[Congressional Record Volume 165, Number 186 (Wednesday, November 20, 2019)]
[Senate]
[Pages S6705-S6706]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                   Unanimous Consent Request--S. 913

  Mr. BRAUN. Mr. President, reserving the right to object, ObamaCare 
has failed because it is the classic example of Big Government getting 
in cahoots with a healthcare industry that is broken. It was doomed to 
fail because when has Big Government and Big Business ever resulted in 
something that is going to cost less and be more effective?
  Under ObamaCare, decisions are made by the healthcare industry 
executives and the Federal Government bureaucrats--not patients, not 
consumers. This program is authorizing millions of dollars we don't 
have to prop up a system that is not working. If ObamaCare was working, 
it would sell itself, but it doesn't work. Costs continue to rise, and 
Americans continue to be stuck with the bill.
  I believe there are things that ObamaCare does that we should keep. I 
actually incorporated it into my own business's plan back before the 
law required you to do it. I covered preexisting conditions and no cap 
on coverage. The pillars of ObamaCare--we should all accept that.
  When they added keeping kids on there until they are 26, that is fine 
too. Those ships have sailed. But the Affordable Care Act is not 
remotely affordable, and it is only going to get worse.
  I applaud the Trump administration for doing their due diligence on 
how healthcare policy changes are going to affect average Americans. 
They are taking the approach to not go deeper in the hole with 
something like ObamaCare but to reform the industry by making it 
competitive, transparent, eliminate the barriers to entry and, yes, 
encourage the healthcare consumer to get involved in his or her own 
well-being.
  I do believe President Trump is right. The Republicans can be the 
party of healthcare without involving more government, but we need to 
do that by putting more power back into the hands of the American 
people, not ceding total power to government bureaucrats and big 
healthcare executives.
  I have a better idea. The truth in pricing act--my bill I am 
countering with--encapsulates some of the ideas behind the proposed and 
final rules announced by the White House last week, which I fully 
support. The complex, opaque nature of healthcare pricing makes it 
difficult for consumers to anticipate, measure, and compare healthcare 
costs and coverage options.

[[Page S6706]]

Hospitals have a chargemaster that nobody can understand, which 
actually inflates retail prices billable to a patient or an insurance 
provider, but insurers usually negotiate steep discounts to these 
inflated prices that consumers and the employers who pay all the bills 
never see. It is done behind closed doors.
  More pricing transparency would address this market failure. 
Increased competition gives more decision making to the people who are 
supposed to use it.
  This is why I introduced the truth in pricing act, which requires 
health insurers to disclose negotiated rates, including any cost-
sharing obligations for consumers for healthcare services covered under 
their health plans. It is difficult for insured consumers to shop for 
healthcare services in our current, opaque, and broken market within 
which ObamaCare works, especially if they don't know actual prices. 
Insurers have the unique ability to provide this information to 
consumers.
  Why subsidize insurance companies to pay for navigators and insurance 
agents when we can instead make the market work better and be more 
consumer-driven and transparent? This is the way we break the 
stranglehold that government in big healthcare has on healthcare 
delivery.
  I ask unanimous consent that the Senator modify her request and 
instead, as in legislative session, the Committee on HELP be discharged 
from further consideration of S. 913, the True Price Act, and the 
Senate proceed to its immediate consideration. I ask unanimous consent 
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.
  The PRESIDING OFFICER. Does the Senator so modify her request?
  Mrs. SHAHEEN. Reserving the right to object, let me say that I agree 
with my colleague that we need more transparency in healthcare pricing. 
I would argue that one of the places we most need that transparency is 
when it comes to the price of prescription drugs.
  As I am sure my colleague knows, the cost of prescription drugs is 
probably the biggest cost driver right now in increases in 
healthcare. Yet we in Congress and the Centers for Medicare and 
Medicaid are stymied because they can't negotiate with the big drug 
companies to lower the prices of prescription drugs and to make that 
more transparent to consumers.

