[Congressional Record (Bound Edition), Volume 155 (2009), Part 18]
[Senate]
[Pages 24561-24563]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. BROWN. Madam President, yesterday was a fateful day as we moved 
forward on health care legislation. Yesterday America's Health 
Insurance Plans, the insurance companies, unveiled a report criticizing 
the Senate Finance Committee's health reform legislation. This is the 
committee that negotiated with Republicans for 6 months; the committee 
that worked with the insurance industry for 6 months; a committee that 
has, frankly, not included a public option; a committee that has, 
frankly, bent over backwards to listen to insurance company interests.
  America's Health Insurance Plans unveiled a report saying that as a 
result of this health care bill, health insurance premiums are going to 
increase by double-digit percentages as far as the eye can see.
  Families USA pointed out that ``this criticism by the insurance lobby 
gives hypocrisy a bad name.''
  AHIP, America's Health Insurance Plans, talked about rate shock; that 
if we move forward on this health insurance bill, Americans are going 
to be victimized by rate shock. Rate shock is a significant increase in 
premiums that insurance companies have inflicted upon Americans over 
the past decade, year after year after year.
  I just got off the phone with a small business person in Cincinnati 
who has fought as hard as he possibly can. He came to my townhall 
meeting in Cincinnati, the most conservative part of the State, saying 
he needed to go in with other businesses in an insurance exchange, 
perhaps with a public option so he could get his rates in check. The 
insurance companies just raised his rates so dramatically that he is 
likely going to lose his insurance.
  Rate shock is when between 2000 and 2009 average family insurance 
premiums for employer-based health coverage increase from $6,700 to 
over $13,073, an increase of 93 percent. Rate shock is when between 
1999 and 2009, premiums for employer-sponsored insurance in my State--
from Findlay to Gallipolis, from Galion to Youngstown--grew 108 
percent. Rate shock is when 20 percent of middle-income Ohio families 
spend more than 10 percent of their income on health care. Rate shock 
is when between 2000 and 2008, the percentage of employees with an 
annual deductible greater than $1,000 increased from 1 percent to 18 
percent. One out of five Ohioans is paying a more than $1,000 
deductible. Rate shock is when since 2000, insurance costs for small 
businesses have increased 129 percent.
  Who is going to provide the jobs in this economy to get us back on 
our feet as a nation? It is small businesses. Yet the insurance 
companies have more than doubled insurance premiums for small business, 
a 129-percent increase in less than a decade. Rate shock is when small 
business workers pay an average of 18 percent more in premiums than 
those in large firms for the same benefits.
  When America's Health Insurance Plans, the insurance industry, talks 
about rate shock, rate shock is what they have inflicted on the 
American public, what they have inflicted on large corporations, what 
they have inflicted on small business people, what they have inflicted 
on individual American workers, on individuals holding insurance plans.
  Here is what rate shock, inflicting these huge premiums, has done. We 
know what it has done to the American public. We know what it has done 
to small business. We know what it has done to workers. We know what it 
has done to taxpayers. We know what it has done to local and State 
governments wrestling with insurance costs while providing other 
education, health care, public safety, public service services.
  Here is what it has meant to insurance companies. Between 2000 and 
2007, rate shock, inflicting high costs on ratepayers, has meant 
profits at 10 of the country's largest publicly traded health insurance 
companies going up 428 percent. They are doing just fine, thanks to the 
rate shock they are imposing upon American business and American 
individuals.

[[Page 24562]]

  From 2007, CEOs of these companies collected a combined total 
compensation--10 companies, 1 year--of $118.6 million, $11.9 million 
each, 468 times more than the $25,000 an average American worker made 
that year. The CEOs of the insurance companies made $11.9 million each 
while they are saying to people: Sorry, you can't get insurance. You 
have a preexisting condition. Sorry, we are going to rescind your 
policies because you got too sick and you spent too much. Sorry, we 
will not cover you. We will cancel your policy because you are the 
wrong age or the wrong gender or live in the wrong place or you have 
the wrong disability.
  The first half of this year, to top it all off, here is what rate 
shock meant to the insurance industry. AHIP spent $3.9 million on in-
house lobbying efforts and another $500,000 on outside lobbying firms 
and consultants.
  It is just a question of fairness. The question of fairness says to 
all of us, this is not right. People are paying more and more for their 
insurance. People are losing their insurance because they cannot afford 
it. People are getting cut off their insurance because of preexisting 
conditions. People are being discriminated against because of 
disability or gender or age or location. That--coupled with the 
salaries, the CEO compensation--all of that is not fair.
  But what does that mean individually? Why, other than questions of 
fairness--which really matter. Another is productivity in our economy. 
As these health care costs are so burdensome to employers, they simply 
cannot hire people. I spoke today to a group. I had a roundtable, one 
of about 140 I have done around Ohio, in my hometown of Mansfield, OH, 
with about 15 manufacturers, people who are struggling with all kinds 
of things.
  They cannot get credit. They are victimized by the Chinese currency 
problems that American industry faces and our government will not do 
enough about. They are badly hurt by health insurance costs. So we know 
about the question of fairness. It is not fair what has happened to our 
workers, to our small manufacturers, to our companies, to our 
taxpayers, while CEOs are doing so well.
  But let me talk about what this really means. I am going to read four 
or five letters from people in Ohio about why this matters, why this 
insurance crisis matters. I know the Presiding Officer gets letters--
whether they come from Hanover or whereever they come from in her 
State--she gets letters such as this too. Most of the letters I get are 
from people who thought they had pretty good insurance, and then they 
get sick and their insurance is canceled or then they find out that one 
of their children has a preexisting condition or a spouse has a 
preexisting condition and they cannot renew their insurance or it gets 
so costly they cannot renew it. That is what comes through in so many 
of these letters.
  Let met share a few of them. This is a letter from Robert from Lake 
County. It is a county just east of Cleveland on Lake Erie in northeast 
Ohio:

