[Congressional Record (Bound Edition), Volume 160 (2014), Part 11]
[Senate]
[Pages 16152-16155]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. MURPHY. Madam President, this past Saturday, open enrollment 
began for the second round of State-based and Federal exchanges all 
across the country.
  We can think about where we were a year ago today: The government was 
in shutdown. The Federal Web page where people went to enroll was a 
blank screen for many. There was frustration all across the country, 
and a lot of our friends on the other side of the aisle were claiming 
that this was proof the health care reform law could not work. They 
claimed it was a failure from the beginning.
  Well, a year makes a big difference. It is a year later, and we have 
7 million, 8 million people who have insurance on these exchanges 
across the country. We have lowered the number of people without 
insurance by 25 percent in a year's period of time. That is remarkable. 
In my State of Connecticut, where we run the best exchange in the 
entire country, we have cut the number of uninsured in half in just a 
year's period of time. That is an even more stunning number. Health 
care rates of inflation are as low as they have been in most of our 
lifetimes. The State of Connecticut is actually spending less on 
Medicaid than it was a year or two ago, and quality is getting better. 
By most all of the indices that we follow, the number of people who are 
readmitted to a hospital after a surgery or the number of infections 
people get while they are in the hospital are all lower than they were 
when the bill first went into effect.
  While a lot of my Republican friends come to the floor with stories 
about people who have bad insurance with the health care bill, the data 
clearly is on our side. The data tells only one story that the 
Affordable Care Act is working. But we have a lot of stories, too--
millions of them, as it turns out. I have never denied that there will 
be people who have bad experiences with the health care system, with 
the Affordable Care Act, and with the exchanges. But they are in the 
vast minority. The majority are people such as Christina who is a small 
business owner from Stratford, CT. Several years ago, she left a job 
that provided employer-based coverage to start her own business in 
Bridgeport. It was her dream to start her own business. But as with a 
lot of Americans who have a dream to start their own business, she was 
reticent about doing it because she was worried about losing her health 
care insurance. She stayed insured on COBRA until it expired, and then 
she went on the individual market. She recalls having to fill out a 15-
page questionnaire asking, as she says, ``anything that I had ever 
remotely discussed with my doctor.'' Unfortunately for her, she got a 
rejection notice from a carrier that basically just copied and pasted 
what she wrote in the application and said: Here is your preexisting 
condition, and that is why you are uninsurable. Her only remaining 
option was to go into Connecticut's high-risk pool.
  While she was shopping around for insurance, she decided to get her 
annual mammogram at age 40, and the hospital told her they found 
something suspicious on that mammogram.
  Facing a potential cancer diagnosis without health care coverage 
created an enormous amount of anxiety for her. It was at that moment 
that it struck her how important it was for people to have coverage. So 
she went to Access Health, which is our State-based exchange, to look 
at plans, and she realized she had another option. She found a gold 
exchange plan. It asked her to pay $430 a month, which was a big 
difference from the $1,200 per month that she was paying under the 
high-risk pool. By the way, a lot of the repeal-and-replace crowd say 
we should replace the exchanges with high-risk pools. Well, for 
Christina, that was a big financial risk to her. She went from $2,500 a 
month down to $430. She says: I am thankful that there was a solution 
for me to be able to keep my business and to have affordable health 
insurance that can't be taken away.
  Now, Christina hopefully is going to be what a lot of people call job 
creators. She is hopefully going to hire a lot of people for her new 
business. She is going to do it because she was able to start that new 
business because of the Affordable Care Act.
  On Saturday, the first day of enrollment, HHS said that 100,000 
people submitted applications for coverage, and more than 500,000 
people were able to

[[Page 16153]]

log on to healthcare.gov. And more than a million, just since open 
enrollment has begun, have been window shopping for insurance options. 
By and large, Web sites across the country are working, and they are 
allowing people to come back and shop for plans. It is really important 
that people do come back and shop for plans, because what we know is 
that the insurance industry likes this bill as well. Now, a lot of 
people on our side of the aisle don't like the fact that the insurance 
industry likes this bill so much, but they like it so much that there 
are about 25 percent more insurers that are offering plans on these 
exchanges. So if a person is on a plan for a year, they should know 
there are likely more options out there for them. They should go on the 
State exchange or Federal exchange and check it out. There are going to 
be more options with potentially better fits for people.
  That is not to say that people haven't been really happy with the 
insurance coverage they have. Here is some other news we have gotten in 
since the last time I was on the floor. The Gallup poll surveyed 
Americans who had bought insurance in the first year on these plans, 
and what they found is pretty remarkable. Seventy percent of the people 
who bought insurance in the new marketplace last year rated it as good 
or excellent. Would that we had the same ratings for the Senate. 
