Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. Mr. President, I want to talk for a moment about something that is on the minds of anybody in this country who…
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.
Mr. President, I want to talk for a moment about something that is on the minds of anybody in this country who is making $60,000, $70,000, $80,000, $90,000 too much to have a subsidy to pay for your healthcare insurance and maybe are paying $15,000, $20,000, $25,000 of that salary for your insurance this year and who has heard from a lot of people that on October 1, the insurance companies are going to announce that your premium is going up. That is whom I would like to talk with today.
Specifically, let me use the example of a woman named Marty in Tennessee. She came up to me before Christmas at the Chick-fil-A on Charlotte Road in Nashville, and she stopped me while I was getting my mac and cheese at Chick-fil-A, and she said: My name is Marty. I am a self-employed farmer. A few years ago, my health insurance was $300 a month, today it is $1,300 a month, and I cannot afford that.
Well, in Tennessee, prices for health insurance for people who work and don't get any subsidy to help them buy their insurance and don't get insurance on the job, they don't get it from Medicare or Medicaid, people who work, the self-employed farmer, the contractor, the plumber, the songwriter, somebody who might be making $60,000, say--they are like Marty. They are paying $20,000 for their health insurance, and they cannot afford that.
I told Marty: I think we have a Christmas present for you. I think Congress, when we pass the omnibus spending bill, is going to include in it a set of policies we have that is going to lower your rates when they are announced on October 1 of next year, which is 2018.
Well, unfortunately, we had a continuing resolution at the end of the year, and Marty didn't get her Christmas present. Then I thought she might get a Valentine's present, and we went by Valentine's Day and did another CR, a continuing resolution.
Now we have until the end of next week to fund the government for the year we are halfway through. I am on the floor today, and I can say to Marty and to every plumber, songwriter, self-employed person in this country, someone who might be between jobs, that if the Congress will act, we can lower their rates next year for up to as much as 40 percent--40 percent. That is according to Oliver Wyman, one of the leading healthcare consulting firms in this country, which announced on Monday that a set of policies which we call Alexander-Murray-Collins-Nelson, which President Trump supports, which Congressman Walden, who is the chairman of the House committee in this area, supports, which Senator McConnell supports, which I support--we have broad support for this. This policy we have been working on for months, according to Oliver Wyman, over the next 3 years, assuming States take full advantage of all the options we are giving them, could lower rates by 40 percent.
What does that mean? That means that if you are paying $20,000 for your health insurance--you are that $60,000-a-year plumber--that is 40 percent of $20,000, which, by my math, is $8,000. So that would cut your insurance to $12,000, and you get down toward something you might be able to afford. Can you imagine anything more frightening than approaching next year knowing that you might not be able to afford health insurance for your family? You are thinking: Well, look, I am doing everything I am supposed to. The government has not gotten me on any kind of subsidy to buy health insurance. I am out here working. I am paying my taxes. Maybe I got a little tax cut that the Republicans put through last year, but the thing that is really a problem for me is my health insurance. If I am making $60,000, $70,000, $80,000 a year, I cannot afford $15,000, $20,000, or $25,000 a year.
If you are a farmer in Iowa or a miner in Alaska or a songwriter in Nashville, you can't afford that, and you shouldn't have to, and you won't have to if Congress will act next week to accept the set of policies that I am about to briefly describe.
There are three things we propose to do. The most important is 3 years of reinsurance or the invisible risk pool. This is an idea that House Republicans have strongly supported and that Senator Collins and Senator Nelson have strongly supported here. It would allow more States to do what the State of Alaska has done. The Presiding Officer is from Alaska. Alaska took the very sickest people in Alaska and put them in one pool and called that the reinsurance pool and paid for their health insurance. When they did that, it so reduced the cost for everybody else that it lowered the rates for everybody else by 20 percent. What we are talking about is lowering the rate for everybody else by 40 percent if States take full advantage of what we are proposing next week. So reinsurance is the first thing--3 years of reinsurance at $10 billion a year.
The second thing is 3 years of cost-sharing subsidies. You have to stop and think about it a minute, but the cost-sharing subsidies pay for the reinsurance. Cost-sharing subsidies are payments that are made to insurance companies to pay for the copays and the deductibles for low-income people, and that allows the companies to reduce the premiums. When you reduce the premiums, you reduce the ObamaCare subsidies.
