Lead-Safe Housing for Kids Act of 2017

Mr. President, the cost of health insurance has been a major problem with the Affordable Care Act and with many of the bills which have been advanced to repeal and replace this law.

I rise to introduce the Lower Premiums Through Reinsurance Act of 2017. This bill would provide States with the flexibility and support they need to create State-based reinsurance programs for their individual health insurance markets in order to lower premiums while ensuring continued coverage for people with preexisting conditions.

I am very pleased to be joined by my colleague and friend Senator Bill Nelson in introducing this bill. Senator Nelson is a former insurance commissioner who comes to this issue with a wealth of knowledge dating to his experience with Florida's innovative homeowners' reinsurance program, developed in the 1990s in the wake of Hurricane Andrew. For my own part, I spent 5 years in State government overseeing a department which included the Bureau of Insurance.

Over the past 2 weeks, the Senate HELP Committee, on which I am privileged to serve, completed a round of hearings under the able leadership of Chairman Lamar Alexander and Ranking Member Patty Murray. They

looked at the steps we could take in the near term to stabilize the individual market and help to bring down rates. Reinsurance was frequently mentioned as an option Congress should consider and adopt. Insurance commissioners from Alaska, Pennsylvania, South Carolina, Tennessee, and Washington State all spoke positively of its benefits, as did the five Governors who testified before the committee--three Republicans and two Democrats. Although the witnesses presented different views on how a reinsurance mechanism might be structured, they were in broad agreement that reinsurance funding would help stabilize the markets and lower premiums.

The National Association of Insurance Commissioners has recommended that Congress provide reinsurance funding of $15 billion annually to help cover high-cost claims in the individual market. We realize, however, we are living in very tight budget times, and there is an understandable reluctance among many Members to provide that level of Federal funding. We believe the ACA's section 1332's flowthrough mechanism can effectively leverage that level of funding with a much smaller contribution of Federal dollars. Our bill, therefore, would appropriate $2.25 billion per year in 2018 and 2019, which should be sufficient to leverage $15 billion in total reinsurance funding annually, based on the ratios in Alaska's recently approved 1332 waiver.

As Alaska's insurance commissioner told the HELP Committee, next year her State will be able to fund its $55 million reinsurance program with just $6.6 million of its own money--15 percent of the total. The remaining $48.4 million will be provided in Federal flowthrough funding that matches the savings to the Federal Government resulting from the reinsurance program. Let me explain why there would be savings for the Federal Government.

If we are able to reduce the cost of premiums, then the Federal Government will be paying less by way of subsidies to individuals who qualify for those subsidies because they make 400 percent or less of the Federal poverty level.

The bill we are introducing today would allow States to quickly stand up their own reinsurance programs through the Affordable Care Act's section 1332 waiver process. Broadly speaking, the bill would create a menu of options States could use to design reinsurance programs, which in turn would be eligible for Federal seed money grants. States may also obviously add funds from other sources to the mix.

States that want to set up their own reinsurance pools quickly could do so under our bill by using one of three options designed for expedited review: first, by demonstrating that their program is an ``invisible high-risk pool'' along the lines of the Maine and Alaska models, which I will describe in more detail in a moment; second, by showing that their program fits within the parameters of ObamaCare's ``transitional insurance program,'' which expired at the end of last year; and third, by submitting what I would call a ``me too'' application based on another State's program that has already received approval.

I wish to take a moment to explain why our legislation provides expedited review for different reinsurance pool designs. First, many of the witnesses who testified before the HELP Committee made the point that States would have difficulty quickly coming up with their own design. We acknowledge that, and that is why we provided expedited review for a pool based on the transitional ACA reinsurance program previously in effect and with which States are already familiar.

Second, we know from the experience of the States of Maine and Alaska how effective invisible reinsurance pools can be. Alaska's invisible pool reduced a projected 40-percent rate increase to just 7 percent this year and is expected to contribute to a 20-percent decline in premiums next year. Maine saw similar results in its program, the Maine Guaranteed Access Reinsurance Association.

The Maine program, which was in operation from 2012 until the end of 2013, covered approximately 3,600 insured individuals, at a cost of approximately $12,500 per person, per year, and reduced rates in the individual market by about 20 percent on average.

It is important for us to keep in mind that the individual market is where people who do not have employer-sponsored insurance have to go to buy their insurance. If they make 400 percent or less of the Federal poverty level, they get premium tax credits--subsidies, in other words--from the Federal Government to assist them with the cost. But if they make a dollar over 400 percent of the Federal poverty level, they lose that assistance altogether.

Another problem that is in the ACA is those cliffs, which make no sense whatsoever and really penalize individuals who may work in the trades, such as electricians and plumbers, who don't know for certain what their income is going to be and can face an unexpected bill where they have to pay back the entire subsidy. But there are others who make above 400 percent who knew it and didn't qualify for the subsidy, but they still have to purchase in the individual market. I think that should be revisited, but that is a speech for another day.

