[Congressional Record Volume 165, Number 166 (Monday, October 21, 2019)]
[Senate]
[Pages S5909-S5911]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                               Healthcare

  Mr. MURPHY. Mr. President, I want to tell you a quick story about a 
woman from Atlanta. Her name is Dawn Jones. Dawn bought what is 
commonly referred to in the insurance industry as a short-term health 
insurance plan. She brought it from the Golden Rule Insurance Company,

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which is a unit of UnitedHealth, and she needed it because she needed 
some coverage in between jobs. She was then diagnosed with breast 
cancer, and she went through a heartbreaking experience, trying to get 
her insurance company to cover her for her $400,000 medical bill.
  In the end, she could not get her short-term health insurance plan to 
cover her breast cancer treatments, and here is the reason why. The 
insurer didn't need to cover preexisting conditions. Short-term plans 
do not need to cover things we traditionally think of as healthcare 
insurance today. The protections of the Affordable Care Act require 
that insurance cover you regardless of whether you are diagnosed with a 
serious disease, but short-term plans don't need to cover you for those 
things.
  This short-term plan didn't cover her breast cancer, despite the fact 
that she wasn't diagnosed with breast cancer until after she signed up 
for the plan. So you may ask: Why is that a preexisting condition if 
she wasn't diagnosed with breast cancer until she was on this short-
term plan?
  Well, the insurer in this case made a very innovative argument. It 
said that she actually had the cancer before she signed up for 
insurance. So even though she didn't know she had cancer and even 
though she hadn't been diagnosed with cancer, because she technically 
had cancer before she got the insurance plan, she had a preexisting 
condition, and, thus, they would not cover her.
  This is a pretty typical story about what happens on these short-term 
insurance plans in this country. They are more commonly referred to 
these days as junk insurance plans because, for millions of Americans 
who sign up for short-term insurance, they find out that it really 
doesn't cover much of anything.
  One Golden Rule plan excludes pregnancy and provides a lifetime 
maximum benefit of $250,000. That is, by the way, an incredibly low 
amount of lifetime coverage--$250,000. One hospital stay for a serious 
illness can be over $250,000. And the icing on the cake--this 
particular junk plan from Golden Rule doesn't cover a hospital room or 
nursing services for patients admitted on a Friday or Saturday. So good 
luck if you get sick on a Friday or Saturday because you are not going 
to get coverage on those 2 days of the week. These are junk plans 
because they don't cover what you need, and you, by and large, don't 
find out about that until you actually need the insurance.
  How about a gentleman from San Antonio who actually had his short-
term plan for about 6 years? He had been paying it and paying it for 6 
years. Because they are technically short-term plans, he was renewing 
them over and over and over again, and when he was diagnosed with 
kidney disease, they wouldn't cover him because they went back to his 
medical records and found out that he had some blood work done earlier 
that had shown the initial signs of kidney disease, but he wasn't 
diagnosed until later on.
  What they said--just as they did for the woman in Atlanta--was this: 
Because you had signs of kidney disease when you were insured with us a 
year ago, we are not going to cover you now because, technically, you 
are on a new plan.
  He had been getting a plan every 6 months every year. He didn't have 
any gaps in insurance, but because he technically was signing up for 
short-term plan after short-term plan, he didn't get covered for his 
kidney disease.
  Over and over, we hear these stories about individuals who go on 
these junk plans and then find out that they can't get insured for 
anything--can't get insured for hospital stays on Fridays and 
Saturdays, can't get insured for mental health treatment, no 
prescription drug benefits, no coverage for maternity, and all sorts of 
backbending activity to try to stop people from getting coverage for 
illnesses.
  Yet these plans are becoming more and more prolific. Why is that? The 
reason is that the Trump administration is using an innovative method 
to try to get more Americans to sign up for these junk plans, and that 
is what I wanted to come to the floor and talk about today.
  These junk plans are a nightmare for people who get on them and then 
find themselves on the outside of coverage. When you sign up for health 
insurance, you basically think it is going to cover a set of things 
like hospital stays on weekends and coverage for your cancer diagnosis, 
but these junk plans don't cover those things.
  The administration has decided to use a section of the Affordable 
Care Act that was designed to strengthen our healthcare system and, 
instead, use it to weaken the healthcare insurance system by providing 
for more and more of these junk plans.

