No Junk Plans Act

I rise today to once again speak about the ongoing threat in the Trump administration to the healthcare and guaranteed protections that millions of American families depend upon. President Trump has tried to pass through the Congress repeal plans that would take people's healthcare away and allow insurance companies to discriminate against people with preexisting health conditions or refuse to serve them at all.

When that legislative repeal effort failed in 2017, instead of working in a bipartisan way to lower healthcare costs and improve access to care for all Americans, President Trump turned to another tactic--sabotaging our healthcare system--and there are more Americans uninsured today than there were when he took office.

The Trump administration has even gone to court. They have gone to court to support a lawsuit that would overturn the Affordable Care Act, including its provisions that protect people with preexisting health conditions from discrimination. Just think about that. He is asking a court to strike down healthcare protections for Americans. If he succeeds, insurance companies will once again be able to deny coverage or charge much higher premiums

for the more than 130 million Americans who have some sort of preexisting health condition, including more than 2 million who live in the State of Wisconsin.

What is the President's plan to protect people with preexisting conditions? He doesn't have one. He never has. And I have to say that I doubt he ever will. In fact, this administration has expanded what I call junk insurance plans. These are insurance plans that can deny coverage to people with preexisting health conditions, and they don't have to cover basic and essential health services, like prescription drugs or emergency room visits or maternity care. Most of these junk plans don't cover those things.

When I spoke about this expansion of what I call junk insurance on the Senate floor 2 weeks ago, one of my Republican colleagues responded and claimed that these plans preserve preexisting conditions protections and essential health benefits. So today I wanted to clarify the record, and let's look at the fine print together.

One of the junk plans currently available in my home State of Wisconsin reads, ``This plan has a preexisting limitation provision that may prevent coverage from applying to medical conditions that existed prior to this plan's effective date.''

Another junk plan that is sold in Wisconsin states that the plan does not comply with the guaranteed essential benefits provided by the Affordable Care Act. To quote directly, the description reads: ``This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act.'' The tiny fine print on this particular junk plan instructs individuals to check their coverage carefully to make sure they are ``aware of any exclusions or limitation regarding coverage of pre-existing conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). Your certificate might also have lifetime and/or annual dollar limits on health benefits.''

The Affordable Care Act protects people against these insurance company abuses. Yet the expansion of these junk plans puts the power back in the hands of big insurance companies.

Let me be clear. American families do not want to go back to the days when health insurers could discriminate against people with preexisting health conditions, women, and seniors by denying them coverage or charging them higher premiums simply because they get sick.

As I have said in this Chamber many times, the people of Wisconsin want both parties in Congress to work together to make things better by making healthcare more affordable.

I have heard from several Wisconsinites who want to know why the President is working to repeal the Affordable Care Act and take away their protections by expanding these junk plans. They are frightened that if this sabotage of our health system continues, insurance companies will again be able to deny coverage or charge higher premiums for the more than 130 million Americans who have preexisting health conditions, again, including more than 2 million in my home State of Wisconsin.

I heard from Keri from Baraboo. Keri is a three-time cancer survivor--two breast cancer diagnoses and one melanoma. She experienced her first diagnosis at age 29. Now at age 61, Keri is able to get the healthcare she needs without being punished financially for having a preexisting condition. Keri is worried that if the Affordable Care Act is repealed, she could lose her health coverage or could be charged more because of her preexisting condition.

Another Wisconsinite, Keith in Brookfield, recently wrote in to my office about what healthcare means to him and his family. Keith and his son both have type 1 diabetes. Both of them have health insurance through the Affordable Care marketplace that allows them to afford the insulin, glucose test strips, and other medications they need. If the Affordable Care Act is repealed, Keith and his son likely would not even be eligible to purchase one of these junk insurance plans. They could be denied coverage entirely due to their preexisting condition.

We really need to act to stop this sabotage now. I want to protect the guaranteed healthcare protections that millions of Americans depend on. That is why I have introduced legislation, with my colleague, Senator Doug Jones of Alabama, to overturn the Trump administration's expansion of junk insurance plans, because we should be increasing access to affordable, high-quality healthcare options.

The entire Senate Democratic caucus supports this legislation, along with the two Independents who caucus with us. The Nation's top healthcare organizations, representing tens of thousands of the Nation's physicians, patients, medical students, and other health experts, support this legislation.

Anyone who says they support healthcare coverage for people with preexisting conditions should support this bill.

Mr. President, as in legislative session, I ask unanimous consent that the HELP Committee be discharged from further consideration of S. 1556; that the Senate proceed to its immediate consideration; that the bill be considered read a third time and passed; and that the motions to reconsider be considered made and laid upon the table with no intervening action or debate.

Mr. President, I am disappointed that my Republican colleagues have once again chosen to object to protecting people with preexisting conditions.

