Speeches & Floor Statements

Floor Speech: Affordable Care Act Premium Increases

Posted on May 8, 2018

The Democrats who know Obamacare health insurance rates are going to go up in October are busy trying to find someone to blame.

About 10 days ago, Senator Schumer came to the Senate floor and warned that very soon, health insurance companies will begin to announce their proposed rates for the year 2019 in each state across the country, and that when they do, many health insurance companies will propose rate increases.

Today, several Democrat senators made the same charge.

And of course they blame President Trump and Republicans in Congress.

It’s a little like if you sold someone a house with a leaky roof and you tried to blame the new owner for that leaky roof.

Democrats built this house with a leaky roof. They built these individual insurance markets where no one can find insurance. They wrote the sloppy law and they failed to make the markets competitive, they erased the ability of consumers to have choice, they didn’t follow the law when they paid out the cost-sharing reduction payments, and – this is the very worst – when Republicans hadn’t reached agreement on repeal, and were prepared instead to stabilize these markets and lower premiums by as much as 40 percent next year – Democrats blocked our efforts. So not only are they complaining about the slow pace of repairs, they are blocking the repairs from happening.

What Democrats didn’t say, but every American very well knows, is that health insurance rates didn’t start increasing when President Trump took office, they’ve been increasing since Obamacare took effect.

Mr. President, in 2010, I told President Obama right before the law was passed, that the Affordable Care Act would not work.

In 2010, I said directly to President Obama that Obamacare would send an unfunded Medicaid mandate to states. I said, ‘It will cut Medicare by about half a trillion dollars and spend most of that on new programs ... It means there will be about a half trillion dollars of new taxes in it. It means that for millions of Americans, premiums will go up, because when people pay those new taxes, premiums will go up, and they will also go up because of the government mandates.’

This is exactly what happened.

Back then I said, “Our country is too big, too complicated, too decentralized for Washington, a few of us here, just to write a few rules about remaking 17 percent of the economy all at once.  That sort of thinking works in the classroom but it doesn't work very well in our big complicated country.”

Since the exchanges opened in 2014, history has proven this to be right. The Affordable Care Act has not worked the way Democrats promised.

It certainly hasn’t worked for people like Marty—a farmer in Tennessee who stopped me late last year at a Chick-fil-a in Nashville to tell me how the year before Obamacare started, her monthly insurance premium was $300. This year it's $1,300, and it's very hard for her to afford.

Marty is one of thousands of others in Tennessee who have seen their premiums increase 176 percent since 2013, the year before Obamacare marketplaces opened.

The Affordable Care Act hasn’t worked for the nine million Americans, like Marty, who purchase their health insurance in the individual market and receive no government subsidy, who have been hammered by skyrocketing insurance premiums.

The Affordable Care Act does not work because it is too Washington focused. It has made insurance too expensive and is hurting the American people.

So, last year, Republicans in Congress tried to repeal the law, to help make health insurance work again for people like Marty, but we came up short.

And while I hope that Senators Cassidy and Graham can build a coalition to try again, there is still the urgent problem of skyrocketing premiums.

It didn’t have to be this way.

Senator Murray and I, the lead Democrat on the Senate health committee, last year announced we would hold hearings to see if there were steps Congress could take to stabilize and strengthen the individual health insurance markets so that Americans could buy insurance at affordable prices in 2019.

In September, we hosted four bipartisan hearings and four roundtables, which we invited all 100 senators to and were attended by over half of the members of the Senate.

Those bipartisan discussions yielded three proposals that Congress could pass to lower health insurance premiums:

Three years of reinsurance grants at $10 billion each year so states could create funds to insure the needs of the very sick and lower premiums for everyone

Three years of cost sharing reduction subsidy payments to help low-income Americans pay out of pocket expenses

Streamline the Affordable Care Act’s Section 1332 State Innovation Waiver without changing essential health benefits or the prohibition of annual or lifetime limits on benefits or the guarantee of an offer of insurance for those with pre-existing conditions. This new flexibility would have allowed Iowa and other states to increase choices and lower premiums and allowed New York, Minnesota and New Hampshire to use federal insurance funds more effectively. There was new authority for “catastrophic” policies with lower premiums and higher deductibles.

