I rise today also to speak about health care issues, the Affordable Care Act, and Sylvia Mathews Burwell, the nominee to be Secretary of Health and Human Services. The Affordable Care Act has completed its first year of open enrollment.…
I rise today also to speak about health care issues, the Affordable Care Act, and Sylvia Mathews Burwell, the nominee to be Secretary of Health and Human Services.
The Affordable Care Act has completed its first year of open enrollment. Despite some significant technical challenges, 8 million Americans have used the State or Federal health insurance marketplaces, as created by the ACA, to access insurance.
I want to talk about the status of the ACA today, some challenges-- including some comments made by my colleague from Louisiana--and then talk about Sylvia Mathews Burwell.
Of the 8 million Americans who have used the exchanges to access health insurance, over 216,000 of them are Virginians. In addition to the 8 million, 3 million more people have been enrolled in Medicaid or CHIP as of February--in addition to the marketplaces open--and those Medicaid and CHIP expansions were because of the Affordable Care Act provisions.
In addition, an estimated 3.1 million young adults have gained coverage by being able to stay on family policies until age 26. The combined number, just in this expansion of coverage, is now more than 14 million Americans.
Let me put that in context. One year in, 14 million Americans have insurance through the ACA. That is more than the total population of the following States: West Virginia, Idaho, Hawaii, New Hampshire, Montana, Delaware, South Dakota, North Dakota, Vermont, and Wyoming. One year in, more people have insurance through the ACA than the combined populations--entire populations--of those 10 States.
The number dwarfs the population of New Jersey, which is about 9 million today--this 14 million number, which is growing every day. So imagine a program, even with all the challenges and the rollout, within 1 year providing insurance to more people than the combined population of these 10 States, significantly more than the Virginia population as well.
Gallup has polled, since 2008, the percentage of Americans who don't have health insurance--American adults who don't have health insurance. The number was down to 13.4 percent when the poll was last taken in April, which is the lowest monthly uninsured rate since Gallup started taking this poll.
Have there been challenges? Sure. Have there been those who have had some difficulty? Sure. We have been dealing with them on the phone--as the Presiding Officer has too. But the uninsured rate is dropping dramatically. Even at 1 year with the problems, people are receiving insurance as a result of the ACA.
Each one of them has a story. Each one of them has a story of what it was like to live without health insurance and what it is like to live now with the security and comfort of health insurance--not only for when you get ill but also for when you are going to bed at night worried about what will happen to you if you get ill, what will happen to you if your spouse is in an auto accident, what will happen to you if your children get diagnosed with something that might well be a preexisting condition under an earlier day.
The stories aren't just about the 14 million who have health insurance because of the ACA. They are also stories of the nearly 20 million Americans who have received rebates because they overpaid premiums and the insurance companies now have to send them money. It is people who cannot be charged discriminatory rates because they are women. It is seniors who are able to get preventive care under Medicare for free or reduced-price prescription drugs for free. It is all the Americans who had preexisting conditions which would have blocked them from insurance coverage before the ACA passed.
Just briefly, I am one of these stories. When I went onto the open market to buy health insurance a couple of years ago--and like most good families, when you want to do something, you put this really smart person on it--my wife. She started to call around about health insurance. Two insurance companies said to her: We can write you a policy on four of your five family members.
One wouldn't insure me. I think politics is viewed as a dangerous line of work.
One wouldn't insure one of my children. Well, here is an important safety tip. Don't tell my wife or any wife or mother: We will only insure part of your family.
My wife said in each instance: I actually think this is against the law now. I think you have to provide insurance
for everybody, and not just for four of the five. The insurance company rep called the boss and then called back and said: We are sorry; you are right. We have to write you insurance on every member of the family.
Everybody has a story and increasingly these stories accumulate. Whether it's coverage or a preexisting condition ban or equal treatment in rates between men and women, these stories are starting to accumulate and are showing us that this ACA can and will be successful.
Of course, there are measures to improve it that we still need to embrace. I am proud to cosponsor today a bill that the lead sponsor, Senator Franken, called the Family Coverage Act. It was introduced today.
The ACA requires large employers to offer affordable health care coverage to the employees. The IRS definition of affordability suggests that means that an employee's share of the premiums of individual coverage, rather than family coverage, is less than 9.5 percent of family income.
If the employee has an offer of affordable insurance, the employee in the family cannot receive premium tax credits. If it is not affordable, you can receive tax credits.
This measure of affordability, based on what the premium is for the individual, versus what the family premium is, leaves a lot of spouses and families cut out from the possibility of receiving tax credits under the ACA.
An average plan for an individual costs about $5,600, but according to the Kaiser Family Foundation, that average rises to about $15,700 for families. GAO estimates that the currently used definition of affordability would prevent nearly 460,000 uninsured kids from accepting tax credits, even though their parents qualify for the tax credit under the ACA. This is known as the family glitch. It was sort of an unforeseen consequence when the bill was written.
The Family Coverage Act, which Senator Franken is championing with many other cosponsors, would change the definition of affordability within the ACA so that family members of the parent who works for a company that offers health insurance can qualify for tax credits as well.