Seventy percent of the people say the coverage they got was good or 
excellent. Three in four of the newly insured say they are satisfied 
with this aspect of their health care insurance. That is compared to 61 
percent among the general population with insurance.
  So people are actually more satisfied on the exchange-based plans 
than they are on nonexchange-based plans. If people are satisfied now, 
they may be able to get an even better deal because more insurers are 
now signing up.
  The other good news is that premiums are going to be, on average, 
lower. Now, that is an impossible thing to say in the current health 
care environment. People are just not used to hearing that premiums 
from year to year are going to be lower, but that is the truth. A study 
from Kaiser and a study from the Wakely Consulting Group--Kaiser looked 
at the second lowest-cost silver plan in 49 cities around the country 
and found the premiums are going to be decreasing slightly from last 
year. Wakely looked at the largest county in each of the 34 States with 
marketplaces run by the Federal Government and found on average that 
the rate decrease was going to be 1 percent. We, frankly, would be 
happy if rate of increase was only 2 or 3 percent, because on average 
in 2008, the premium increase was 10 percent. In 2009 it was 10.8 
percent, and in 2010 it was 11.7 percent. We are having an average 
premium decrease in the exchanges this year. That is more proof that as 
folks get more coverage, as people get access to preventive care, they 
are driving down overall health care costs because less people get into 
crisis, less people have to run to the emergency room, and they get 
cheaper cost care earlier on. That is better for them, better for the 
taxpayers, and better for their bottom line.
  Kara from Granby, CT, has this story. When Kara was born, the doctors 
immediately told her parents that she was going to face a lifetime of 
obstacles because she was diagnosed with only one ailing kidney and a 
slight hearing impairment. Lucky for her, her parents found a great 
doctor at Connecticut Children's Medical Center.
  About the time she was 1 year old, her kidney had started to fail, 
and a kidney transplant was recommended. Her father gave her one of 
his, and she was able to graduate from high school and college without 
having any major health problems. But she remembers always being warned 
by her parents about how difficult her life was going to be because of 
her health ailment but also because of the fact that her life decisions 
were going to be dictated by whether she could get health care. So she 
was so relieved when she found out she could stay on her parents' plan 
until she was 26, under the new health care law. That was critical to 
her because her health, after she graduated college, took a sudden 
downward turn. She began having frequent headaches, and her voice 
became really hoarse. What she thought was a virus ended up to be 
diagnosed as a brain tumor.
  Because of the ACA and her parents' insurance, she was able to get 
great coverage. She went out to go look for a job but wasn't able to 
find one that offered health care insurance, and she went on Medicaid 
before she could sign up for health care insurance herself. Her tumor 
reappeared, but even despite this latest setback, her doctors still 
believe they can extract the tumor, and her prognosis is good. But she 
has health care, and she has had continuous health care because of the 
Affordable Care Act, because of Medicaid's being expanded throughout 
the States.
  Kara says that I know for sure that I wouldn't have made it this far 
in life without health care. It is incredibly essential to have it. You 
never know what is going to happen to you. Don't take your health for 
granted. Kara, from Granby, has health insurance continuously because 
of the Affordable Care Act. Differences are being made all over the 
country.
  I will tell just one more story. That is one from the middle section 
of the State from Ohio. Jim worked for 37 years for the same company. 
He was typically putting in 50-hour workweeks that included travel and 
working weekends. It started to take a toll on his health, and he knew 
he had to retire. If he wanted to live longer, if he wanted to enjoy 
his years in his sixties and seventies, he had to retire, but he 
couldn't do it because he needed health care for him and his family. 
His wife is a cancer survivor. She had been diagnosed with leukemia 15 
years ago. The only way she was going to be able to get insurance was 
through his employer. He had to keep working even though it was the 
wrong thing for his health because of his job lock caused by his 
necessity to get health insurance from this job he was connected to.
  The Affordable Care Act changed all of that. He retired in March of 
this year. He went and did his home homework on healthcare.gov. The 
plan he chose would have cost him $1,200 per month to cover him and his 
wife, but with the subsidy he received, with the tax credit he 
received, their premium costs were $127 a month. Jim is shopping as we 
speak for plans in 2015, but he knows he is going to live a longer 
life, and he will be able to be there for his wife and for his family 
because of the Affordable Care Act.
  Jim has a pretty interesting take on all of this. He says he got to 
leave his job and spend more time with his family and spend more time 
concentrating on his health. He says: ``I am much healthier and happier 
than I was before. Plus,'' he adds, ``I am helping the economy. When I 
left my job, they had to hire someone else, so I am a job creator 
too.''
  This is one of the great benefits of the Affordable Care Act. It 
reduces job lock. People who have to stay in jobs, people such as Jim 
but also people such as the first woman we talked about, Christina, who 
was able to start her own business because of the Affordable Care Act.
