[Congressional Record (Bound Edition), Volume 159 (2013), Part 13]
[Senate]
[Pages 19474-19476]
[From the U.S. Government Publishing Office, www.gpo.gov]




                               OBAMACARE

  Mr. HATCH. Mr. President, I rise today to discuss the debacle that is 
the so-called Affordable Care Act. I don't think there is anyone in 
this Chamber, Republican or Democrat, who would dispute that thus far 
the implementation of this law has been a disaster, particularly with 
regard to the healthcare.gov Web site and the President's promise that 
``if you like your health care plan, you can keep it.''
  The administration has admitted that it bungled the rollout and has 
tried to cover up for what PolitiFact dubbed ``the lie of the year,'' 
by passing the buck to States and insurers as to whether individuals 
would be able to keep their plans for the next year.
  Let's be clear about this. ObamaCare's problems are deeply rooted in 
its DNA, and they are far larger, far bigger than just a Web site. Is 
the Web site causing the cost of health insurance premiums to go up 
dramatically? Is the Web site causing businesses to force more and more 
employees to work part-time? Is the Web site sending out cancellation 
notices to patients and consumers, telling them that their health care 
plans are no longer available? Of course not. Yet as the functionality 
of the Web site continues to improve, the administration is starting to 
talk as if every problem with the law has been fixed and that all the 
other issues are going to simply dissolve.
  We know that is not the case. In reality the problems with ObamaCare 
are only beginning. I would like to take a few minutes to discuss some 
of the problems we are going to be seeing in the future as the 
President's health law continues to be implemented. I have to say that 
when it comes to ObamaCare, it is a little difficult to make 
predictions. That is because the administration has gone to great 
lengths to muddy the waters with delayed deadlines and unilateral 
policy changes. However, I think we can look through the opaque waters 
and identify at least six general areas where we can expect to see 
major problems in the coming months. These are six areas among many, 
but theses are six I want to talk about today.
  No. 1, we are going to continue to see problems with the 
implementation of ObamaCare. Like I said, there have undoubtedly been 
improvements to the Web site. They should be able to resolve that 
problem. It is a technical problem. It is a shame it was not resolved 
to begin with. It is a shame that enough time wasn't given to resolve 
it, but there still are issues that are far from resolved besides that.
  Let's just look at the enrollment in the exchanges to see how things 
are going. As of November 30, roughly 365,000 individuals enrolled in 
health insurance coverage through the State and Federal exchanges. That 
is a small improvement from the numbers that we saw at the end of 
October but still far short of the benchmarks that the Department of 
Health and Human Services had set for enrollment in the exchanges. 
Originally, HHS touted a goal of enrolling 7 million people in the 
exchanges by March of 2014. According to a memo obtained by the 
Associated press, HHS projected that on the way to reaching that goal 
of 7 million enrollees, they would enroll roughly half a million people 
in the first month. Yet after 2 months they were still more than 
100,000 people short of that one-month benchmark, which is not a high 
benchmark in my opinion.
  The same memo projected that they would have 3.3 million enrollees by 
the end of 2013. Yet, if they are going to reach that goal, they will 
have to enroll nearly 10 times as many people as they have enrolled so 
far in just the next week and a half.
  Sure, many of these enrollment problems are due to a poorly designed 
and poorly executed Web site, but even with the Web site's 
improvements, it would take a substantial miracle for the 
administration to meet its enrollment goals for the coming months.
  There are other significant problems to be concerned about, most 
notably those associated with the premium subsidy program administered 
by the IRS.
  Earlier this month the Treasury Inspector General for Tax 
Administration issued a report that found that the IRS has an 
inadequate system in place for preventing fraudulent premium subsidy 
payments from occurring and that people's personal information will 
likely be at risk. That is the Inspector General for Tax 
Administration. That is not Republicans. There are real questions as to 
whether the IRS can effectively verify the income of those applying for 
these subsidies. I have also raised the concern on a number of 
occasions.
  Similar tax subsidy programs, including, for example, the Earned 
Income Tax Credit, EITC, that are paid out before they are verified, 
have improper payment rates as high as 25 percent. Think of that.