I have cosponsored fixes and improvements to the ACA in the Small Business Tax Credit Accessibility Act, a small business tax credit enhancement, and in the Expanded Consumer Choice Act. Through a plan called the ``copper plan,'' it provides all of the coverage but at a lower premium, because those choosing the plan will pay more on the deductible so they can buy down their premium by more cost sharing.
There is the Commonsense Reporting Act of 2014, introduced by Senator Warner, to ease the compliance burden on employers, and the Protect Volunteer Firefighters and Emergency Responders Act. Many of us were cosponsors of that bill. There is an act called the EACH Act, which is a technical correction to the religious exemption in the ACA.
I have also written a lot of letters to the administration asking them to do things within their administrative purview to make the act better.
This is what we should be doing. We shouldn't be talking about repealing the Affordable Care Act and taking 14 million people who have insurance through the ACA and telling them: Back out into street with you.
We shouldn't be talking about stonewalling a wonderful public servant from coming in and being head of the HHS. We should be engaged in the business of reforms and improvements.
This is what legislators do. When I was Governor of Virginia, my legislature would pass about 1,000 bills a year. They would come to my desk for my review, editing, amending, signing, and potentially vetoing. What I noticed was that of the action of my legislative body, 800 bills were reforms to existing law. Only about 200 were new laws.
What legislative bodies do is they go into existing laws, improve them, fix them, and make them better, and that is what we should be about here.
Certainly we have learned, through the bad rollouts and some other things, that nobody can stand back and say this thing is perfect and no reforms are needed. Reforms are always needed.
But I would also hope my colleagues might have learned something-- those who wanted to repeal the Affordable Care Act. Those who were willing to shut down the Government of the United States to advocate a repeal of the Affordable Care Act should also be focused now on reforms not repeals, because repeals mean those 14 million would lose insurance and families like mine would now be subject again to being turned down because of preexisting health conditions.
It strikes me that the reform caucus is growing and the repeal caucus is shrinking--as it should. Every day finds more and more people who have had this experience and understand that the ACA should not be allowed to be repealed. I am thrilled that is occurring.
One more item about the Affordable Care Act. It has been stated by some, including some in this Chamber, that the Affordable Care Act has done a horrible thing by allowing Members of Congress and their staffs to get a subsidy in their health insurance that the American public doesn't get. Then there are those who have stood and made that case on the floor of this body, on television, and in this country. They have talked about that subsidy as this horrible thing that these congressional staffers--such as those who are sitting here at the desk or those who work in my office--shouldn't be getting.
The Presiding Officer knows--and I know--that statement is inaccurate. The subsidy that anyone gets in this building is an employer contribution to their health insurance premium. It has been a long and standard feature of employer-provided health care plans in this country that employers contribute to the health insurance of their employees.
In the private sector, over 55 million Americans have employers who contribute to the health insurance premium of their employees. Hard- working men and women who are working in this Senate or working in the House or who are working on congressional staffs have every bit as much right to have an employer that would contribute part of the premium cost for them as do the people who work at newspapers, automobile manufacturers, retail stores, and restaurants. All over this country, employer provision of a portion of the premium is a standard feature of how insurance has been provided for decades.
For those who say that Members of Congress are getting some special treatment, some congressional subsidy, when the reality--and they know the reality--is that this subsidy is just the employer-provided share of a premium that is standard among all Americans, I find it very troubling.
What would they propose? Would they propose that uniquely, if you happen to work for the article I branch--the legislative branch--you should be denied an employer contribution to your health insurance, just like other Americans get, because you work for the article I branch that is specified in the Constitution? I think that is essentially their argument.
I had not intended to get into this topic today, but I think it is very clear we should make plain to the American people that public servants who do work in this Chamber and in the House Chamber, and for Members who were elected in the States and districts in this country-- they are entitled to the same kind of treatment by their employer, which is a standard feature of life in most American companies, nonprofits, State and local governments, and other institutions.
I have known Sylvia Mathews Burwell for 25 years. I met her when she was working for the Clinton administration as a young hotshot West Virginia student, educated at Harvard, a Rhodes scholar like some other notable Members of this body.
I am proud to support her confirmation to be Secretary of Health and Human Services. She has had a strong background not only in the public sector, most recently as the Director of the Office of Management and Budget, but she has also had a superb track record in the private sector. When dealing with health care issues, we know that strong private sector experience is very important in an issue that is so significant.
I have been very impressed with Sylvia Mathews Burwell's work in the Office of Management and Budget. I think she brought a more businesslike
and regular order approach to the Federal budgeting issues that are so important, and I think she will take that approach and expertise into the HHS position--not just around matters of the Affordable Care Act but around a whole portfolio of issues which are so critically important.
We have got to be about reforms and improvement. Sylvia Mathews Burwell is a person who walks in to work every day, wanting things to be better today than they were yesterday, and she has the experience to do this job. I am proud to stand and support her nomination.
Mr. President, I yield the floor and I suggest the absence of a quorum.