[Congressional Record (Bound Edition), Volume 157 (2011), Part 4]
[Senate]
[Page 5729]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          FREE CHOICE VOUCHERS

  Mr. WYDEN. Madam President, in one cruel swoop late last week, more 
than 300,000 Americans lost the opportunity to buy affordable health 
insurance for years to come. Specifically, I am talking about the 
removal behind closed doors by budget negotiators of the free choice 
voucher provision that would have been a lifeline to hundreds of 
thousands of low-income Americans.
  One could say: Senator Wyden, everybody has to give a little during 
tough times. Why is this different?
  The difference is that hundreds of thousands of Americans without 
health care options, in a process that doesn't even have any direct 
cost to the Federal budget, are being asked to give up a guarantee of 
coverage just a year after passage of the Affordable Care Act. They are 
going to be forced to make a Hobson's choice between unaffordable 
insurance and going without health care, directly contradicting the 
theoretical underpinnings of the Affordable Care Act. Under that 
provision, those whose income falls below 400 percent of the poverty 
line and whose employer-sponsored health insurance premiums are between 
8 and just under 10 percent would be exempt from having to purchase 
health coverage.
  Unfortunately, now that they do not have access to the exchanges, 
they will also not qualify for government assistance to insurance. The 
provision leaves hundreds of thousands of Americans who need health 
care as a lifeline out in the cold.
  With free choice, however, folks who fell into this hole and couldn't 
afford the plan they were offered at work could use their employer's 
contribution. They could have gotten a voucher to choose a more 
appropriate affordable plan in the exchange. The amount of the voucher 
would be set at the same percentage that employers pay today: 70 
percent of the cost of a typical plan. The amount would be fixed, 
giving employers certainty in the cost of doing business. For these 
families, it could mean the difference between being able to buy a 
health plan they could afford or going without coverage. If they found 
a plan in the exchange that's cheaper that was cheaper than the voucher 
amount, but gave them everything they needed, they could have pocketed 
the difference in cost. This gives that family an incentive to shop for 
lower cost coverage and helps hold down everyone's health care costs.
  This kind of concept is not only good for the employee, it is good 
for our businesses, particularly the small businesses that so strongly 
back this provision. When the impact of free choice was proposed during 
the health reform debate, the Congressional Budget Office and the Joint 
Committee on Taxation estimated that more than 300,000 families could 
benefit from this new approach to choice and competition. That was 
then.
  Since passage of the health care reform law, the need for free choice 
vouchers is greater than ever. The Kaiser Family Foundation, in their 
recent analysis, found that employers, even since the law, are shifting 
more of the health care cost on to the backs of the workers. In that 
analysis, The Kaiser Family Foundation reported that the typical 
increase for family coverage went up three percent on average last 
year, but the cost for the typical worker went up 14 percent. The 
employer was paying virtually none of that increase. The worker was 
eating almost all of it because costs were being shifted from employers 
on to the backs of the workers. So if anything, even more people would 
likely need free choice vouchers, and would have been eligible to use 
them, than was originally envisioned when we passed the law.
  I am of the view that it is not that businesses don't want to provide 
affordable benefits to workers. It is just making less and less sense 
to do so given the way the current system operates. Incentives would 
not change in 2014, leaving an increasing number of families with a 
choice between the unaffordable and the unavailable. Up until late last 
week, in the dark of night, those families had a choice. They had a 
choice, a third path. The two that I mentioned, unaffordable and 
unavailable, were not very appealing, and free choice vouchers would 
have created a third option that would have worked for those families. 
They would have had a chance to take their pretax dollars provided by 
their employer to the free market exchange and decide for themselves 
which plans they could afford that provide the benefits they need.
  Free choice is good for workers, it is good for business, it is good 
for our country's bottom line; it offers a way to rein in higher health 
care costs by putting purchasing power back into the hands of the 
consumer. Once people know they are paying for their health coverage 
and can shop for a plan that answers their specific needs, costs will 
come down.
  We hear often colleagues on both sides of the aisle talk about choice 
and competition and market forces. What this did was provide a chance 
for both sides to take principles they hold dear, expanding coverage 
with a market based approach for workers who are hurting, and say: Free 
choice vouchers can do that. The arguments against free choice didn't 
start with Democrats or Republicans. The arguments started with the 
interest groups, the lobbies, the special interests that have a vested 
stake in holding their employees captive and locking them into this 
incredibly inefficient status quo.
  This provision has no budget impact in the fiscal year. Three hundred 
thousand low-income Americans are being hurt in this budget bill for 
something that spends no money in the upcoming year; 300,000 Americans 
with no acceptable alternative to make sure that when they go to bed at 
night with their families they can take care of an illness or a medical 
expense that comes up in the morning.
  I don't think this had to be. Clearly, if we had had the opportunity 
in an open forum to address this, there would have been a different 
result because that is how it got into the law in the first place. I 
want to make sure colleagues know we will have to be back here to get 
some relief for the 300,000 Americans we put out in the cold as a 
result of that particular provision. I hope, once again, we can do it 
in a fashion that brings Democrats and Republicans together the way 
free choice vouchers and the principles it represents did in the first 
place.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Minnesota.
  Ms. KLOBUCHAR. Madam President, I first acknowledge my colleague from 
Oregon for his great leadership in this area. We look forward to 
working with him. He has taken an essential lead on this important 
matter. This has been a difficult time for all of us with some of the 
changes being made.

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