Congressional Record, Volume 165 Issue 94 (Wednesday, June 5, 2019)

[Congressional Record Volume 165, Number 94 (Wednesday, June 5, 2019)]
[Senate]
[Pages S3242-S3245]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

Unanimous Consent Request--S. 1556

Ms. BALDWIN. I rise today to once again speak about the ongoing
threat in the Trump administration to the healthcare and guaranteed
protections that millions of American families depend upon. President
Trump has tried to pass through the Congress repeal plans that would
take people's healthcare away and allow insurance companies to
discriminate against people with preexisting health conditions or
refuse to serve them at all.
When that legislative repeal effort failed in 2017, instead of
working in a bipartisan way to lower healthcare costs and improve
access to care for all Americans, President Trump turned to another
tactic--sabotaging our healthcare system--and there are more Americans
uninsured today than there were when he took office.
The Trump administration has even gone to court. They have gone to
court to support a lawsuit that would overturn the Affordable Care Act,
including its provisions that protect people with preexisting health
conditions from discrimination. Just think about that. He is asking a
court to strike down healthcare protections for Americans. If he
succeeds, insurance companies will once again be able to deny coverage
or charge much higher premiums

[[Page S3243]]

for the more than 130 million Americans who have some sort of
preexisting health condition, including more than 2 million who live in
the State of Wisconsin.
What is the President's plan to protect people with preexisting
conditions? He doesn't have one. He never has. And I have to say that I
doubt he ever will. In fact, this administration has expanded what I
call junk insurance plans. These are insurance plans that can deny
coverage to people with preexisting health conditions, and they don't
have to cover basic and essential health services, like prescription
drugs or emergency room visits or maternity care. Most of these junk
plans don't cover those things.
When I spoke about this expansion of what I call junk insurance on
the Senate floor 2 weeks ago, one of my Republican colleagues responded
and claimed that these plans preserve preexisting conditions
protections and essential health benefits. So today I wanted to clarify
the record, and let's look at the fine print together.
One of the junk plans currently available in my home State of
Wisconsin reads, ``This plan has a preexisting limitation provision
that may prevent coverage from applying to medical conditions that
existed prior to this plan's effective date.''
Another junk plan that is sold in Wisconsin states that the plan does
not comply with the guaranteed essential benefits provided by the
Affordable Care Act. To quote directly, the description reads: ``This
coverage is not required to comply with certain federal market
requirements for health insurance, principally those contained in the
Affordable Care Act.'' The tiny fine print on this particular junk plan
instructs individuals to check their coverage carefully to make sure
they are ``aware of any exclusions or limitation regarding coverage of
pre-existing conditions or health benefits (such as hospitalization,
emergency services, maternity care, preventive care, prescription
drugs, and mental health and substance use disorder services). Your
certificate might also have lifetime and/or annual dollar limits on
health benefits.''
The Affordable Care Act protects people against these insurance
company abuses. Yet the expansion of these junk plans puts the power
back in the hands of big insurance companies.
Let me be clear. American families do not want to go back to the days
when health insurers could discriminate against people with preexisting
health conditions, women, and seniors by denying them coverage or
charging them higher premiums simply because they get sick.
As I have said in this Chamber many times, the people of Wisconsin
want both parties in Congress to work together to make things better by
making healthcare more affordable.
I have heard from several Wisconsinites who want to know why the
President is working to repeal the Affordable Care Act and take away
their protections by expanding these junk plans. They are frightened
that if this sabotage of our health system continues, insurance
companies will again be able to deny coverage or charge higher premiums
for the more than 130 million Americans who have preexisting health
conditions, again, including more than 2 million in my home State of
Wisconsin.
I heard from Keri from Baraboo. Keri is a three-time cancer
survivor--two breast cancer diagnoses and one melanoma. She experienced
her first diagnosis at age 29. Now at age 61, Keri is able to get the