  Open enrollment is upon us. People have 25 percent more options. On 
average, people have premiums that are lower than they were last year. 
People can sign up for something better than they had or they can join 
the 8 million people who have signed up on the exchanges and 
participated in Medicare expansion all across the country. People can 
be part of this pretty amazing story that is being told all across the 
country.
  An Affordable Care Act that is insuring more people than ever before 
in this country, contributing to a stabilization of health care costs 
across this country, that still leaves us with a lot of room to go. 
There are still way too many people paying way too much for health 
care, but it at least charts us in the right direction and is making 
people healthier all at the same time, which is what this is all about. 
It is not just about saving money. It is about allowing people a better 
quality of life, and it is doing that as well.
  As we mark the coming second week of open enrollment, it is important 
again to point out a very simple fact,

[[Page 16154]]

which is the Affordable Care Act works.
  I yield back and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. BARRASSO. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BARRASSO. Madam President, with regard to the health care law, 
the proof has come out today. The administration has been cooking the 
books. That is not just me saying it. It has come out all across the 
press. USA Today, just out: ``Obama administration gave bad health 
exchange numbers.'' Associated Press: ``Oops, administration erred on 
health law signups.''
  Let's take a look at this. The Department of Health and Human 
Services said Thursday--this is reading from USA Today--it made a 
mistake in how it calculated enrollments under the Affordable Care Act, 
including 400,000 dental plans in its figures for medical plans. Those 
dental plans allow the Obama administration to claim more than 7 
million enrollments and 7 million was long considered the magic number, 
the magic number that would allow the new health insurance exchanges to 
be sustainable. What does the Secretary of Health and Human Services 
say? Today she said this mistake is unacceptable. I agree with the 
Secretary.
  This mistake is unacceptable, but it is not a surprise to the 
American people. We have questioned a long time what numbers the 
administration was putting out. I think it is fascinating that the 
administration has continued to lower and lower the numbers as more and 
more information and research has been done, and they can hide it no 
longer that they were cooking the books. Earlier today Bloomberg went 
up to the--with the story based on analysis from the House Committee on 
Oversight and Government Reform. The committee found the Obama 
administration has included people who purchased this stand-alone 
dental coverage and now HHS has admitted the duplicity. Let's take a 
look at this. On May 1 Health and Human Services released exchange 
enrollment information for a period from October 1, 2013, through April 
19, 2014. At the time Health and Human Services said over 8 million 
people had selected a plan through an exchange, either the State or 
Federal exchange.
  In the report, HHS also disclosed 1.1 million selected to stand-alone 
dental plans through the Federal exchanges. A footnote in that report 
said totals for stand-alone dental plans do not include individuals who 
are enrolled in the marketplace plans that provide integrated medical 
and dental coverage. So then on May 21, and after previously touting 
the 8.1 million exchange enrollees, Health and Human Services decided 
they would stop issuing additional reports. No more monthly ObamaCare 
exchange enrollment information. September 18, in testimony before the 
House Oversight Committee, the CMS Administrator, Marilyn Tavenner, 
testified that there were 7.3 million people enrolled in the health 
insurance marketplace coverage as of August 15. Remember the magic 
number for saying this was a sustainable program was still 7 million.
  When we take a look at the oversight committee's analysis it shows 
nearly 400,000 of these enrollees didn't purchase insurance through the 
exchange for health care, rather stand-alone dental coverage. That 
takes the total number to under 7 million.
  On November 10, earlier this month, Secretary Burwell said there were 
7.1 million exchange enrollees as of the end of October. However, she 
also failed to break out the coverage of those stand-alone dental 
insurance policies, indicating the true number as of last month, likely 
closer to 6.7 million or 6.8 million individuals.
  The nearly 20 percent drop in the exchange enrollees suggests that 
once many people learn about the ObamaCare problems, extremely high 
deductibles, narrow networks, they stop paying. They stop paying their 
premium in spite of the fact that there continues to be large 
government subsidies they are receiving. This drop is likely the 
central reason HHS dramatically lowered its exchange estimates earlier 
this month saying that by the end of the next year, instead of the 13 
million people predicted by the Congressional Budget Office that there 
would be about only 9.1 million people enrolled.
  I have heard from my colleague from Connecticut who came and told an 
individual story, but the health care law overall remains very 
unpopular. It is so unpopular that as of earlier this week and all of 
the polling ever done about the health care law, it is more unpopular 
now than ever before. Popularity is at an alltime low and unpopularity, 
disapproval is at an alltime high. Why would that be? There are a 
number of reasons. One is the front page of the New York Times the 
other day. November 15, cost of coverage under the care act set to 
increase. President Obama stood before the American people and said 
under his plan the cost of insurance policies would go down $2,500 per 
family. They have not gone down. They headed in the other direction, 
and again this year the cost of coverage under the health care act is 
set to increase. It is no surprise people are concerned when the 
President tells them one thing and something else happens, they 
question the President.