  The Veterans' Administration can negotiate for the cost of 
prescription drugs. If you talk to any veteran about the cost of their 
prescription drugs and compare them to what people are paying in the 
marketplace, there is a huge difference because they have that ability 
to negotiate.
  I am sure that at some point we could probably find some agreement on 
transparency that would make sense. I think what my colleague is 
proposing is not something that has had a chance to go through the HELP 
Committee and, therefore, would need a further look. I would want to 
know what hospitals in New Hampshire, the doctors, consumers, and the 
insurance department in my State would have to say about that. Until I 
find that out, I would have to object to what my colleague is 
proposing, but I hope we could work together to address the challenges 
that my constituents--and I am sure his constituents--are facing 
because of the cost of healthcare.
  He talked about the failure of the Affordable Care Act. Actually, in 
New Hampshire, we have over 90,000 people who have now gotten coverage 
for health insurance because of the Affordable Care Act. Through the 
expansion of Medicaid, we have reduced the number of uninsured in New 
Hampshire to half the number we had before we passed the Affordable 
Care Act.
  What my legislation would do is help people understand what the 
filing period is and how to sign up for the Affordable Care Act and 
health insurance.
  In fact, under the Affordable Care Act as it exists now, according to 
estimates from the administration, approximately 54 percent of Granite 
Staters who are shopping for coverage on healthcare.gov are eligible 
for a plan with net monthly premiums of less than $75, after accounting 
for tax credits, and nearly 40 percent of Granite Staters shopping on 
healthcare.gov can find a plan with net monthly premiums under $10.
  Now, the cautionary note is that when constituents of mine or in 
Indiana or anywhere else in the country are shopping for plans, they 
need to watch out for those short-term, limited-duration insurance 
plans--what are commonly called junk plans--because they are not 
required to cover preexisting conditions. I was pleased to hear my 
colleague from Indiana say that for existing conditions, coverage is 
important.
  Those junk plans are not required to provide coverage for essential 
health benefits, like maternity care, prescription drugs, and mental 
health services. If you don't pay very careful attention when you go on 
the healthcare.gov website, you can be redirected to third-party 
insurance broker sites that sell both junk plans and ACA-compliant 
marketplace plans. That creates further confusion for customers. What 
we heard is that those insurance brokers are able to charge multiple 
times the price for those plans for their fee than they are for plans 
under the Affordable Care Act.
  The administration has been allowing these links to redirect 
consumers to sites that sell junk plans, even though the ACA expressly 
prohibits any health insurance exchange from making available any plans 
that are not qualified health plans under the Affordable Care Act.
  A number of my colleagues and I have been pressing the administration 
to conduct better oversight of brokers to ensure that healthcare.gov 
customers are not being sold junk plans.
  I urge consumers, when they go on the website, to make sure they stay 
on the healthcare.gov website or their State's official health 
insurance exchange website when they are shopping for coverage. Be 
careful when you click on links that provide assistance from third-
party insurance brokers.
  I encourage Granite Staters and people across this country who need 
health insurance coverage to take a look at their options between now 
and December 15, during this year's open enrollment period. There is 
still time to enroll. It is important to tell your friends and 
neighbors and your family members who may not know about open 
enrollment because the amount of money available for outreach has been 
reduced so dramatically.
  When the administration was trying to repeal the Affordable Care Act 
and this Senate voted, Americans across the country made their voices 
heard. Now we need that same level of engagement to raise awareness of 
this year's open enrollment and overcome this administration's sabotage 
of the ACA.
  Thank you. And if it was not clear earlier, I object.
  The PRESIDING OFFICER. The objection is heard to the modification.
  Is there objection to the original request?
  The Senator from Indiana.
  Mr. BRAUN. Mr. President, reserving the right to object, we have made 
progress here this evening in the sense that my colleague has brought 
up another topic--transparency for prescriptions.
  Across the board, when it comes to hospitals and exposing their 
charge practices, drug companies becoming transparent and competing, 
health insurance companies getting rid of the secret agreements behind 
the scenes, and even practitioners, publish your prices in print or on 
the web so we as employers and consumers of healthcare can try to make 
the right decisions and bring costs down.
  I do object to the original request.
  The PRESIDING OFFICER. The objection is heard.
  The majority leader.