Mr. President, I am introducing the Empowering Patients First Act, companion legislation to H.R. 2300, introduced in the House of Representatives by Congressman Tom Price. I thank Congressman Price…
Mr. President, I am introducing the Empowering Patients First Act, companion legislation to H.R. 2300, introduced in the House of Representatives by Congressman Tom Price. I thank Congressman Price for all the hard work he did on this legislation. I am very grateful for that.
I believe this legislation would give patients, families, and doctors the power to make medical decisions, and not Washington.
Specifically, this legislation would enable everyone to purchase health insurance through deductions, credits, or advanceable credits; equalize tax treatment of employer-sponsored plans and plans purchased by individuals by letting individuals buy health insurance
with pre-tax dollars; let small business owners band together across State lines through association health plans, known as AHPs, and take advantage of the increased purchasing power which larger businesses are able to take advantage of through increased bargaining power, volume discounts, and administrative efficiencies. It would let consumers buy insurance across State lines, and let individuals own their insurance like a 401(k) plan so they can take it with them across State lines if they change jobs.
I don't think there is any doubt in the majority of Americans' minds--and poll after poll indicates--that ObamaCare is a failure. The American people do not believe in it. And it isn't just the problems with the rollout of the Web site--it is all of the aspects of it which have become so complex and so difficult.
Basically, it is as some of us who fought it day after day here on the floor said: an experiment in social engineering, where young people who are healthy are going to pay for the health care of those who are older and sicker--a redistribution of wealth that then-Senator Obama favored and stated when he was running for President.
That is not the way to address health care needs in America. It has not bent the health care curve down. It has not allowed people, if they want to keep their insurance, to be able to keep it. I noticed that was voted as the biggest lie of the year by one of the periodicals here. And it is a failure.
We on the other side of this issue are also required to come up with alternatives, because we vowed to repeal and replace ObamaCare, not just repeal it. I believe that what Congressman Price has introduced, and what I am introducing today as a companion bill, is a step in that direction.
It is time that we on this side of the aisle came up with our agenda for health care in America because we know that the inflation associated with health care costs is unsustainable, that there are millions of Americans who do not have health care, and there is a particular problem for those with preexisting conditions.
We need to repeal this horrendous mistake--which, by the way, was done on strictly party line votes, the first entitlement program ever enacted that was done without a single bipartisan vote on it. As many of us predicted back in 2009 when this legislation was passed, it was doomed to failure. Time after time, amendment after amendment, as we attempted to repeal it for 25 days, I believe it was, of floor consideration back in 2009, it was voted down on a party line basis.
They sowed the wind and are now reaping the whirlwind. We need to repeal the Affordable Care Act, and we need to replace it because health care in America is still not satisfactory, nor have we fulfilled the needs and the obligations we have to all of our citizens.
The problems with the Affordable Care Act are well known: A failed Web site rollout that has hindered enrollment and the purchase of mandated coverage. As of December 17, only an estimated 440,835 people have enrolled for a health plan. That is 6.2 percent of the enrollment goal of 7 million by March 31, 2014.
There is a destructive tax on medical devices that will discourage innovation and encourage these businesses to move offshore. We have already seen medical device manufacturers leaving the United States of America as they said they would if they were taxed to the point where they could not be competitive with medical devices that were manufactured in foreign countries.
There is disappointment for Americans who are happy with their current coverage and want to keep their coverage. It is estimated that 10 million Americans will have their health plans terminated due to ObamaCare.
According to a December 17 Washington Post-ABC poll, only 19 percent of Americans believe ObamaCare is improving the country's health care system. Only 8 percent believe ObamaCare is improving their insurance coverage. Only 5 percent of Americans believe their health care costs are decreasing as a result of ObamaCare, and 47 percent of Americans believe the President's health care law is increasing the cost of their health care.
It is clear that ObamaCare is not working for the American people, and they have little faith in the administration's efforts to fix our broken health care system.
This legislation I am introducing today makes the purchase of health care financially feasible for all Americans--from deductions to advanceable, refundable credits so that everyone has an economic incentive to purchase coverage they want for themselves and their families, not what the government forces them to buy. In addition, it allows greater choices in portability, so that every health policy is owned by the patient, regardless of who pays. This means the coverage would go with the person if they change or lose their job. It gives employers more flexibility in the benefits offered and provides many more coverage options for people with preexisting conditions so that no one is priced out of the market, regardless of health status.
