[Congressional Record (Bound Edition), Volume 163 (2017), Part 7]
[House]
[Pages 9166-9167]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   CANARY IN THE OBAMACARE COAL MINE

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Tennessee (Mr. Duncan) for 5 minutes.
  Mr. DUNCAN of Tennessee. Mr. Speaker, ObamaCare has created a 
healthcare crisis for the people in my district. Not long ago, I 
received this letter from one of my constituents in Knoxville: ``I just 
read where Humana Insurance Company will not offer health insurance in 
any of the exchanges in 2018. This puts my wife in a predicament, as 
there will be no health insurance companies offering health insurance 
in 2018 in Knoxville at this time. We need help with this mounting 
issue, as I am sure there are a lot more of us in the same boat. When 
we first signed up for ACA insurance 3 years ago, her monthly premium 
was $245. The second year it was $660. This year it is $963 a month. 
This is absolutely ridiculous for a person on a limited income.''
  Many thousands in Tennessee and across the Nation have very similar 
stories. My constituent was right. It is ridiculous. Now, even this 
expensive insurance will disappear, and there are a lot of people in 
the same boat as my constituent and his wife.
  Because there has been so much publicity about how the Republicans 
now control both Congress and the White House, it seems a great many 
people do not realize that we are still totally and completely under 
ObamaCare. A bill was passed in the House, but a different version is 
being discussed in the Senate. So Republicans have not yet done 
anything to change ObamaCare. So if someone is still having trouble 
getting health insurance or is still paying too much for their 
insurance, it is still because of ObamaCare.
  Just today, in the nonpartisan Capitol Hill newspaper, The Hill, is 
this headline, ``Insurer exits bolster GOP case for ObamaCare repeal.'' 
Insurance companies are still pulling out right and left all over the 
country because of ObamaCare. ObamaCare is still imploding all over the 
country.
  ObamaCare's allegedly compassionate regulations were supposed to 
guarantee access to healthcare for the sick. Instead, they have made 
access worse. Current propaganda seems to be persuading some people 
that ObamaCare is really protecting the people it claims to be, but 
Harvard and others are finding otherwise in their studies. They are 
finding that the ObamaCare regulations literally penalize insurers who 
offer quality coverage for the sick. This motivates insurers to offer 
only unattractive plans to people with expensive medical conditions.
  The insurance company who offers the best plans ends up with the 
most--and the sickest--enrollees, and so the highest costs. Sadly, this 
is causing a race to the bottom. The ObamaCare regulations are causing 
everyone, including people with preexisting conditions, to have low-
quality coverage or no insurance options at all.
  ObamaCare's harmful government regulations have driven every insurer 
out of the marketplace exchange in 16 counties in the Knoxville region. 
For 43,000 Tennesseans--unless Blue Cross Blue Shield can come back 
into the area, which they are considering--there will be no exchange 
plans available after December.
  But it is not just in Knoxville. Millions of Americans have only one 
insurer left in the exchange, if any. ObamaCare's regulations are 
driving out more and more insurers every day, leaving Americans with 
less choice and ultimately no choice.
  Throwing more taxpayer money at this problem won't solve it. This 
will continue to happen all across this country as long as we have 
ObamaCare's harmful regulations on the books.
  Knoxville, Tennessee, is the canary in the ObamaCare coal mine. Mr. 
Speaker, President Trump says he wants to repeal ObamaCare. He should 
send his healthcare people to Knoxville, talk and listen to our people, 
share my constituents' stories, show the American people that 
ObamaCare's regulations are the cause of our Nation's crisis and are 
limiting access to healthcare.
  If President Trump goes before the Nation on national television and 
explains in understandable detail what is going on with ObamaCare now 
and how he is trying to fix it, the American people will rally once 
again to repeal ObamaCare's harmful government regulations.
  Mr. Speaker, I include in the Record this Wall Street Journal article 
written by Michael Cannon, director of health policy studies at the 
Cato Institute.

             [From the Wall Street Journal, Feb. 28, 2017]

                    How ObamaCare Punishes the Sick

                          (By Michael Cannon)

       Republicans are nervous about repealing ObamaCare's 
     supposed ban on discrimination against patients with pre-
     existing conditions. But a new study by Harvard and the 
     University of Texas-Austin finds those rules penalize high-
     quality coverage for the sick, reward insurers who slash 
     coverage for the sick, and leave patients unable to obtain 
     adequate insurance.
       The researchers estimate a patient with multiple sclerosis, 
     for example, might file $61,000 in claims. ObamaCare's rules 
     let MS patients buy coverage for far less, forcing insurers 
     to take a loss on every MS patient. That creates ``an 
     incentive to avoid enrolling people who are in worse health'' 
     by making policies ``unattractive to people with expensive 
     health conditions,'' the Kaiser Family Foundation explains.
       To mitigate that perverse incentive, ObamaCare lobs all 
     manner of taxpayer subsidies at insurers. Yet the researchers 
     find insurers still receive just $47,000 in revenue per MS 
     patient--a $14,000 loss per patient.

[[Page 9167]]

       Predictably, that triggers a race to the bottom. Each year, 
     whichever insurer offers the best MS coverage attracts the 
     most MS patients and racks up the most losses. Insurers that 
     offer high-quality coverage either leave the market, as many 
     have, or slash their coverage. Let's call those losses what 
     they are: penalties for offering high-quality coverage.
       The result is lower-quality coverage--for MS, rheumatoid 
     arthritis, infertility and other expensive conditions. The 
     researchers find these patients face higher cost-sharing 
     (even for inexpensive drugs), more prior-authorization 
     requirements, more mandatory substitutions, and often no 
     coverage for the drugs they need, so that consumers ``cannot 
     be adequately insured.''
       The study also corroborates reports that these rules are 
     subjecting patients to higher deductibles and cost-sharing 
     across the board, narrow networks that exclude leading cancer 
     centers, inaccurate provider directories, and opaque cost-
     sharing. A coalition of 150 patient groups complains this 
     government-fostered race to the bottom ``completely 
     undermines the goal of the ACA.''
       It doesn't have to be like this. Employer plans offer drug 
     coverage more comprehensive and sustainable than ObamaCare. 
     The pre-2014 individual market made comprehensive coverage 
     even more secure: High-cost patients were less likely to lose 
     coverage than similar enrollees in employer plans. The 
     individual market created innovative products like ``pre-
     existing conditions insurance'' that--for one-fifth the cost 
     of health insurance--gave the uninsured the right to enroll 
     in coverage at healthy-person premiums if they developed 
     expensive conditions.
       If anything, Republicans should fear not repealing 
     ObamaCare's pre-existing-conditions rules. The Congressional 
     Budget Office predicts a partial repeal would wipe out the 
     individual market and cause nine million to lose coverage 
     unnecessarily. And contrary to conventional wisdom, the 
     consequences of those rules are wildly unpopular. In a new 
     Cato Institute/YouGov poll, 63% of respondents initially 
     supported ObamaCare's pre-existing-condition rules. That 
     dropped to 31%--with 60% opposition--when they were told of 
     the impact on quality.
       Republicans can't keep their promise to repeal ObamaCare 
     and improve access for the sick without repealing the ACA's 
     penalties on high-quality coverage.

     

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