  There are a number of reasons it is not popular. That is just one. 
The President's solutions of putting many more people on Medicaid under 
the health care law, a program that has already failed and is failing 
and continues to be a problem--the front page of the Wall Street 
Journal, Friday, 14 of November, ``As More Join Medicaid, Health 
Systems Feel Strain''--stories about people who can't get care, people 
who are providers who can't afford to provide the care for Medicaid 
patients because the reimbursement is so low. That is the President's 
solution--force more people on to Medicaid because the President's 
focus during all of these discussions has been on coverage. As a doctor 
I will tell you the focus should be on the word ``care.'' People want 
care, and they know what they want. They know what they need in health 
care reform.
  They want affordable care, quality care, and choice. That is what a 
Republican plan will look like to replace and strip out the terrible 
parts of this health care law. Then for people living all across the 
country in rural communities--I know in the Presiding Officer's State 
and in mine, we know what impact the loss of a rural hospital has on 
that community.
  But yet, front page, USA Today, last weekend, November 14 to 16, 
``Rural Hospitals in Critical Condition.'' ObamaCare critics say the 
law is speeding up the demise of the facilities. There is a map of the 
United States, a list of 43 hospitals that have closed since January of 
2010 as a result of the health care law.
  You say: Is it as a result of the health care law? I believe it is, 
because it was Ezekiel Emanuel, one of the architects of the health 
care law, who said and recently wrote that between now and the year 
2020, up to 1,000 hospitals in the United States were likely to close. 
We know what the impact of the cuts that happen to our seniors on 
Medicare as a result of the health care law will have to rural 
hospitals, where a disproportionate number of the patients are seniors 
on Medicare. The hospitals cannot sustain themselves.
  That was part of the original budget numbers as they looked at the 
health care law, as we debated it on this Senate floor and said: Please 
do not pass this, Democrats--who one by one by one voted for the health 
care law--because it is going to impact our rural hospitals.
  Now we see 43 hospitals in rural communities all around the country 
and tell stories of people who could not get care, had to travel such a 
long distance in that critical hour after a heart attack, were unable 
to survive. So the health care law continues to be very unpopular 
across the country. Yes, it is possible for colleagues to come to the 
floor and tell a story about one individual whose life may have been 
improved as a result of the health care

[[Page 16155]]

law. But across the country, there are many people who are finding they 
cannot keep their doctor, they cannot keep their child's pediatrician, 
they cannot go to the hospital in their local community because of the 
specific components of the health care law which have caused so much 
damage and wreaked havoc in communities all around America.
  I continue to hear from people in Wyoming who have lost the insurance 
that worked for them and they liked. They had to buy other insurance, 
much more expensive, that covered things they did not need, did not 
want, and cannot afford. Many now find themselves for the first time 
without insurance when they had it before. It worked for them and their 
families.
  So that is why all across the country, people are saying: This health 
care law is not working for me. That is why the signups are down and 
the belief is that fewer people are going to sign up because for them 
they do not feel they are getting good value. They see what they are 
going to have to pay out of pocket for deductibles, what they have to 
pay out of pocket for copays, what their premiums are. As a result, 
they are saying: No, thank you.
  Even with the subsidies, Health and Human Services has significantly 
lowered their predictions of how many people will sign up for the 
health care law this year. That is in spite of the fact that the fines 
are going up.
  Then, on top of all of this, there is a health care MIT economist, 
Professor Jonathan Gruber, who has made comments that are disparaging 
of American citizens. He has said not just once but time and time 
again, as the videos continue to come out of this Gruber miniseries of 
TV videos, that this health care law was sold to the American people by 
trying to confuse them. He has questioned their intelligence. It was 
Nancy Pelosi who said: First you have to pass it before you get to find 
out what is in it.
  American people are furious about the way this administration has 
treated them, has behaved toward them, and has acted upon their 
willingness to believe an administration and believe a Speaker of the 
House at a time people wanted health care reform in America. People did 
not get what they wanted. They did not get what they were promised.
  So, today, I come to the floor to say to my colleague who just spoke 
about the health care law, that perhaps for the folks he mentioned it 
has worked. We want health care to work for people all across the 
country so they can get the care they need, from a doctor they choose, 
at lower cost. That is what they want. So today, the proof comes out, 
the administration has been cooking the books. As USA Today says, the 
Obama administration gave bad health exchange numbers and the 
Associated Press starts its story on this very same topic with one 
word, ``Oops!''
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Udall of Colorado). The clerk will call 
the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. REID. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________