healthcare she needs without being punished financially for having a
preexisting condition. Keri is worried that if the Affordable Care Act
is repealed, she could lose her health coverage or could be charged
more because of her preexisting condition.
Another Wisconsinite, Keith in Brookfield, recently wrote in to my
office about what healthcare means to him and his family. Keith and his
son both have type 1 diabetes. Both of them have health insurance
through the Affordable Care marketplace that allows them to afford the
insulin, glucose test strips, and other medications they need. If the
Affordable Care Act is repealed, Keith and his son likely would not
even be eligible to purchase one of these junk insurance plans. They
could be denied coverage entirely due to their preexisting condition.
We really need to act to stop this sabotage now. I want to protect
the guaranteed healthcare protections that millions of Americans depend
on. That is why I have introduced legislation, with my colleague,
Senator Doug Jones of Alabama, to overturn the Trump administration's
expansion of junk insurance plans, because we should be increasing
access to affordable, high-quality healthcare options.
The entire Senate Democratic caucus supports this legislation, along
with the two Independents who caucus with us. The Nation's top
healthcare organizations, representing tens of thousands of the
Nation's physicians, patients, medical students, and other health
experts, support this legislation.
Anyone who says they support healthcare coverage for people with
preexisting conditions should support this bill.
Mr. President, as in legislative session, I ask unanimous consent
that the HELP 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 motions
to reconsider be considered made and laid upon the table with no
intervening action or debate.
The PRESIDING OFFICER. Is there objection?
Mr. THUNE. Mr. President, reserving the right to object, let me just
say that the plans to which the Senator from Wisconsin is referring are
plans that tens of thousands of people are buying, and one of the
reasons they are buying them is because it allows them to buy the
insurance they want at a price they can afford.
I can tell you, as I am sure the Presiding Officer can and probably
everybody here can, when they travel across the country and talk with
the farmers and ranchers and people who are buying their insurance on
the individual market, the individual market has blown up. It has
exploded. People are paying $3,000 a month in premiums--$36,000 a
year--and have huge deductibles. So what they are doing is they are
dropping coverage because they can't afford it. One of the reasons they
can't afford it is because, under ObamaCare, there were so many
mandates and requirements, it drove up the price. So they have these
skyrocketing premiums, higher deductibles, and higher copays.
I think that is precisely why the administration decided that, let's
take these plans and give people an opportunity to buy the insurance
they want at a price they can afford.
Literally tens of thousands of Americans are now in these plans. What
the Senator from Wisconsin is saying is, we are going to throw all
these people off these plans. What does that do? That puts them back
out, probably uninsured, which is what a lot of farmers and ranchers in
places in South Dakota are doing--they are just dropping coverage
because they can't afford it. Who can afford to pay $3,000 a month?
That is what ObamaCare has left us. That is why we need new solutions.
This solution is one that allows people to buy a plan they want at a
price they can afford, coupled with association health plans--which
Democrats, I think, here in the Senate are also objecting to and
opposing--which are also giving individuals opportunities to join
larger groups and spread their risk and drive down their premiums. We
need plans that people in this country can afford, or more and more
people are going to be in the ranks of the uninsured.
So, Mr. President, I object.
The PRESIDING OFFICER. Objection is heard.
The Senator from Wisconsin.
Ms. BALDWIN. Mr. President, I am disappointed that my Republican
colleagues have once again chosen to object to protecting people with
preexisting conditions.
Mr. WYDEN. Mr. President, would my colleague yield?
Ms. BALDWIN. Senator, I would be happy to yield.
Mr. WYDEN. Mr. President, I appreciate my colleague. I am in such
strong support of her legislation, the No Junk Plans Act. I will speak
briefly on it after the Senator has concluded her important remarks.
But apropos of what the distinguished Senator from South Dakota just
said, isn't it correct that of course a plan is more affordable if it
doesn't cover anything? I would be interested in my colleague's
reaction to that, as she is the lead sponsor.