My point is that they would benefit greatly from a 20-percent reduction in the premiums they pay. That was our experience in Maine. On average there was a 20-percent reduction in premiums when the reinsurance pool was in effect. The reinsurance pool even generated a surplus of $5 billion during its 18 months of operation.

The Maine pool was successful for several reasons. First, risks were ceded up front so insurers could not wait until a policyholder developed an unexpected serious health condition to decide who was going to be in the high-risk pool and who was not. The rules also required policies for individuals who suffered from certain high-risk conditions to be automatically ceded to the pool on enrollment.

I note that when an insurer made the decision to cede to the pool the risk for a particular policyholder, or if it was an automatic ceding, 90 percent of the premiums from that policyholder went to the reinsurance pool to help finance it.

Second--and this is important--the program was invisible to both individuals who were insured through it and to healthcare providers. Individuals were covered seamlessly and enjoyed the same benefits as nonpool enrollees. Likewise, healthcare providers did not know whose policy had been ceded to the pool.

Third--and also very important--Maine's program operated with the full set of consumer protection guardrails set by the ACA, including guaranteed issue, guaranteed renewability, and prohibitions against taking preexisting conditions or health status into account in issuing policies or setting rates.

Fourth, the Maine program was designed to provide true reinsurance. Insurers paid the first $7,500 in costs, plus 10 percent of the next $25,000. After that threshold, the pool picked up the rest of the costs.

Finally, Maine's program was backed by a stable funding source. In addition to receiving 90 percent of the premiums for ceded policies, it also received funding that was assessed at a rate of $4 per person, per month, on all healthcare policies.

While Alaska's reinsurance program differs from Maine's in some respects, the success of both models shows the promise and proves the promise of invisible reinsurance pools, and that is why our bill includes invisible reinsurance pools as an option for expedited review and approval.

Open enrollment in the ACA exchanges begins November 1, just about 6 weeks from now. In just days, CMS is expected to finalize the premiums insurers will charge in the ACA exchanges next year. While I personally remain ever hopeful that a bipartisan agreement on a targeted, consensus approach to stabilizing the markets and reducing premiums can still be reached, clearly, we have very little time. Beyond providing cost-sharing reduction funding, there is no step that would be more powerful in stabilizing markets and reducing premiums than providing reinsurance.

This Chamber is deeply divided on what to do on healthcare policy, but surely we ought to be able to come together and build on the good work that the leaders of the HELP Committee have done--work that more than 60

Senators have witnessed and participated in by attending coffees that Senator Lamar Alexander and Senator Patty Murray have sponsored with our witnesses and by participating in the HELP Committee hearings. They have worked hard to produce a bill that would really make a difference.

The bill Senator Nelson and I are introducing today helps to fill out the reinsurance provisions that I know from attending each of those hearings have been widely supported by virtually every witness who testified before us. It would enable States to stand up their own reinsurance program simply and quickly, and it would reduce the costs of the Federal Government if we used the section 1332 flow-through mechanism far below what would otherwise be required. Most important of all, it is something that we could do right off, along with the cost- saving reductions, which help low-income people with their copays and their deductibles--their out-of-pocket costs. Those two steps are actions that we could take right now to help moderate premium increases that would otherwise occur and that would be of real benefit to anyone who is in the individual market.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, when he was running for President, Donald Trump laid out a pretty clear vision of how he would deal with Wall Street. He said: ``Wall Street has caused tremendous problems for us.'' He claimed he wasn't ``going to let Wall Street get away with murder,'' and he called out Goldman Sachs as the prime example of a big bank that has too much influence over the political process. That was really powerful stuff.

When Candidate Trump became President Trump, he seemed to forget every scrap of his tough-on-Wall Street talk. Within weeks of taking office, he turned over his administration's economic agenda to none other than Goldman Sachs. His senior strategist, Steve Bannon, spent half a decade at Goldman Sachs as an investment banker. His National Economic Council Director, Gary Cohn, came directly from Goldman Sachs, where he spent 25 years and rose to become President of the bank. His Secretary of the Treasury, Steve Mnuchin, spent 17 years at Goldman Sachs before leaving to start his own hedge fund, which brings us to Jay Clayton, President Trump's nominee to run the Securities and Exchange Commission. To be fair, Mr. Clayton never worked at Goldman Sachs, he just worked for Goldman Sachs, taking their money and representing them for years as a lawyer at a major New York City law firm.