Experts at Oliver Wyman consulting predicted these proposals could reduce rates by up to 40 percent over three years.

Almost all Democrats liked the three ideas; many Republicans were skeptical because they said the ideas would “shore up Obamacare.”

But, the Congressional Budget Office said that if scoring reflected that CSRs are being paid through the tax credit, enacting the proposals would actually save taxpayer dollars.

So these seemed like very good proposals to lower premiums in the individual market.

On Saturday, March 17, President Trump asked Senator McConnell and Speaker Ryan to include these three proposals in the Omnibus Spending Bill.

McConnell and Ryan said “yes.”

But Democrats said “no.”

The reason: Democrats would not apply to these proposals the traditional Hyde compromise language regarding federal funding for elective abortions—even though Democrats have voted for Hyde language in every appropriations bill since 1976 and voted to apply Hyde to more than 100 other provisions in that same Omnibus bill later that same week.

I’ll say that again: Even though Democrats have voted for Hyde language in every appropriations bill since 1976 and voted to apply Hyde to more than 100 other provisions in that same Omnibus bill later that same week, they would not apply Hyde to these proposals that would lower insurance premiums up to 40 percent.

Senator Howard Baker once said the essence of Senate leadership is becoming an eloquent listener. That means hearing and understanding what people have to say because what they are saying is not always what they mean.

My conclusion is that, by their words and by their actions, what Democrats REALLY were saying was: we won’t change one sentence of Obamacare, even to parts that obviously are not working, and even when most of their caucus supports the changes.

Given Democrats’ attitude, I know of nothing that Republicans and Democrats can agree on to stabilize the individual health insurance market.

No one regrets Congress’ failure to reach an agreement on this more than I do. 

I ran for the United States Senate because I want to achieve bipartisan results on important issues, and often I have done that, but I could not here.

When Democrats blocked these proposals from being included in the Omnibus in March, I said, “Now let’s look down the road… insurance companies will announce their rates for 2019… and rates will continue going up instead of going down.”

And this month, we will see the start of that as insurance companies begin to file rates. 

Millions of Americans will begin hearing about yet another premium increase for next year.

Democrats could have worked with us to lower premiums by as much as 40 percent but instead choose to cling to an unworkable law.

So now efforts to help Americans paying skyrocketing premiums will turn to the Trump Administration and the states.

I’m encouraged by Labor Secretary Alex Acosta’s proposed rule on association health plans.

It would allow some self-employed Americans, like Marty the farmer, and employees of small companies to buy the same kind of insurance with the same lower cost and same protections that roughly 160 million Americans who work for large employers have today.

The Trump Administration has also proposed a rule that would reaffirm the role of states in regulating short term health insurance. This could provide a coverage option for Americans who today are uninsured because plans in Affordable Care Act markets are too expensive.

Neither of these changes require the approval of Congress.I am talking with Secretary Azar and Seema Verma, the Administrator of the Centers for Medicare and Medicaid Services, about other administrative actions they can take to give states more flexibility to help lower health insurance premiums, especially for the nine million working Americans who do not receive a federal subsidy in the individual market.

I will be encouraging governors and state insurance commissioners to do everything they can to help repair the damage caused by the Affordable Care Act.

And my own efforts will turn to other pressing health care issues including the opioid crisis, overall health care costs, electronic health care records, prescription drug prices and the 340B program.

Contrary to Senator Schumer’s speech—this is not a crisis of Republican’s making—the last five years of rate increases are the fault of a law designed, drafted, and approved by Democrats.

Last year, Republicans freed Americans from the individual mandate requirement—which was a tax on the poor that forced many Americans to buy insurance they could not afford or that did not meet their needs. 

And we tried to provide even more freedom from this unworkable law but the Democrats refused.

So if you have an insurance premium that is going up 40 percent next year, on top of an over 105 percent increase since 2013, you can thank a Democrat.

If you’d like greater choice, and the opportunity for lower premiums, you should support Republicans.