       In 1986 my wife was terminally ill with cancer and several 
     other illnesses. When I switched jobs and looked for new 
     insurance, we were denied because of her pre-existing 
     condition.
       In 2001, when I was 58, I lost my job. When COBRA ran out, 
     I was denied insurance based on my pre-existing conditions of 
     diabetes and heart disease.
       I managed to limp through until I turned 65 and became 
     eligible for Medicare.
       I'm sure the fear and anxiety I suffered over health 
     insurance hasn't been at all beneficial to my overall health.

  I have heard person after person--in talking to people one-on-one or 
looking at the letters they write or reading something they have 
written on the Internet--tell me they are not quite 65, they might be 
55, they might be 62, and they just hope they can hold on until they 
are 65 so they can get a decent government-sponsored health plan, 
Medicare. That tells me why the public is demanding the public option. 
The public understands a public option--which is just an option--will 
make the insurance companies more honest.
  A public option will not cancel people for having a preexisting 
condition anymore than Medicare does. A public option will give people 
choice. It will discipline the insurance companies and keep costs in 
check.
  We know, when you look at this report I just talked about--this AHIP 
report that talked about rate shock--that is as good an argument for a 
public option as any I have ever heard of because the insurance 
companies say: We are going to raise rates even higher than we have 
already raised them, an even higher percentage than we have already 
raised them, an even faster climb than we have already done in the last 
decade. That is why we need a public option, to discipline the 
insurance companies, to compete with them. They seem to be competing to 
raise rates, not competing to keep things in check, unlike the way 
competition used to work in this country. That is why a public option 
is so important.
  Shelly from Coshocton, a community in sort of southeast, east central 
Ohio, writes:

       I have no health insurance coverage for myself or my son. 
     My husband is disabled and receives Social Security 
     Disability and Medicare.
       My son was born with a congenital heart defect [and] has 
     already had one open heart surgery.
       Along with my pre-existing condition, neither of us can 
     afford private coverage.
       Pre-existing conditions should be illegal for insurance 
     companies to use to delay health care for Americans.

  Shelly is right. When she says that, understand that, yes, we are 
going to change the law so we are going to ban the whole practice of 
``preexisting condition.'' No more ``preexisting condition'' under this 
legislation, no more caps on cost, on coverage, and no more annual or 
lifetime caps, no more discrimination based on gender or disability or 
geography or age.
  But even with that, we clearly need a public option to enforce those 
rules so the insurance companies cannot find a way to game the system, 
as they have over and over, year after year after year. That should be 
our commitment to Shelly from Coshocton.
  Tina from Cuyahoga County--the Cleveland area--writes:

       My husband and I have been married for 30 years.
       We've lived in the same three bedroom home for the last 26 
     years, where we sent our two sons to college, without debt, 
     while running our small business.
       We have our own insurance, but have seen raised deductibles 
     and scaled back coverage. I would guess we've spent some 
     $150,000 on premiums over the healthy years of our lives.
       Unfortunately, last fall I was diagnosed with non-Hodgkin's 
     lymphoma. The deficiencies in our current policy were then 
     made clear.

  Again, a good health care policy until she really needed it, which is 
too much par for the course in this country.

       Our plan covers only certain services. After 2 different 
     and unsuccessful treatments, I have an $80,000 balance with 
     the hospital.
       I firmly believe most people have no idea of their exposure 
     because they have been fortunate not to have had the need to 
     use their insurance. I alternate between being furious and 
     depressed.
       At 53, what have I to look forward to other than single 
     handedly having ruined my family's financial future.
       Something has to be done. It is immoral that insurance 
     companies should make a profit over people's health 
     conditions.