Senator, I would be happy to yield.

I would concur and say that the reason they have earned the nickname ``junk plans'' is because, frankly, some of them are hardly worth the paper they are written on.

First of all, they do not have to comply with some of the very important protections we included as part of the Affordable Care Act-- otherwise known as ObamaCare--especially to protect people who have been ill once before or have been injured once before, people who have a preexisting health condition, maybe a chronic condition that will require medical care throughout their lives.

In the old days, which apparently the Republican Senator wants to return to, there were all sorts of abuses, I would argue, that insurance companies could employ in order to limit their exposure, if you will. They had annual limits. They had lifetime limits. They had the capacity to drop somebody from coverage after an illness developed. They had the capacity to say: No, we are not going to offer you insurance. They certainly had the capacity to charge discriminatory premiums based on the preexisting condition. That causes great concern.

I just recently saw a report about how much a typical--put it this way: a woman with a breast cancer diagnosis who requires chemotherapy and radiation treatment and medication--how much she would be anticipated to spend out-of-pocket if she had a junk plan at the time that diagnosis was made. It was, on average, $40,000.

We also need to talk about another impact these junk plans have, and that is, if you think you have a really good chance of being healthy for the next year, and you decide ``This is a risk I can take,'' you are then fundamentally changing the structure of the marketplace for everyone else. You can anticipate that this is a choice healthier, maybe younger people will make, and it has a distorting impact on premiums in the marketplace. In fact, that is why these plans were curtailed under the previous administration. Now, this administration is greatly expanding these. They are no longer short term. They are long term, and a lot of harm will come.

I want to conclude and say that when we have an administration that first fought legislatively to repeal the Affordable Care Act and then acted administratively to undermine and sabotage the Affordable Care Act through all sorts of administrative Executive actions, including defunding the State navigators who helped people make wise selections for their insurance and also limiting the open enrollment period, and when we have an administration that has decided to go to court and asked the court to strike down a U.S. law in its entirety, we know there is sabotage going on.

I think the choice for the American people couldn't be clearer. We want to make things better, and the administration--enabled by some of my Senate Republican colleagues--is walking down a path that has led to 2 million people losing their health insurance and others at grave risk of losing it in the future.

With that, I yield the floor.

Mr. President, would my colleague yield?

Mr. President, I appreciate my colleague. I am in such strong support of her legislation, the No Junk Plans Act. I will speak briefly on it after the Senator has concluded her important remarks. But apropos of what the distinguished Senator from South Dakota just said, isn't it correct that of course a plan is more affordable if it doesn't cover anything? I would be interested in my colleague's reaction to that, as she is the lead sponsor.

I remember being in Wisconsin and seeing the wonderful support folks there have from my colleague because she has been a leader on these issues.

I am just curious, because certainly my friend from South Dakota, who is a distinguished member of the Finance Committee and works with Senator Cortez Masto and me, often works with us on matters. But unless I am missing something, he said that what he is interested in is care that is more affordable. But it doesn't cover anything. What are my colleague's thoughts on that?

Mr. President, before she leaves the floor, I want to tell my colleague from Wisconsin--and I think I speak for the distinguished Senator from Nevada as well--we are counting on our colleague from Wisconsin to come back to this floor again and again to try to pass her bill. I just want to tell her I will be with her every step of the way because I think, colleagues, without the bill from the distinguished Senator from Wisconsin, what we are looking at is a new golden age for scam artists peddling insurance that isn't worth much more than the paper it is written on.

I was struck by my friend from Wisconsin's mentioning the old days of junk insurance.

Well, I was around for those old days. I remember when the health insurance system in this country was basically for the healthy and wealthy. If you were healthy, no sweat, you could get insurance. If you were wealthy, you just went off and paid the bills. But the insurance companies could go out there and clobber people with preexisting conditions. So that was junk insurance.

But I am even older than that. I remember when I was director of the Oregon Gray Panthers. I would go to a senior's house, and they would pull out a shoebox full of policies--10 or 15 policies. The distinguished Senator from Nevada, who has done so much consumer advocacy for consumers, I am sure knows about this challenge with seniors. These policies weren't worth the paper they were written on. They had--because I am kind of a lawyer in name only--what were called subrogation clauses. So if you had two policies, and they basically covered the same thing, both of them would try to squirm out of covering it. Talk about junk insurance.

Finally, I got elected to Congress, like my colleague activist, and we passed a law that said we are going to get rid of that system and that you could have really only one policy, except in unusual situations. There were strong consumer protections.

But if you look at what the Trump golden age of scams is going to bring back, there are going to be lots of people who are going to get clobbered, and, as my colleagues know, the people who are really going to get hit by this are, for example, older women who are pre-Medicare, because very often, in their late fifties and early sixties, they have a lot of difficulty trying to find jobs that pay good salaries and jobs that have good healthcare coverage.