[[Page S3244]]

I remember being in Wisconsin and seeing the wonderful support folks
there have from my colleague because she has been a leader on these
issues.
I am just curious, because certainly my friend from South Dakota, who
is a distinguished member of the Finance Committee and works with
Senator Cortez Masto and me, often works with us on matters. But unless
I am missing something, he said that what he is interested in is care
that is more affordable. But it doesn't cover anything. What are my
colleague's thoughts on that?
Ms. BALDWIN. I would concur and say that the reason they have earned
the nickname ``junk plans'' is because, frankly, some of them are
hardly worth the paper they are written on.
First of all, they do not have to comply with some of the very
important protections we included as part of the Affordable Care Act--
otherwise known as ObamaCare--especially to protect people who have
been ill once before or have been injured once before, people who have
a preexisting health condition, maybe a chronic condition that will
require medical care throughout their lives.
In the old days, which apparently the Republican Senator wants to
return to, there were all sorts of abuses, I would argue, that
insurance companies could employ in order to limit their exposure, if
you will. They had annual limits. They had lifetime limits. They had
the capacity to drop somebody from coverage after an illness developed.
They had the capacity to say: No, we are not going to offer you
insurance. They certainly had the capacity to charge discriminatory
premiums based on the preexisting condition. That causes great concern.
I just recently saw a report about how much a typical--put it this
way: a woman with a breast cancer diagnosis who requires chemotherapy
and radiation treatment and medication--how much she would be
anticipated to spend out-of-pocket if she had a junk plan at the time
that diagnosis was made. It was, on average, $40,000.
We also need to talk about another impact these junk plans have, and
that is, if you think you have a really good chance of being healthy
for the next year, and you decide ``This is a risk I can take,'' you
are then fundamentally changing the structure of the marketplace for
everyone else. You can anticipate that this is a choice healthier,
maybe younger people will make, and it has a distorting impact on
premiums in the marketplace. In fact, that is why these plans were
curtailed under the previous administration. Now, this administration
is greatly expanding these. They are no longer short term. They are
long term, and a lot of harm will come.
I want to conclude and say that when we have an administration that
first fought legislatively to repeal the Affordable Care Act and then
acted administratively to undermine and sabotage the Affordable Care
Act through all sorts of administrative Executive actions, including
defunding the State navigators who helped people make wise selections
for their insurance and also limiting the open enrollment period, and
when we have an administration that has decided to go to court and
asked the court to strike down a U.S. law in its entirety, we know
there is sabotage going on.
I think the choice for the American people couldn't be clearer. We
want to make things better, and the administration--enabled by some of
my Senate Republican colleagues--is walking down a path that has led to
2 million people losing their health insurance and others at grave risk
of losing it in the future.
With that, I yield the floor.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Mr. President, before she leaves the floor, I want to tell
my colleague from Wisconsin--and I think I speak for the distinguished
Senator from Nevada as well--we are counting on our colleague from
Wisconsin to come back to this floor again and again to try to pass her
bill. I just want to tell her I will be with her every step of the way
because I think, colleagues, without the bill from the distinguished
Senator from Wisconsin, what we are looking at is a new golden age for
scam artists peddling insurance that isn't worth much more than the
paper it is written on.
I was struck by my friend from Wisconsin's mentioning the old days of
junk insurance.
Well, I was around for those old days. I remember when the health
insurance system in this country was basically for the healthy and
wealthy. If you were healthy, no sweat, you could get insurance. If you
were wealthy, you just went off and paid the bills. But the insurance
companies could go out there and clobber people with preexisting
conditions. So that was junk insurance.
But I am even older than that. I remember when I was director of the
Oregon Gray Panthers. I would go to a senior's house, and they would
pull out a shoebox full of policies--10 or 15 policies. The
distinguished Senator from Nevada, who has done so much consumer
advocacy for consumers, I am sure knows about this challenge with
seniors. These policies weren't worth the paper they were written on.
They had--because I am kind of a lawyer in name only--what were called
subrogation clauses. So if you had two policies, and they basically
covered the same thing, both of them would try to squirm out of
covering it. Talk about junk insurance.
Finally, I got elected to Congress, like my colleague activist, and
we passed a law that said we are going to get rid of that system and
that you could have really only one policy, except in unusual
situations. There were strong consumer protections.
But if you look at what the Trump golden age of scams is going to
bring back, there are going to be lots of people who are going to get
clobbered, and, as my colleagues know, the people who are really going
to get hit by this are, for example, older women who are pre-Medicare,
because very often, in their late fifties and early sixties, they have
a lot of difficulty trying to find jobs that pay good salaries and jobs
that have good healthcare coverage.
I am so appreciative of what my colleague is talking about.
We are going to hear a lot of buzz words. Opponents of the Baldwin
legislation are going to talk about how they are offering flexibility
and they are offering patient-centered care. But that is just a bunch
of eyewash because what they really do, as you touched on, is to fail
to give patients care when they most need care.
Today, Americans ought to be protected from these worthless,
predatory scams. One of the things that I was proudest of, really,
before my colleagues came here, is a piece of legislation I wrote, the
Healthy Americans Act. A number of Republican Senators were cosponsors
of this bill. It had airtight, loophole-free protection to ensure that
people with preexisting conditions didn't face discrimination.
By and large, we got that provision into the Affordable Care Act. It
meant, as John McCain knew--we often talked about it--that healthcare
would no longer be there just for the healthy and the wealthy. There
would be real protections for those with preexisting conditions.
For all practical purposes, that was really one of the two or three
centerpieces of the Affordable Care Act, because, talk about a new age
in insurance, that was it. Healthcare insurance would no longer be
there for the healthy and wealthy only.
Senator Baldwin is here, and what she is trying to do--I am looking
at that clock--is trying to keep the Trump people from turning it back.
That is what they want to do when Senator Baldwin talks about the old
days--a forced march back to the days when the insurance companies
could really, in many instances, just beat the stuffing out of
vulnerable people.
I thank my colleague for what she is doing. I heard just a little bit
about it before I came over. I basically said: Let's hold off on things
for a couple of hours so I can go out there and stand with Senator
Baldwin and her allies.
I say to the Senator: To me, what is important is that you have been
here today, and it is going to be even more important that you come
back again and again and again so that that clock continues to move
forward in terms of American healthcare and not go backward. I thank my
colleague.
We are really delighted to have Senator Cortez Masto on the Senate
Finance Committee, where she has been doing a lot of good work in
healthcare