According to conversations we have had with the Congressional Budget Office, if we do 3 years of cost-sharing subsidies and 3 years of reinsurance at $10 billion, the cost-sharing subsidies more than pay for the reinsurance, if you base it on reality, which is, if Congress passes a law that costs $30 billion over 3 years for reinsurance and 3 years of cost-sharing subsidies, the cost-sharing subsidies pay for the reinsurance and leave $2 billion over to reduce the Federal debt.
The third part is a set of proposals that would give States more flexibility. This streamlines the section 1332 waiver in the Affordable Care Act. It makes some changes that permit the agency we call CMS to approve waivers from States, like the State of Alaska or Nebraska or Tennessee, which may say: We would like to spend our ObamaCare subsidy money in a different way, and we would like to add some of this reinsurance money to it. By doing that, that is how you achieve the 40- percent savings for the Nebraska self-employed farmer or the Nashville songwriter in their insurance policies.
So that is the set of proposals, plus within there is a provision for what we call a catastrophic policy, which is a policy that has somewhat higher deductibles but lower premiums, which people may choose to buy.
All of that policy has broad bipartisan support. I think the reinsurance provision--in the Republican discussions we have had in the Senate, almost everybody seems to agree that the only way we can have an individual market, which is the market for people who buy insurance on their own--people who don't get it from Medicare, people who don't get it from Medicaid, people who don't get it on the job--let's say you are between jobs or you are self-employed. You are the songwriter. You are the plumber. Those are the people whom we are focused on here. There are about 11 million in the United States, but there could be a lot more because all of us know what it is like to think, well, I might lose my job, or, I might change jobs, and what do I do for insurance in the interim? I have the so-called COBRA available, but it is very expensive. If I suddenly find I am losing my job or if I am changing jobs and I am worrying about insurance--that is the person we are talking about.
Where did these ideas come from? Did we just write them on the back of an envelope and give them to Congress? No. We went through a very serious process here in the Senate. Senator Murray, the ranking Democrat on the Senate HELP Committee--I am the
chairman--and I held four hearings last fall after Republicans failed to repeal and replace the ObamaCare law. We invited all Senators to participate. We had more than half the Senate come to our hearings and to our meetings with the witnesses. Out of that came the proposals to streamline the 1332 waiver--that is flexibility for States--and the need to pay for the cost-sharing subsidies temporarily, because people began to understand that they don't cost money, but they save taxpayer money because they reduce the need for Federal taxpayer subsidies. So that is where that came from.
The single most important idea that was not a part of the original Alexander-Murray proposal was reinsurance. In the House, they call it the invisible risk pool. Senators Collins and Nelson have championed it here. Representative Costello, Representative Meadows, and other people championed it over there. It was part of the Republican repeal-and- replace legislation in the House of Representatives. So the idea of 3 years of reinsurance really has come from both bodies and from both sides of the aisle. It is the most essential part of any long-term policy to create an individual market where people can buy insurance if they don't get it on the job or from the government.
This would give States half a billion dollars in the current year, 2018, to plan for their reinsurance pools. It would then create $10 billion over 3 years that States could use to help pay for their reinsurance pools, and they would use their 1332 streamlined waiver in the second and third year. So they could have a combination of State money, reinsurance Federal money, and ObamaCare subsidy money and hopefully, in that process, create their own way of helping to pay for the needs of the very sickest people in the State and, by taking them out of the insurance pool, lower the rates for everybody else over that 4-year period, according to the Oliver Wyman consulting firm, by as much as 40 percent.
The Congressional Budget Office has also reviewed the set of proposals I have just described. My staff has been working closely with them because we want to know what it costs if we are going to put it in the omnibus bill, and the preliminary feedback from the Congressional Budget Office is more conservative than the Oliver Wyman estimate. The Congressional Budget Office says that it would reduce premiums by an average of 10 percent in 2019 and 20 percent in 2020 and 2021 if States take full advantage of the 1332 waiver they have.
As you can imagine, State Governors and State insurance commissioners are delighted with this package. First, they like to see us do something in a bipartisan way to stabilize the health insurance market so people aren't scared to death that they may not be able to buy a policy next year, but second, they think it is sound policy. It is sound policy.
Much of this started when the President called me last August and said: Between now and the time we make a final decision on what to do about the Affordable Care Act, or ObamaCare, I want to make sure that people aren't hurt. So he asked me if I would work with Senator Murray and see if we could come up with a bipartisan set of proposals that would stabilize the individual market. He called me several times about that, and we have worked together since then. That is when we came together with the original Alexander-Murray proposal.
