Speeches & Floor Statements

Floor Speech: The Health Care Options Act of 2017

Posted on March 29, 2017

The Health Care Options Act of 2017 – introduced by Senator Corker and I – would address the emergency in the health insurance exchanges in Tennessee and in other states. This legislation would allow any American who receives a subsidy and has no insurance available on their exchange next year to use that subsidy to buy any state-approved insurance off the exchange.

Second, the legislation would waive the Affordable Care Act requirement that these Americans—who, remember, have zero insurance options for their subsidies—have to pay a penalty for not purchasing insurance.

Third, the legislation would bring peace of mind between now and the beginning of 2018 to millions of Americans—some of the most vulnerable people in our country—who face having zero options of health insurance to purchase with their subsidy in the year 2018 because of the collapsing Obamacare exchange markets.

Here is why urgent action is needed. There are 11 million Americans who buy individual insurance now on the Affordable Care Act exchanges. Approximately 85 percent of them receive a subsidy to help them buy insurance. For those who don't like subsidies for people buying insurance, I would remind us that about 60 percent of insured Americans get insurance on the job, and the average tax break for people with employer sponsored insurance is about $5,000. What we are talking about is the 4 percent of insured people who don't get insurance on the job, who don't get it from the government and Medicare and Medicaid, and this subsidy gives them some money to help them buy insurance if they are mostly low-income.

While these 11 million make up only 4 percent of the total insured population in this country, this 4 percent is where much of today's political turmoil rests.

In the Knoxville area where I live, the one remaining insurance company on the Affordable Care Act exchange has pulled out for the year 2018. So it is a near certainty that there will be zero insurance options for 40,000 Tennesseans who live there and buy their insurance on the exchange. In other words, for approximately 34,000 Tennesseans living in Knoxville who rely on an Affordable Care Act subsidy to buy health insurance, their subsidies will be worth as much as a bus ticket in a town with no buses running.

There is a real prospect that the same thing may happen to all 230,000 Tennesseans who buy insurance on the exchange. As I said, 85 percent of them rely on a subsidy to afford insurance; they just will not have any insurance policies to buy.

The decision Friday by the House of Representatives to not vote on the health care bill changes nothing about the urgency of rescuing these 230,000 Tennesseans who buy insurance on the Obamacare exchanges that our state insurance commissioner has told us are “very near collapse.”

While Congress continues its work to enact long-term structural health reforms, we must take immediate action to help these 230,000 Tennesseans and millions of Americans in other states facing the same dire consequences.

This is not just a problem for Tennesseans. Last year, 7 percent of counties in the country had just one insurer offering plans on their Affordable Care Act exchange. This year, that 7 percent has risen to 32 percent of the counties in this country having just one insurer offering plans on the Affordable Care Act exchange. There are five states this year that have only a single insurer offering ACA plans in their entire state: Alabama, Alaska, Oklahoma, South Carolina and Wyoming. And in nine states, there is only one insurer offering ACA plans in a majority of the counties in the states: Tennessee, North Carolina, West Virginia, Utah, Nevada, Arizona, Mississippi, Missouri and Florida.

Next year, in 2018, we know the problem will be much worse. As more insurance companies announce their plans for the 2018 plan year, it is very likely that more counties across the nation will face challenges similar to those in the Knoxville area, where again, having an Obamacare subsidy will be as useful as having a bus ticket in a town with no buses running.

Now, there is a solution to this. As I mentioned, the legislation that Senator Corker and I are introducing will do three things: First, it will allow Americans to use their Affordable Care Act subsidy—the money they are getting now—to purchase any health insurance plan outside of the exchange, as long as the insurance is approved by the state for sale in the individual market. That means Americans on the exchanges will have options to purchase insurance where the Affordable Care Act has left them with none. This option will be given to individuals who live in the counties where the Secretary of Health and Human Services certifies that there are zero options on the ACA exchange.

Second, when the Secretary certifies that there are zero insurance options on the exchange, the legislation will waive the Affordable Care Act's requirement to buy a specific health plan or pay a fine of as much as $2,000 for a family of four. The law's individual mandate, in other words, will not apply to these individuals. And of course, it shouldn't. They shouldn't be penalized for not buying insurance when there is no insurance to buy. The legislation's temporary authority would be in place only through the end of the 2019 plan year.

Third, I hope that this legislation will provide some peace of mind for those Knoxville area residents and Americans in counties across the country trapped in collapsing exchanges.

This is not a permanent solution. Congress has a responsibility to continue its work to solve this problem and to give more Americans more choices of lower cost health insurance.

Long term, Americans should have the freedom to make their own choices about their family's health care needs. But in the short term, we must act on behalf of 230,000 Tennesseans, some of the most vulnerable citizens in our state, and millions of other Americans in other states who are likely to have zero choices of insurance in 2018.

Earlier this afternoon, the Tennessee insurance commissioner, Julie Mix McPeak, who has testified before the Senate and made public statements that the Tennessee Affordable Care Act exchanges were in virtual collapse—what she means by that is no one will be selling insurance in them—issued this statement in support of the bill that Senator Corker and I have introduced. She said:

This bill “would definitely be helpful for Tennessee consumers. We are in favor of any legislation that improves consumer choice and provides access for Tennesseans. It is completely unacceptable for our consumers to have a subsidy but no ability to purchase insurance on the exchange. We support any option that avoids that result.”