[[Page S3245]]

for consumers and seniors. I look forward to her remarks and to working
with both of my colleagues.
The PRESIDING OFFICER. The Senator from Nevada.
Ms. CORTEZ MASTO. Mr. President, let me just say, on behalf of the
State of Nevada, that I am so appreciative that I get to work with my
colleagues from Wisconsin and Oregon. I thank them for their commitment
because this is the No. 1 issue in the State of Nevada.
I say to Senator Baldwin: What you are doing is really standing up
for people and their right to have access to affordable healthcare in
this country when they need it, access to medication when they need it,
and the comfort in knowing that if they purchase a plan, if something,
God forbid, should happen to them, then, they will have access to that
medication and those doctors when they need it. Thank you for your hard
work.
I stand today because I want to tell you about one of these people in
the State of Nevada. Her name is Carol Elewski. She is from Reno, NV.
Carol has chronic asthma. She manages it with medications that cost up
to $400 a month--$400 a month.
In October of 2016, Carol had such a bad asthma attack that she was
admitted to the hospital for 10 days as doctors struggled to get her
breathing under control. Thankfully, today Carol's health is stable,
but because of her preexisting condition and high prescription drug
costs, she depends on the protections of the Affordable Care Act to
keep her healthcare costs in check.
This administration, as we have heard today from my colleagues, keeps
chipping away at those protections. Literally, we have heard from the
President that he is proud of sabotaging the Affordable Care Act. He
has weakened the ACA by expanding access to these junk plans. These
short-term, limited-duration plans don't cover essential services, like
prescription drugs, emergency rooms visits, and maternity care.
Today, I am joining my colleagues to, once again, urge that we do
away with these scam insurance policies. These plans appeal to
consumers because they are low cost, but they are also low benefit, as
we have heard. Many people who purchase them don't realize just how
limited the coverage is. All those details are in the fine print of the
policies in dense legal jargon, and it is nearly impossible to
understand. I am an attorney, and I will tell you that even attorneys
have difficulty understanding that dense legal jargon in some of these
policies. Consumers don't know that the plans they are signing up for--
because of the dense legal jargon and because they are not given
specifics, and there is not enough transparency--don't even cover their
preexisting conditions. Consumers may not realize that their coverage
has annual or lifetime spending caps.
Take Carol, for instance. Let's say she had signed up for a junk plan
instead of an ACA-compliant plan--an easy mistake to make, since
companies hide the differences between the two. With the junk plan,
Carol's insurance could have refused to cover her healthcare costs
because of her asthma. They could have denied payment for the emergency
treatment she needed when she literally could not breathe, and they
could have declined coverage for the essential medications she needs to
keep the asthma in check.
Under these junk plans, women who get pregnant don't get coverage for
prenatal care or for delivering their babies. People with lifelong
genetic conditions, like cystic fibrosis, can be denied coverage, as
can those facing mental health issues.
What is more, even if you don't buy a junk healthcare plan, these
plans' very existence drives up our healthcare costs in this country.
That is because younger, healthier people are more likely to risk
choosing a limited junk plan because those plans are cheaper. That
leaves the rest of the population, including many women and children,
in a much more expensive insurance pool.
Estimates say that junk plans could cost a family of four with an ACA
plan over $3,000 in increased insurance premiums every year. The No
Junk Plans Act that Senator Baldwin has introduced undoes the
administration's order that allowed insurance companies to offer
consumers up to 3 years of deceptive, skimpy coverage.
Under the No Junk Plans Act, customers can only use these short-term
plans for 90 days. The plans would work the way they were intended--as
a bridge between coverage at one job and the next.
I hear this all the time in Nevada. Americans have told us time and
again what they want their healthcare to do: to cover preexisting
conditions, keep down prescription drug costs, include women's health,
cover mental health, and pay for emergency rooms visits.
I am going to continue to fight for what the American people want,
and that is the comprehensive coverage of the Affordable Care Act.
We cannot let the administration succeed in doing an end-run around
the ACA. The House has already passed legislation to do away with these
flimsy and deceptive junk plans. Now it is time for the Senate to step
up and do the same.
Thank you.
I yield the floor.
The PRESIDING OFFICER. The Senator from Utah.
(The remarks of Senator Udall pertaining to the submission of S. 1753
are printed in today's Record under ``Submitted Resolutions.'')
Mr. LEE. I yield the floor.
The PRESIDING OFFICER. The majority leader.