  If we see the same improper payment rate on these ObamaCare subsidies 
as we do on the EITC, it will end up costing taxpayers hundreds of 
billions of dollars over the next 10 years. As I have said in the past, 
the ObamaCare premium subsidies with the lack of security and 
safeguards are a fraudster's dream. We have warned the administration, 
and I personally warned the administration.
  The administration may claim that with the recent improvement to the 
healthcare.gov Web site all is now right with the world. However, as 
you can see, there are a number of administrative problems that, even 
with a functional Web site, have yet to be resolved.

[[Page 19475]]

  No. 2, Americans will be left without coverage due to the problems 
with ObamaCare. As a result of the dismal rollout of ObamaCare, many 
Americans, particularly those who have tried to enroll in the 
exchanges, could very well end up being uninsured for a time. Maybe a 
significant time.
  Last week an article appeared in the Washington Post that told the 
stories of people who were forced out of their existing health plans 
due to ObamaCare's coverage mandates but are unable to sign up for the 
new plans on the exchange due to the failings of the Web site. The 
deadline for signing up for coverage that starts on January 1, 2014, is 
December 23, 2013. Anyone who has been kicked off their plan who is 
unable to sign up before that date, which is just a few days away, will 
find themselves facing a gap in medical coverage.
  For the chronically ill or for people with expensive medical 
conditions, this gap in coverage will be particularly acute. These 
people are, according to the Washington Post, ``ObamaCare's biggest 
losers.'' Yet, ostensibly, these are the very people that this law was 
enacted for and supposed to help.
  Another reason countless Americans may end up seeing gaps in coverage 
is simply because they will be unable to navigate the ever-changing 
landscape that is ObamaCare's dates and deadlines. Due to the failures 
of the rollout, the administration has delayed or shifted virtually 
every deadline associated with obtaining and paying for coverage. For 
example, like I said, the deadline for enrolling in insurance coverage 
that starts on January 1 is December 23, just a few days away. The 
deadline for actually getting the first premium payment to insurers is 
December 31. Both of these dates have been moved at least once already 
and could be moved again. They probably will be. On top of that, the 
administration has issued statements ``encouraging'' insurers to extend 
their own deadlines for payment and enrollment.
  This is on top of the delays in the employer mandate, the SHOP 
exchanges, and the countless other provisions we have seen delayed or 
extended over the past year.
  People are bound to be confused by all of these changes. It is nearly 
impossible for anyone, let alone those with serious medical conditions, 
to keep track of the ever-changing deadlines the administration keeps 
issuing. With no clarity as to when people should sign up and who they 
should pay and when, it is a virtual certainty that many consumers will 
find themselves uncovered for a period of time through no fault of 
their own.
  The administration added to all of this uncertainty last night with 
the announcement it was going to allow people with canceled insurance 
plans to either buy catastrophic plans or avoid the requirement that 
they buy health insurance altogether. It has been less than a full day, 
and already this decision is causing confusion among insurers. It will 
almost certainly do the same for consumers.
  It seems the Obama administration is making all of this up as they go 
along. Undoubtedly, many people will suffer the consequences of this 
ineptitude. The administration should be ashamed of the way this is 
bollixed up and messed up, and it is just going to get worse.
  No. 3, there will continue to be spikes in premiums and other costs. 
We have already seen what is happening to the price of insurance in the 
individual market. Thanks to ObamaCare, millions of people have already 
lost their existing health insurance and have found that their options 
on the exchanges come with much higher premiums. This sticker shock has 
been widely reported. But that is not the end of the crisis problem.
  Unfortunately, many people are also finding that their out-of-pocket 
costs will be dramatically increased thanks to higher copayments and 
prescription drug costs, included in plans on the exchanges. In many 
cases, it is difficult for patients to determine which medications are 
covered on the ObamaCare plans.
  Unlike in Medicare Part D, the ObamaCare Web site does not have a 
plan finder that would enable consumers to search for plans based on 
coverage. These new costs are particularly high when compared with the 
insurance plans that were recently canceled.
