estimated 
that 130 million people in our country are living with preexisting 
conditions--130 million people. That is 130 million people who could be 
hurt either directly or indirectly by these short-term junk plans.
  Two weeks ago, I had the chance to speak at the Detroit Race for the 
Cure, which raises money for breast cancer research and services. As I 
stood on the stage and looked out at over 10,000 people, a lot of 
beautiful pink all surrounding us in downtown Detroit, I saw people 
with preexisting conditions. One woman, who was standing on the stage 
near me, asked me the question: Why is it that I have to worry about 
whether or not I will be able to get insurance in the future? Why do I 
have to worry about that?
  She added: Why don't President Trump and other Republicans understand 
this is my life?
  It is not political for her. It is personal. It is her life. I think 
that is a very good question: Why don't Republicans understand that 
people like Tiffany and those women in pink deserve healthcare 
protections?
  Protecting people with preexisting conditions isn't about politics. 
It is about saving lives. I urge my colleagues to support this 
commonsense legislation and the efforts of Senator Baldwin and Jones.

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