I am so appreciative of what my colleague is talking about.

We are going to hear a lot of buzz words. Opponents of the Baldwin legislation are going to talk about how they are offering flexibility and they are offering patient-centered care. But that is just a bunch of eyewash because what they really do, as you touched on, is to fail to give patients care when they most need care.

Today, Americans ought to be protected from these worthless, predatory scams. One of the things that I was proudest of, really, before my colleagues came here, is a piece of legislation I wrote, the Healthy Americans Act. A number of Republican Senators were cosponsors of this bill. It had airtight, loophole-free protection to ensure that people with preexisting conditions didn't face discrimination.

By and large, we got that provision into the Affordable Care Act. It meant, as John McCain knew--we often talked about it--that healthcare would no longer be there just for the healthy and the wealthy. There would be real protections for those with preexisting conditions.

For all practical purposes, that was really one of the two or three centerpieces of the Affordable Care Act, because, talk about a new age in insurance, that was it. Healthcare insurance would no longer be there for the healthy and wealthy only.

Senator Baldwin is here, and what she is trying to do--I am looking at that clock--is trying to keep the Trump people from turning it back. That is what they want to do when Senator Baldwin talks about the old days--a forced march back to the days when the insurance companies could really, in many instances, just beat the stuffing out of vulnerable people.

I thank my colleague for what she is doing. I heard just a little bit about it before I came over. I basically said: Let's hold off on things for a couple of hours so I can go out there and stand with Senator Baldwin and her allies.

I say to the Senator: To me, what is important is that you have been here today, and it is going to be even more important that you come back again and again and again so that that clock continues to move forward in terms of American healthcare and not go backward. I thank my colleague.

We are really delighted to have Senator Cortez Masto on the Senate Finance Committee, where she has been doing a lot of good work in healthcare

for consumers and seniors. I look forward to her remarks and to working with both of my colleagues.

Mr. President, let me just say, on behalf of the State of Nevada, that I am so appreciative that I get to work with my colleagues from Wisconsin and Oregon. I thank them for their commitment because this is the No. 1 issue in the State of Nevada.

I say to Senator Baldwin: What you are doing is really standing up for people and their right to have access to affordable healthcare in this country when they need it, access to medication when they need it, and the comfort in knowing that if they purchase a plan, if something, God forbid, should happen to them, then, they will have access to that medication and those doctors when they need it. Thank you for your hard work.

I stand today because I want to tell you about one of these people in the State of Nevada. Her name is Carol Elewski. She is from Reno, NV. Carol has chronic asthma. She manages it with medications that cost up to $400 a month--$400 a month.

In October of 2016, Carol had such a bad asthma attack that she was admitted to the hospital for 10 days as doctors struggled to get her breathing under control. Thankfully, today Carol's health is stable, but because of her preexisting condition and high prescription drug costs, she depends on the protections of the Affordable Care Act to keep her healthcare costs in check.

This administration, as we have heard today from my colleagues, keeps chipping away at those protections. Literally, we have heard from the President that he is proud of sabotaging the Affordable Care Act. He has weakened the ACA by expanding access to these junk plans. These short-term, limited-duration plans don't cover essential services, like prescription drugs, emergency rooms visits, and maternity care.

Today, I am joining my colleagues to, once again, urge that we do away with these scam insurance policies. These plans appeal to consumers because they are low cost, but they are also low benefit, as we have heard. Many people who purchase them don't realize just how limited the coverage is. All those details are in the fine print of the policies in dense legal jargon, and it is nearly impossible to understand. I am an attorney, and I will tell you that even attorneys have difficulty understanding that dense legal jargon in some of these policies. Consumers don't know that the plans they are signing up for-- because of the dense legal jargon and because they are not given specifics, and there is not enough transparency--don't even cover their preexisting conditions. Consumers may not realize that their coverage has annual or lifetime spending caps.

Take Carol, for instance. Let's say she had signed up for a junk plan instead of an ACA-compliant plan--an easy mistake to make, since companies hide the differences between the two. With the junk plan, Carol's insurance could have refused to cover her healthcare costs because of her asthma. They could have denied payment for the emergency treatment she needed when she literally could not breathe, and they could have declined coverage for the essential medications she needs to keep the asthma in check.

Under these junk plans, women who get pregnant don't get coverage for prenatal care or for delivering their babies. People with lifelong genetic conditions, like cystic fibrosis, can be denied coverage, as can those facing mental health issues.

What is more, even if you don't buy a junk healthcare plan, these plans' very existence drives up our healthcare costs in this country. That is because younger, healthier people are more likely to risk choosing a limited junk plan because those plans are cheaper. That leaves the rest of the population, including many women and children, in a much more expensive insurance pool.