  But it is not just happening in the individual market. These price 
spikes are also hitting people with employer-provided insurance. 
According to a recent poll by the Associated Press, nearly half of 
Americans with job-based or other private insurance say their policies 
will be changing next year, mostly for the worse. So 69 percent say 
that the cost of their insurance will be going up; 59 percent say their 
annual deductibles or copayments are increasing. The Affordable Care 
Act did little to reign in the actual cost of health care.
  When you add in the costs associated with the law's mandates and 
regulations, costs are going up, particularly for small businesses, our 
main job creators.
  A recent survey of small business owners by the National Federation 
of Independent Business confirmed that this is already starting to 
happen. In the survey, 64 percent of small businesses reported that 
they paid more for employee health insurance premiums in 2013 than they 
did in 2012. Small business owners consistently cite the rising cost of 
health care as their top business concern.
  This brings us to the next obvious prediction, No. 4. Millions of 
people will lose their existing employer-provided health insurance. 
Once again, we are all too familiar with President Obama's infamous 
promise, ``If you like your health care plan, you can keep it,'' but 
little has been said about the threats ObamaCare's mandates pose to 
people who get their health insurance from their employers.
  Put simply, the health law was designed specifically to invalidate 
existing health care plans--those deemed inadequate by the drafters of 
the law--in order to force people into more expensive plans with 
expanded coverage they don't necessarily want or need. This applies to 
both individual market plans and employer-provided plans alike. The 
administration's own estimates, published in the Federal Register, 
predicted that tens of millions of Americans with employer-sponsored--
keep in mind, employer-sponsored--insurance will see their plans 
invalidated by the so-called Affordable Care Act's mandates and 
regulations.
  According to a recent analysis by the American Enterprise Institute, 
as many as 50 to 100 million insurance policies in the employer-
provided insurance market will see their plans canceled next fall when 
all business plans must be fully compliant with ObamaCare's insurance 
mandates. At that point businesses will have to face a difficult 
choice: Offer a more expensive health care plan to their employees or 
send employees into the exchanges. As we have already seen, that is not 
a great place to be.
  No. 5, health insurers will either leave the market or face 
bankruptcy. One of the foundational assumptions made by the drafters of 
the Affordable Care Act was that the costs to insurers of providing 
vastly expanded coverage would be offset when more young and healthy 
patients are brought into the risk pools. Indeed, this is almost the 
entire basis for the individual mandate. The problem is that so far 
this doesn't seem to be happening, and I doubt it ever will. There is 
good reason to question whether it ever will. With the ever-increasing 
cost of insurance as a direct result of ObamaCare, there will likely be 
many who opt to stay out of the market altogether.
  There is ample data right now to support this conclusion. For 
example, in a poll released earlier this month from the Harvard 
Institute of Politics, those in the millennial generation--the very 
people whom proponents of ObamaCare desperately need to add to the 
insurance pool--were shown to be highly skeptical of the law. In the 
poll, a majority of 18- to 29-year-olds disapproved of the Affordable 
Care Act and said it will increase their personal health care costs. 
Only 18 percent of respondents in that age group said they thought the 
law would improve their health care.
  Clearly, the authors of ObamaCare thought that the individual 
mandate,

[[Page 19476]]

along with the strong sense of civic duty, would coerce people into 
acting against their own interests and paying expanded costs for 
coverage they don't necessarily want or need; however, in the real 
world where people weigh costs and benefits before making a decision, 
millions of people are more likely to pay a fine instead of entering a 
skewed and unstable insurance market where costs are forever going up. 
A lot of these young people will not even pay the fine because there is 
no penalty for not doing so.
  Without a greatly expanded risk pool of younger and healthier 
consumers, it is not going to be worth it for many insurers to stay in 
the market. Those insurers who do stay and try to stick it out will do 
so at greater risk to their financial future.
  Insurers are not the only ones facing a dismal economic outlook as a 
result of ObamaCare, which brings me to my final prediction. Remember, 
I am just limiting it to six today. I will have more later.