It addresses increasing costs by clamping down on abusive lawsuits, ends the practice of defensive medicine, gains significant savings from health care efficiencies--sifting out waste, fraud, and abuse--and bringing our Nation's budget under control.
Finally, it establishes doctor-led quality measures, ensuring that patients receive quality care defined by people who know medicine, not by government. It encourages healthier lifestyles by giving employers and health policies more flexibility to offer discounts for healthy habits through wellness and prevention programs.
If enacted, this legislation would save trillions of dollars. Douglas Holtz-Eakin, who is the former director of the Congressional Budget Office and one of the most credible people in this town, estimates this legislation would save American tax payers $2.37 trillion in its first decade alone. According to the analysis of Mr. Holtz-Eakin, compared to current law this legislation would produce smaller premium increases on average, yielding lower premiums than current law--nearly 19 percent for single policies and up to 15 percent for family policies; increase patient access to physicians; produce a 10-percent increase in medical productivity; and increase the number of insured individuals by 29 percent.
Americans are looking for an alternative to ObamaCare. This legislation is a step in the right direction and will provide Americans an alternative that empowers patients, families, and doctors to make the medical decisions, not those in Washington, DC.
I find of interest in the Wall Street Journal an opinion piece entitled ``ObamaCare's Troubles Are Only Beginning,'' by Michael Boskin, a very well respected economist. It says:
Be prepared for eligibility, payment and information
protection debacles--and longer waits for care.
He says:
The shocks--economic and political--will get much worse
next year and beyond. Here's why: The ``sticker shock'' that
many buyers of new, ACA-compliant health plans have
experienced--with premiums 30% higher, or more, than their
previous coverage--has only begun. The costs borne by
individuals will be even more obvious next year as more
people start having to pay higher deductibles and copays.
If, as many predict, too few healthy young people sign up
for insurance that is overpriced in order to subsidize older,
sicker people, the insurance market will unravel in a ``death
spiral'' of ever-higher premiums and fewer signups. The
government, through taxpayer-funded ``risk corridors,'' is on
the hook for billions of dollars of potential insurance-
company losses. This will be about as politically popular as
bank bailouts.
The ``I can't keep my doctor'' shock will also hit more and
more people in coming months. To keep prices to consumers as
low as possible--given cost pressures generated by the
government's rules, controls and coverage mandates--insurance
companies in many cases are offering plans that have very
restrictive networks, with lower-cost providers that exclude
some of the best physicians and hospitals.
Finally, there is an article entitled ``Second wave of health care plan cancellations looms.'' It goes on to say:
An analysis by the American Enterprise Institute, a
conservative think tank, shows the administration anticipates
half to two-thirds of small businesses would have policies
canceled or be compelled to send workers into the ObamaCare
exchanges. They predict up to 100 million small and large
business policies could be canceled next year.
I ask unanimous consent these articles be printed in the Record.
It is time for us to begin to consider alternatives and recognize that this legislation needs to be repaired and replaced.
I yield the floor.
[Dec. 15, 2013]
ObamaCare's Troubles Are Only Beginning
Be prepared for eligibility, payment and information protection
debacles--and longer waits for care.
(By Michael J. Boskin)
The White House is claiming that the Healthcare.gov website
is mostly fixed, that the millions of Americans whose health
plans were canceled thanks to government rules may be able to
keep them for another year, and that in any event these
people will get better plans through ObamaCare exchanges.
Whatever the truth of these assertions, those who expect
better days ahead for the Affordable Care Act are in for a
rude awakening. The shocks--economic and political--will get
much worse next year and beyond. Here's why:
The ``sticker shock'' that many buyers of new, ACA-
compliant health plans have experienced--with premiums 30%
higher, or more, than their previous coverage--has only
begun. The costs borne by individuals will be even more
obvious next year as more people start having to pay higher
deductibles and copays.
If, as many predict, too few healthy young people sign up
for insurance that is overpriced in order to subsidize older,
sicker people, the insurance market will unravel in a ``death
spiral'' of ever-higher premiums and fewer signups. The
government, through taxpayer-funded ``risk corridors,'' is on
the hook for billions of dollars of potential insurance-
company losses. This will be about as politically popular as
bank bailouts.