  Here is a little bit of legislative history. There is a section of 
the ACA that was set up so that you could apply to the State for a 
waiver to improve coverage. The waiver says that you can do some 
innovative things in the ACA so long as you prove that whatever you are 
going to do is going to provide health coverage that is just as 
comprehensive as what is required under the ACA, that you are not going 
to cost consumers any more than what they are paying under the ACA, 
that the number of people who are insured under the ACA in your State 
isn't going to down--it is going to stay stable or go up--and you are 
not going to increase the Federal deficit.
  Well, President Trump, in October of 2018, issued new guidance that 
essentially guts all of those protections for these waivers. President 
Trump basically says that these short-term insurance plans can be 
approved, even if they cost people more, even if they don't cover 
things like preexisting conditions, and even if they result in fewer 
people getting insurance.
  This October 2018 guidance allowed for these junk plans to be sold in 
more States to more consumers. Even worse, the 2018 guidance said that 
these junk plans could be sold side by side with the Affordable Care 
Act plans right on the same web page, disguising the fact that some 
plans would actually cover you for your preexisting conditions and 
others wouldn't.
  So, today, we have more and more of these junk plans available to 
individuals and more people who are vulnerable to all of the old abuses 
that used to happen left and right in the healthcare insurance system, 
largely to people who have pretty serious illnesses.
  Now, 130 million Americans have a preexisting condition. In my State, 
over a half million people have some sort of preexisting condition. If 
they sign up for one of these junk plans--either because they were 
marketed the plan under the belief that it would cover them or by 
mistake because they didn't notice the difference between the ACA-
regulated plans and the junk plans on the website that they went to--
they are at risk of not getting covered for their preexisting 
condition.
  It gets even worse than that because what economists tell us is that 
these junk plans, which cover very little, are admittedly going to be 
attractive to some people who are presently pretty healthy. Young 
people and people who don't have any preexisting conditions may sign up 
for those junk plans because it doesn't really matter to them at the 
time that they don't get coverage for much at all; the junk plans are 
going to have prices that are lower, in most instances, than the plans 
that cover basic healthcare services. In the short term, that might be 
OK for the people who are relatively healthy until, of course, they get 
sick and find out that their junk plan doesn't cover anything. But for 
the people who have preexisting conditions, who can't sign up for the 
junk plans, and who need to be on the plans that are regulated by the 
Affordable Care Act, their premiums are going to skyrocket.
  This is health insurance 101. As more healthy people go to the junk 
plans, leaving behind on the Affordable Care Act plans folks who have 
these preexisting conditions, their prices will go up.
  The Trump administration's junk plan rule is, frankly, bad news for a 
lot of people who are on junk plans if and when they actually need 
healthcare insurance, but it is also really terrible news for the 130 
million Americans who have preexisting conditions, who are likely going 
to see their insurance rates skyrocket.
  Next week we are going to have a vote on the floor of the U.S. 
Senate, a vote on a resolution of disapproval for the administration's 
junk plan guidance. I have listened for a long time to

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Members of the Senate on both sides of the aisle talk about how the one 
thing we agree on is that we need to protect people with preexisting 
conditions, and though many of our Republican colleagues might not 
support the Affordable Care Act, they do agree that we should support 
people with preexisting conditions, which I generally read to mean that 
we should make sure we don't pass legislation and we don't let the 
administration do anything that will make it even harder than it 
already is to live with a cancer diagnosis or a diagnosis of serious 
heart disease.
  Yet it is completely clear that the Trump administration's guidance 
is going to make life a lot worse for people with preexisting 
conditions, for those who go on the junk plans, and for those who stay 
behind.
  Here is a quote from an article in The Atlantic magazine, which did a 
summary of these junk plans and what they are like and, frankly, how 
important they are to insurance companies. The article says that these 
short-term junk plans ``make up a high-profit portion'' of the 
insurance industry's business.

       They are largely designed to rake in premiums, even as they 
     offer little in return. And even when they do pay for things, 
     they often provide confusing or conflicting protocols for 
     making claims. Collectively, short-term plans can leave 
     thousands of people functionally uninsured or underinsured 
     without addressing or lowering real systemwide costs.

  That is the story of junk plans. They are a pretty good deal for the 
insurance industry, which is why they have been pushing the Trump 
administration to allow more of these junk plans to be sold. They are a 
good deal for the insurance companies because ultimately they don't 
require the insurance companies to pay out a lot in benefits, but they 
ultimately make a ton for the insurance companies in the premiums they 
collect.
  It is time for everybody in this body who has stood up and said that 
they support individuals with preexisting conditions to vote that way. 
Next week, we will have an opportunity to stop in its tracks the Trump 
administration's rule allowing for more of these junk plans to be sold 
to consumers. Because we know the House of Representatives will join 
us, we now have the chance to actually do something about it and stop 
this erosion of healthcare for people with preexisting conditions 
before it is too late.
  I get that the country and this Congress are rightly consumed with 
the ongoing scandal surrounding the impeachment inquiry and the recent 
heartbreaking, unconscionable events in Syria, but that doesn't mean 
folks in our States are as concerned with those headline-grabbing 
issues as we are. They still have to make their budgets balance every 
single month, and they are deeply worried--at least those families I 
talked to in Connecticut who are still struggling with serious 
illnesses--about our ability to make sure the protections for 
preexisting conditions, which were a lifeline for millions of Americans 
when we passed the Affordable Care Act, are not undermined by this 
President. We have a chance to step up and do something about it next 
week.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. SCHUMER. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Ms. Ernst). Without objection, it is so 
ordered.