Speeches & Floor Statements

Floor Speech: Alexander on Bipartisan Alexander-Murray Deal

Posted on November 13, 2017

Mr. President, healthcare is on the minds of the American people. In the elections in Virginia yesterday, according to the Washington Post, it was by far the biggest issue in the voter’s minds.

Maine expanded Medicaid. In my home state of Tennessee, because of the Affordable Care Act's structure, premiums have gone up 176% over the last four years and another 58% on average for 2018 is predicted.

Tennesseans, like millions of Americans are going through open enrollment and have sticker shock when they see the prices of the health insurance that they might buy. And the 178 million people who are getting their insurance on the job, that's 60% of us, know that they might lose their job. They might change their job, and they might be in the individual market themselves and might find themselves exposed to these skyrocketing premiums and the chaos that results from that.

This is especially difficult for Americans who have no government subsidy to help them buy insurance. There were in 2016, according to the Department of Health and Human Services, about 9 million of those Americans.

There are 350,000 people in Tennessee who buy insurance in the individual market. That means they don't get it on the job. They don't get it from the government. They go out and buy it themselves. 150,000 of those pay the whole brunt.

So if the insurance costs go up 176% over four years, another 58% this year, that means the songwriter, the farmer, the self-employed person has a very difficult time buying insurance. It's a terror terrifying prospect.

That's why health care is on the minds of the people. And one would think that the American people might turn around and look at Washington and say, well, why doesn’t the President of the United States and why don't members of the Congress, the Republicans as well as the Democrats, get together and do something about the skyrocketing premiums?

Well, Mr. President, what would you think if I told you this -- that the President of the United States, President Trump, last month called me and asked me to do just that. He said, I don't want people to be hurt over the next couple of years while we're continuing to debate the long-term structure of health care in the individual market.

So why don't you get with Senator Murray, the senator from Washington, she's the ranking Democrat on the Senate health committee, why don't you try to work something out so people won't be hurt during these two years.

He said, I have to cut off the cost-sharing payments because the court has said they're not legal. But we can put them back. Go negotiate. See what you can do. Try to get some flexibility for the states.

Well, fortunately, Senator Murray and I were already working on that, and to have the president's call was encouraging to me. He called me three more times over the next two weeks. And the long and short of it is, we produced a result.

Here's what the result looks like. I'm going to talk about it from the point of view why Republicans are supporting it. Some -- Senator Murray and the Democratic senators were here earlier saying why they were supporting it.

Senator Rounds, a Senator from South Dakota, the former governor of that state, a man who understands insurance very well, who helped develop this proposal, we're here today to say this happens to be one of those bills where there are good reasons for Democrats support it and there are good reasons for the Republicans to support it, and the president has asked for it.

Here's what it does from my point of view: the so-called Alexander-Murray legislation, which was recommended to the Senate by Senator Murray and me and by -- recommended to the senate, there were 12 Republicans and 12 Democrats who were original cosponsors, including Senator Rounds and myself.

That doesn't happen very often here. That's a quarter of the Senate offering a bipartisan bill on a contentious subject to the Senate. Here's what it did. One, it lowered premiums. In 2018, where the rates were already set, it requires the states to work with insurance companies and give rebates for the high premiums that have been already set. And in 2019, it will lower premiums. That's the first thing it does, and the first reason why I and many Republicans support it.

Because the premiums are lower, Mr. President, it also means fewer tax dollars going to pay for Obamacare subsidies.

That's another reason Republicans and conservatives like the idea of the Alexander-Murray bill. Another reason we like it is because there are lower subsidies, there is less federal debt. The Congressional Budget Office has examined our bill and says it actually saves money over ten years. Nearly $4 billion.

And then there are other reasons we like it, because it gives states flexibility, increasing the variety and choices of the insurance policies they can recommend. That's the biggest difference of opinion we have between that side of the aisle and this side of the aisle. They want Washington to write the rules. We want the states to write the rules. And on this, we agreed to make some changes so states can write more rules.

For example, the Iowa Senators, Senator Grassley and Senator Ernst, are cosponsors of the bill because the language in the Alexander-Murray amendment would permit the federal government to approve the Iowa waiver.

Iowa has a way that it wants to use the federal dollars to insure more people, to enroll more people, give them lower costs. It would allow New Hampshire to use Medicare -- Medicaid savings to help pay for its Obamacare waiver. Both the democratic senators and the Republican governor of New Hampshire have asked for that.

It allows Minnesota to use a stream of federal funding so it could have its own waiver. It would allow Oklahoma, which has been waiting to get its waiver approved, and what do we mean by waivers? What this means is that states can look at the people in their state and make their own decisions or more of their own decisions about variety of choices.

Alaska did that earlier. They're one of the only states that has been able to use the section 1332 innovation waiver, as we call it, and they were able to create a special fund for very sick people and then to lower rates for everybody else by 20% and to do 85% of that with federal dollars.

No new federal dollars, no new federal dollars, 15% by the states. So the reason Republicans like the Alexander-Murray bill, the reason we have 12 of us on this side of the aisle cosponsoring it along with 12 Democrats is lower premiums, less tax dollars for Obamacare subsidies, less federal debt, more flexibility for states, a new so-called catastrophic insurance policy so that you can buy a policy with a lower premium and a higher deductible, so that a financial -- a medical catastrophe doesn't turn into a financial catastrophe.

All of those are reasons to support it. So, Mr. President, here is the long and short of it. The America people have health care on their minds. Certainly true in Tennessee where the rates are up 58%. Certainly true in Virginia yesterday, certainly true in Maine.

I see the senator from Maine who is here who has been an important part of the discussion. The people of America say, well, why doesn't the president and the congress, the Republicans and the Democrats in both bodies get together and do something about it? Well, I'm happy to report we have.

We've got a proposal, a bipartisan proposal. It doesn't solve every problem, but it limits the damage, it lowers premiums, it avoids chaos, it saves federal tax dollars, and it has the support of a significant number of Republicans and Democrats, and it's done at the request of the president.

So I hope that when the president returns from Asia, he will go to his desk and find a nice package there with a bow on it, presented by Senator Murray and me, 24 of us in the United States Senate, Republicans, Democrats, that does exactly what the American people I think want us to do -- lower premiums, avoid chaos, work together, take a step in the right direction, and let's see if we can help the American people in that way.

Mr. President, I know the senator from South Dakota is here, and I want to thank him for his leadership on this. He, along with the senator from Maine who is here, Senator king, spent a good deal of time working on this piece of legislation that has a lot that Democrats like and a lot that Republicans like, so much so that we're able to recommend it in a bipartisan way, and I know he may have things that he may want to say about the bill. Thank you. I yield the floor.