The ``I can't keep my doctor'' shock will also hit more and
more people in coming months. To keep prices to consumers as
low as possible--given cost pressures generated by the
government's rules, controls and coverage mandates--insurance
companies in many cases are offering plans that have very
restrictive networks, with lower-cost providers that exclude
some of the best physicians and hospitals.
Next year, millions must choose among unfamiliar physicians
and hospitals, or paying more for preferred providers who are
not part of their insurance network. Some health outcomes
will deteriorate from a less familiar doctor-patient
relationship.
More IT failures are likely. People looking for health
plans on ObamaCare exchanges may be able to fill out their
applications with more ease. But the far more complex back-
office side of the webssite--where the information in their
application is checked against government databases to
determine the premium subsidies and prices they will be
charged, and where the applications are forwarded to
insurance companies--is still under construction. Be prepared
for eligibility, coverage gap, billing, claims, insurer
payment and patient information-protection debacles.
The next shock will come when the scores of millions
outside the individual market--people who are covered by
employers, in union plans, or on Medicare and Medicaid--
experience the downsides of ObamaCare. There will be longer
waits for hospital visits, doctors' appointments and
specialist treatment, as more people crowd fewer providers.
Those with means can respond to the government-driven
waiting lines by making side payments to providers or seeking
care through doctors who do not participate in insurance
plans. But this will be difficult for most people.
Next, the Congressional Budget Office's estimated 25%
expansion of Medicaid under ObamaCare will exert pressure on
state Medicaid spending (although the pressure will be
delayed for a few years by federal subsidies). This pressure
on state budgets means less money on education and
transportation, and higher state taxes.
The ``Cadillac tax'' on health plans to help pay for
ObamaCare starts four years from this Jan. 1. It will fall
heavily on unions whose plans are expensive due to generous
health benefits.
In the nearer term, a political iceberg looms next year.
Insurance companies usually submit proposed pricing to
regulators in the summer, and the open enrollment period
begins in the fall for plans starting Jan. 1. Businesses of
all sizes that currently provide health care will have to
offer ObamaCare's expensive, mandated benefits, or drop their
plans and--except the smallest firms--pay a fine. Tens of
millions of Americans with employer-provided health plans
risk paying more for less, and losing their policies and
doctors to more restrictive networks. The administration is
desperately trying to delay employer-plan problems beyond the
2014 election to avoid this shock.
Meanwhile, ObamaCare will lead to more part-time workers in
some industries, as hours are cut back to conform to
arbitrary definitions in the law of what constitutes full-
time employment. Many small businesses will be cautious about
hiring more than 50 full-time employees, which would subject
them to the law's employer insurance mandate.
On the supply side, medicine will become a far less
attractive career for talented young people. More doctors
will restrict practice or retire early rather than accept
lower incomes and work conditions they did not anticipate.
Already, many practices are closed to Medicaid recipients,
some also to Medicare. The pace of innovation in drugs,
medical devices and delivery is expected to slow
significantly, as higher taxes and even rationing set in.
The repeated assertions by the law's supporters that nobody
but the rich would be worse off was based on a beyond-
implausible claim that one could expand by millions the
number of people with health insurance, lower health-care
costs without rationing, and improve quality. The reality is
that any squeezing of insurance-company profits, or reduction
in uncompensated emergency-room care amounts to a tiny
fraction of the trillions of dollars extracted from those
people overpaying for insurance, or redistributed from
taxpayers.
The Affordable Care Act's disastrous debut sent the
president's approval ratings into a tailspin and
congressional Democrats in competitive districts fleeing for
cover. If the law's continuing unpopularity enables
Republicans to regain the Senate in 2014, the president will
be forced to veto repeated attempts to repeal the law or to
negotiate major changes.
The risk of a complete repeal if a Republican takes the
White House in 2016 will put enormous pressure on Democratic
candidates--and on Republicans--to articulate a compelling
alternative to the cost and coverage problems that beset
health care. A good start would be sliding-scale subsidies to
help people buy a low-cost catastrophic plan, purchasable
across state lines, equalized tax treatment of those buying
insurance on their own with those on employer plans, and
expanded high-risk pools.