Estimates say that junk plans could cost a family of four with an ACA plan over $3,000 in increased insurance premiums every year. The No Junk Plans Act that Senator Baldwin has introduced undoes the administration's order that allowed insurance companies to offer consumers up to 3 years of deceptive, skimpy coverage.

Under the No Junk Plans Act, customers can only use these short-term plans for 90 days. The plans would work the way they were intended--as a bridge between coverage at one job and the next.

I hear this all the time in Nevada. Americans have told us time and again what they want their healthcare to do: to cover preexisting conditions, keep down prescription drug costs, include women's health, cover mental health, and pay for emergency rooms visits.

I am going to continue to fight for what the American people want, and that is the comprehensive coverage of the Affordable Care Act.

We cannot let the administration succeed in doing an end-run around the ACA. The House has already passed legislation to do away with these flimsy and deceptive junk plans. Now it is time for the Senate to step up and do the same.

Thank you.

I yield the floor.

Mr. President, I am certainly disappointed that my Republican colleagues have chosen to object to protecting people with preexisting conditions.

It is my contention that some of the very opposite impacts, because of these junk plans, are occurring than what my colleague has recited. In fact, I hardly consider them insurance plans. Many have argued that they are not worth the paper that they are written on. They don't cover many essential benefits. They are not required to cover people with preexisting health conditions. They can drop people. They can charge outrageous prices. What we found--and the reason that the Obama administration went from yearlong plans to 3-month plans--is that they saw the distortion in the markets. They saw that people who had believed that they might not get sick--healthy, often younger people-- were availing themselves of these plans, making the Affordable Care----

I would yield to one question, and then I want to wrap up my comments.

Mr. President, these short-term plans do not have to cover preexisting conditions. I can tell you, as I have inquired--

I yielded already for a question. But I want to say----

It may not be to the Senator's liking, but I was going to tell you about the plans that I read the fine print on from the State of Wisconsin. Now that these short-term plans are renewable for up to 3 years, in these junk plans, you can see the fine print. Many times they start with this: We will not cover a preexisting condition. Every single one of them refuses to cover maternity care. That means none of these junk plans cover that essential benefit. Most of them don't cover

emergency room care. Most of them don't cover prescription drugs. So regardless of how the law impacts people who have other types of insurance, I feel strongly that these junk plans are very distorting of the market and not worth the paper they are written on for those who have chosen to take that route.

Last fall, we heard all my colleagues across the aisle say, often repeatedly, that they support protections for people with preexisting health conditions. Today I just offered an opportunity for Democrats and Republicans to come together to protect people's access to quality, affordable healthcare when they need it the most, but there was an objection.

I say to the American people that we must not lose sight of the fight right in front of us. We have a President who time after time has sabotaged our healthcare system, raised healthcare costs, and pushed these junk insurance plans that don't have to cover people with preexisting conditions. We have an administration that is asking a court to strike down the Affordable Care Act and its protections for people with preexisting conditions in their entirety.

The choice for the American people could not be more clear. We want to make things better, and my Republican colleagues refuse to join us in this effort, which would be to prevent this administration from making things worse.

I yield the floor.

Mr. President, reserving the right to object, let me just say that the plans to which the Senator from Wisconsin is referring are plans that tens of thousands of people are buying, and one of the reasons they are buying them is because it allows them to buy the insurance they want at a price they can afford.

I can tell you, as I am sure the Presiding Officer can and probably everybody here can, when they travel across the country and talk with the farmers and ranchers and people who are buying their insurance on the individual market, the individual market has blown up. It has exploded. People are paying $3,000 a month in premiums--$36,000 a year--and have huge deductibles. So what they are doing is they are dropping coverage because they can't afford it. One of the reasons they can't afford it is because, under ObamaCare, there were so many mandates and requirements, it drove up the price. So they have these skyrocketing premiums, higher deductibles, and higher copays.

I think that is precisely why the administration decided that, let's take these plans and give people an opportunity to buy the insurance they want at a price they can afford.

Literally tens of thousands of Americans are now in these plans. What the Senator from Wisconsin is saying is, we are going to throw all these people off these plans. What does that do? That puts them back out, probably uninsured, which is what a lot of farmers and ranchers in places in South Dakota are doing--they are just dropping coverage because they can't afford it. Who can afford to pay $3,000 a month? That is what ObamaCare has left us. That is why we need new solutions. This solution is one that allows people to buy a plan they want at a price they can afford, coupled with association health plans--which Democrats, I think, here in the Senate are also objecting to and opposing--which are also giving individuals opportunities to join larger groups and spread their risk and drive down their premiums. We need plans that people in this country can afford, or more and more people are going to be in the ranks of the uninsured.

So, Mr. President, I object.