So here we are, just over 8 years after Wall Street triggered a financial crisis and brought the economy to its knees, and President Trump has put the Goldman Sachs gang in charge of holding Wall Street accountable. Trump's betrayal of his campaign promises on Wall Street is shameful, but it is also dangerous, especially when it comes to picking the person to lead the SEC. The SEC is supposed to be the cop on the beat for Wall Street. That is why Congress created it in the 1930s, after fraud and other misconduct on Wall Street led to an enormous stock market crash and the Great Depression. Congress gave the SEC the authority to oversee financial markets and to hold companies and individuals accountable when they defrauded investors.

When the SEC doesn't do its job, the consequences can be devastating. Look at what happened the last time the SEC was under Republican control in the years leading up to the 2008 crisis. The SEC was asleep at the switch. While Wall Street flooded the market with dangerous securities and lied to investors, the SEC heard nothing, saw nothing, stopped nothing. The Republican-led SEC did nothing. When the whole market blew up, it was ordinary

investors and working families who got asked to bail out Wall Street.

So what kind of SEC Chairman would Mr. Clayton be? Let's start by looking at how he would lead the SEC's enforcement efforts against Wall Street, how he would be as a cop on the beat. Under ethics rules, for the first half of his term, Mr. Clayton cannot participate in any enforcement action that involves one of his former clients. That means he cannot take part in any case against Goldman Sachs. OK. But there is more. Goldman Sachs is just one of his former big bank clients. Mr. Clayton also can't take action against Deutsche Bank or against UBS or against Barclays. These are some of Wall Street's biggest and most egregious repeat offenders, and Mr. Clayton would be barred from enforcing the law against them.

That is not all. Ethics rules also prevent Mr. Clayton from participating in any enforcement case against a party that is represented by his former law firm, Sullivan and Cromwell. Sullivan and Cromwell is a premier Wall Street firm, with a long client list that includes big banks like JPMorgan Chase and the credit rating agency Moody's. That means there will likely be even more cases against top Wall Street firms that Mr. Clayton can't work on.

Here is why that matters so much. For most enforcement actions, it takes a majority vote of the five SEC Commissioners. In other words, it takes three people to advance an enforcement action. In a number of recent cases, the two Democrats have voted for stronger enforcement and the two Republicans have voted against it. If the Chairman can't vote-- and Mr. Clayton can't vote if some of the biggest and most disreputable banks are involved--then the Commission is likely to come up short of the necessary three votes. You know what that means. It means the banks walk free. Confirming Mr. Clayton to run the SEC will almost certainly result in weaker enforcement against the major players on Wall Street.

Mr. Clayton is also likely to pursue a Wall Street-friendly agenda when it comes to the SEC's rulemaking responsibilities. When he testified before me and before other members of the Banking Committee, Mr. Clayton refused to commit to completing the rules that Congress asked the SEC to write all the way back in 2010 as part of its postcrisis financial reforms. Mr. Clayton even refused to commit to implementing and enforcing some of the postcrisis rules that the SEC has already finalized and put in place.

I don't have any faith that Mr. Clayton will be the kind of tough, independent leader we need at the SEC. His nomination is just one more broken promise, one more time that Donald Trump has put Wall Street ahead of the interests of the American people. The last time a Republican President led us down this path, it resulted in the worst financial crash of our lifetime. We can't go down that path again.

I will be voting against Mr. Clayton's nomination, and I urge my colleagues to do the same.

Thank you, Mr. President.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, the Department of Homeland Security, DHS, is tasked with keeping the American public safe in the homeland. Its mission ranges from thwarting terrorist attacks to responding to natural and manmade disasters, from interdicting the movement of illicit drugs at the border to combating human trafficking and protecting its victims. Nearly one-quarter of the population within our borders are children They have unique needs, and we must ensure those needs are met in the face of threat and in recovery.

For example, when children are stranded at school because of a terrorist attack or a natural disaster, they need a planned route and means to get home safely. A child is caught up in a drug cartel and used as a trafficking mule--the child is a victim, not a criminal. He needs help breaking the addiction. An adolescent, promised a better life, has her passport stolen and forced to sell herself. She needs help escaping her captors and healing.

The recent tragedies of wildfires in Montana and across the Northwest and Hurricanes Harvey and Irma are all too recent reminders that we need to plan for the needs of children in both building resiliency and responding to disasters. That is why I am introducing the-Homeland Security for Children Act. This legislation would simply ensure DHS's Under Secretary for Strategy, Policy, and Plans includes input from organizations representing the needs of children when soliciting stakeholder feedback and developing policies. Further, a technical expert at the Federal Emergency Management Agency would be authorized to lead its external collaboration and policy developments to integrate the needs of children into its activities to prepare for and respond to, disasters.

I thank Senator Hassan for being an original cosponsor of this bill, as well as Representative Donald Payne of New Jersey for leading in the House of Representatives. I ask my Senate colleagues to join us in support of this important legislation.

Mr. DAINES Mr. President, I ask unanimous consent that the text of the legislation be printed in the Record.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.