  I think that says it all: again, so many people have what they think 
is pretty good health insurance until something really bad happens. 
That is what health insurance should be all about. It really is not 
insurance if it does not work when you really need it. And Tina from 
the Cleveland area understands that. A public option will work to make 
sure she continues with her health coverage, that she cannot be denied 
coverage, that even when she gets really sick, she will be in a pool 
that will work for her.
  I have two more letters, Madam President, and then I will yield the 
floor to the Senator from Utah.
  This is a letter from Priscilla from Miami County--a county in 
southwest Ohio, just north of Dayton:

       I am a 62-year-old widow with controlled cholesterol and 
     high blood pressure.
       I bring in $2,300 per month on fixed income but pay $1,900 
     per month for health insurance premiums.

  So $2,300 a month she brings in, and she pays $1,900 a month for 
health insurance premiums. She is not quite Medicare eligible. She is 
62 years old.


[[Page 24563]]

       I keep my thermostat at 62 degrees in the winter and 
     minimize the use of hot water, unless when needed.
       I spend about $100 per month on groceries.
       Since August 2007, I've spent more than $40,000 in 
     premiums, co-pays, and out-of-pocket expenses.
       My private insurer paid only $8,500 for my medical and 
     prescription claims in that period.

  Priscilla's health insurance simply does not work for her. It is a 
health insurance policy that too often does not respond when she needs 
it to respond. She likely--as so many people I know and who call my 
office--spends much of her time on the phone trying to get her 
insurance company to pay. You have to figure the stress on people, 
dealing with insurance companies and getting turned down time after 
time after time, probably compromises their health.
  She has to wait another 3 years before she is Medicare eligible. This 
legislation will help her with that. This legislation will give her the 
chance to go into an insurance exchange. She can pick a private plan or 
she can pick the public option. Either way, she simply will not have 
these kinds of premiums. She will not have these kinds of out-of-pocket 
expenses. She will have some costs. She will get some help because she 
does not make very much money. That is what this country should do, I 
think, for people like Priscilla.
  The last letter I will read is from Cheryl from my home county of 
Lorain--Elyria, Avon, North Ridgeville, Oberlin, Amherst, that area of 
the State just west of Cleveland on Lake Erie:

       We are a working class family riding the fine line between 
     blue and white collar income.
       I work as a business executive assistant, aware of how big 
     business can influence the outcome of this bill. My husband 
     is a retired fire captain who was forced into retirement 
     after being injured on the job.
       We get insurance through my employer, but we've seen costs 
     increased considerably in the last three years alone.
       Our daughters, ages 28 and 26, both work but face difficult 
     choices regarding their health care.
       One daughter's employer plan is based on her overall 
     health--she lives in fear that something like high blood 
     pressure could possibly increase medical costs by hundreds of 
     dollars a month.
       My other daughter is a contract worker who has to pay for 
     her own insurance. She makes about $45,000 a year and 
     supports a family of three, but has out-of-pocket expenses 
     anywhere from $2,500 to $5,000 before the deductible is even 
     met.
       These are examples of hard working people who will survive 
     in the short term but in the long term will be paying medical 
     insurance rather than a house payment.
       Please continue the fight, you cannot let [us] down.

  I know the Presiding Officer from New Hampshire gets these kinds of 
letters from people who are really the backbone of this country, people 
such as her daughter making $45,000 a year. She has had barely a 
middle-class standard of living. It is clear, with her job as a 
business executive assistant, she has all kinds of out-of-pocket costs.
  If we are going to get this economy back in shape--and I got that 
again today talking with those manufacturers, small companies of 30 and 
50 and 100 people, most of them--if we are going to get this economy 
back in shape, we cannot have health care costs weighing down our 
businesses and individuals who simply cannot get ahead, who are 
fighting every day to figure out: How do I pay for this? How do I 
balance paying for my medicine with making my house payment, with 
heating my home, with buying my food? How can we in this society 
continue to do that?
  Then, to top it off, as I said, the insurance industry, yesterday, 
put out a report that talked about rate shock, that if this bill 
passes--the kind of threat they made to this institution, to the House 
and the Senate, to the American people--they are going to jump health 
care prices.
  Well, that is, again, why the public option is so important. The 
public option will provide competition to these insurance companies, 
competition they are not used to getting from each other. It might mean 
that the chief executive officers of the 10 biggest companies will not 
average $11.9 million in salaries. It might mean their profits will not 
continue to escalate. It might mean they have to tighten their belts 
and compete with a public option so their prices are more in check with 
what the American people can afford.
  The time is now. It is imperative that we in this institution send 
legislation to the President of the United States for him to sign--
good, strong legislation that helps small businesses, that helps people 
keep the insurance they have, if they want to keep it, if they are 
satisfied with it, and has a public option included in it to compete 
with insurance companies and keep them honest and to keep costs in 
check. It is our duty. It is our imperative. It is what we must do in 
the next few weeks.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah.

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