Then we had a big disagreement here within the Senate, and we had our tax bill wherein we repealed the individual mandate in the Affordable Care Act. Republicans thought that was a good idea. It made people buy insurance they didn't want, and it was a tax on low-income people, so we got rid of it. Democrats didn't like that at all.
It is true that taking the individual mandate out, even though States could add it back if they want to, does increase the cost of insurance in the individual market. Despite that, this set of policies that I have described--State flexibility, the 3 years of cost-sharing subsidies, and the 3 years of reinsurance/invisible risk pools--those three policies, according to Oliver Wyman consulting, which is one of the leading health consulting firms in America, could lower rates to 40 percent lower than they otherwise would be. According to the Congressional Budget Office, a nonpartisan agency that looks at things for us, it will lower them 10 percent in 2019 and as much as 20 percent in the next 2 years after that. Even if it is only 20 and not 40, 20 percent of $20,000 is $4,000 for Marty, the self-employed farmer in Nashville who stopped me at Chick-fil-A and said her insurance had gone from $300 to $1,300, $1,400 a month.
I ask unanimous consent to have printed in the Record the report of the Oliver Wyman consulting company that says that the combination of policies I just described--reinsurance, cost-sharing subsidies, and the section 1332 waiver, which is the State flexibility--that those three policies will reduce rates by up to 40 percent.
Finally, I would ask the question, What if we don't do this? I am generally a very optimistic person. I am results-oriented, and you don't get results if you don't work across party lines and if you don't think you are going to succeed. So I always think we will succeed. This has been more difficult to do than it should have been.
I would like to suggest to my colleagues and to the American people that we should focus on October 1 of this year because that is the date when insurance rates for next year, 2019, will be announced all across the country. Insurance companies are working with insurance commissioners in every State to try to figure out what is going to happen, what the rates will be. They will be announcing rates on October 1, which is about a month before the next election.
There a lot of people who are going to be looking at that because, in my State of Tennessee, rates were up 58 percent this year, and that is for the plumber who makes $60,000 a year; the songwriter; Marty, the farmer; and the people I have been describing. There was a 58-percent increase. So they are going to be looking on October 1 to see whether they can even afford any insurance in 2019.
If we do what we are proposing here in the Alexander-Murray-Collins- Nelson set of policies, which has broad bipartisan support in the House and the Senate and the support of the President, if we do that next week, Marty, the self-employed farmer in Tennessee, will be able to see on October 1 that her rates will go down and that, if Oliver Wyman is correct, instead of her rates going up 58 percent the way they did this year, they will go down 40 percent over the next 2 or 3 years. That means she could afford insurance.
If we don't do it, rates will go up, and the individual market will probably collapse. It was near collapse a year ago. By collapsing, I mean there will be counties where people can't buy insurance at all. There will be 11 million people who are between jobs, who are self- employed, or who are working who literally cannot afford insurance, and they are not going to be very happy campers. They are going to blame every one of us, and they should. They are going to blame the President, they are going to blame Republicans, they are going to blame Democrats, and they are going to blame insurance companies because we have an opportunity next week to solve that problem in a bipartisan way, developed through a bipartisan process, incorporating ideas that virtually everyone who looks at them says make very good policy sense.
We have a couple of things to work through on ancillary issues, but those shouldn't cloud the fact that we can reduce rates by up to 40 percent for the working Americans who can't afford insurance--the insurance companies will announce that on October 1--or we can do nothing, and we can let the markets falter.
There will be some counties where you can't buy insurance at all, some counties where you can't afford insurance at all, and we will have people look at us and say: My goodness, why did we send them up there to do nothing about that?
I am optimistic. I think we can do it. I appreciate the hard work on both sides of the aisle. In many respects, it has been a very difficult negotiation. I appreciate the President's consistency over the past couple of months in supporting this and the Vice President's work. Senator McConnell has been very supportive of this, which makes it very helpful in terms of getting it into the bipartisan agreement next week.
I look forward to being able to say to my songwriters, self-employed business men and women, plumbers, and Marty, the farmer, that if they are making $60,000 or $70,000 in Tennessee, we put in place something that will lower their rates by 40 percent over the next 3 years.
I yield the floor.
I suggest the absence of a quorum.