  No. 6, ObamaCare will continue to be a drag on business and our 
overall economy. It isn't just patients and consumers who are suffering 
under ObamaCare; employers are also facing difficulties as a direct 
result of ObamaCare. As I have discussed here on the floor at length in 
anticipation of the employer mandate, businesses all across the country 
have either reduced employment or have stopped hiring. Workers who had 
full-time jobs before the passage of ObamaCare are finding themselves 
moved into part-time work because under the law employers will be 
forced to provide coverage for full-time workers.
  Even the unions, which were among the largest and biggest supporters 
of the health law when it was being debated in Congress, have come out 
and said the law is destroying the 40-hour workweek for American 
workers.
  Last week the National Association of Manufacturers released its 
quarterly survey of its members which showed overwhelmingly that the 
President's health care law is having a negative impact on the 
manufacturing sector. According to that survey, more than 20 percent of 
manufacturers have cut or decelerated their business investment as a 
result of ObamaCare. Nearly one-quarter of them have either reduced 
employment or ceased hiring. Roughly one-third of them say they have 
reduced their business outlook for 2014 as a result of the so-called 
Affordable Care Act. And more than 77 percent--nearly 8 in 10--of 
manufacturers cited rising health insurance costs as a primary business 
challenge.
  In other words, at a time when our economy is growing at a sluggish 
pace and job growth remains lackluster, the President and Democrats in 
Congress continue to support a health care law that is making America a 
much more difficult place to do business and to find and keep a job. It 
is only going to get worse as this wears on. These are just some of the 
problems we are going to see in the coming months as a direct result of 
ObamaCare, and they are not going to go away so long as the Affordable 
Care Act remains in place.
  As I see it, with 2013 coming to a close, the President and his 
allies here in Congress are at a crossroads. As I see it, they have two 
choices: They can continue to double down on the same failed policy 
that is increasing the cost of health insurance in this country and 
causing millions of people to lose their existing coverage and will 
continue to wreak havoc well into the future or they can, for once, try 
to work with Republicans on replacing this failure with something that 
has a real chance of success. I hope that eventually my colleagues will 
choose the latter, but needless to say I don't think I can keep my 
hopes up.
  Last but not least, I hope this is not leading to a throwing of the 
hands in the air, admitting this doesn't work, and then saying we have 
to go to socialized medicine, or what many call a single-payer system. 
If we do that, I have to tell you, we will never get out from under 
this mess.
  We had a system that was working pretty well. There were up to 30 
million people who did not have coverage. Why didn't we just 
concentrate governmentally on helping the 30 million people rather than 
doing this colossally bad bill that we are all going to rue the day we 
did? I am so concerned about it.
  There are ways we can work together. I really believe we have to find 
some folks on the other side of the aisle who really understand this 
and who really understand that they are getting killed by this bill. 
Hopefully, we can find some folks who will sit down and work with 
people like myself. I have been instrumental in an awful lot of health 
care legislation over the last 37 years. Hopefully, we can work 
together in order to get this terrible problem resolved. I am concerned 
about it.
  Health care should never have been a partisan issue, and in this case 
it is a totally partisan issue. Every Democrat in the House and Senate 
voted for it. Not a single Republican in the House or Senate voted for 
it. We all voted against it, knowing in advance that it would be a 
disaster. Frankly, I would like to get rid of the disaster, and I hope 
we can find some colleagues on the other side who will be willing to 
work to do that.
  I hope the President will wake up. I think he thinks he is going to 
double down and fight for this, when, in fact, it is killing his 
reputation and the Democratic Party's reputation as well.
  We clearly can't keep going the way we are.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  The PRESIDING OFFICER. The Senator from South Carolina.
  Mr. GRAHAM. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRAHAM. I ask unanimous consent to be able to engage the Senator 
from New Hampshire in a colloquy for about 20 minutes. I would 
appreciate it if the Presiding Officer would let us know when the 20 
minutes has expired. I would like to discuss the military retiree 
position and the budget with Senator Ayotte when she gets here.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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