Speeches & Floor Statements

Floor Speech: Group of 24 Senators Cosponsors Short-Term Legislation to Stabilize Premiums, Access to Insurance

Posted on October 19, 2017

Mr. President, a week ago Saturday night, I was having dinner with my wife, it was about 8:30 in the evening and my cellphone rang.

I pulled it out and it was the White House operator and the president was calling. I walked out of the restaurant and sat on a curb outside in the dark and had about a 15-minute conversation with the President of the United States while my dinner got cold.

President Trump said I'm calling about the cost-sharing reductions payments. I have cut them off as of October 1. The court says they are illegal. I don't want insurance companies to be bailed out. I think I can get block grants to replace Obamacare, but I don't want people to suffer in the meantime.

So he said to me, I think I might want to get a bipartisan interim deal, a short-term deal. I’ve called Chuck Schumer and told him that. The president put that out in a tweet that day. The president said to me, why don't you negotiate with Senator Murray and try to get one, meaning a short-term bipartisan deal. I said, well, what about the CSR payments? He said, I can put them back and you can use that as a negotiating tool to get a better deal with the Democrats.

I responded that I was already working on an agreement with Senator Murray. He said finish it and let me know. He called me again last Saturday and we talked twice yesterday. I reported to the president that we have finished our negotiations and that we're here today to present to the Senate the agreement we recommend.

The bill has 22 sponsors, half Democrat, half Republican. Very few bills come to the floor with that many cosponsors originally. There are a number on the Republican side and I understand from Senator Murray, a number on the Democratic side who support the idea.

I ask consent that the text of the cosponsors that I'm about to read be inserted in the record.

The presiding officer: Without objection.

Mr. Alexander: And I ask consent that the text of the agreement that Senator Murray and I would like to present to the Senate for its consideration and the president's consideration and the consideration of the House of Representatives be spread in the record following my remarks.

The presiding officer: Without objection.

Mr. Alexander: Mr. President, the Republican senators who are cosponsoring the Alexander-Murray proposal, in addition to me, are Senator Rounds, Senator Graham, Senator McCain, Senator Cassidy, Senator Collins, Senator Ernst, Senator Murkowski, Senator Burr, and Senator Corker.

I thank them all for doing that and Senator Murray will talk about the equal number of Democrat cosponsors that we have.

We hope that Senator McConnell and Senator Schumer, the President of the United States, and the House of Representatives will consider our proposal.

This is a first step. Improve it, and pass it sooner rather than later. Our purpose is to stabilize and then lower the costs of premiums in the individual insurance market for the years 2018 and 2019.

In plain English, most Americans get their insurance from the government or on the job. About six percent or 18 million Americans go into the individual market to buy it. They are the ones we're worried about. They are the ones we're seeking to help. There are 350,000 such people in Tennessee – songwriters, farmers, small businesses women. They are the ones that are terrified of skyrocketing premiums or even the possibility they may not be able to buy insurance at all.

Our agreement tries to help in two ways.

One, it permanently amends the Affordable Care Act to give new flexibility for states to create insurance policies that have a larger variety and lower costs.

And, number two, it continues the cost-sharing reduction payments during 2018 and 2019.

First, about cost-sharing. Cost-sharing reduction payments are subsidies that pay for copays and deductibles for low income Americans. That's what they are. Every Democrat wants them to continue, so do many Republicans, including, Mr. President, every Republican in the majority in the House who voted for their repeal and replace bill this year because it continued the cost-sharing payments for two years.

Let me say that again. Every Republican in the House of Representatives who voted to repeal and replace Obamacare this year, voted for a provision that continued the cost-sharing payments for two years. Our bill does the same thing. The only difference is that we eliminate any question about whether paying them is legal.

Now, why would so many Republicans, so many Democrats, support these payments for two years and the President of the United States be interested in them?

Because the Congressional Budget Office has told us that if we don't do it, if we let them expire, premiums in 2018 will go up an average of 20%. They are already set in most cases. The federal debt will increase by $194 billion over ten years because of the extra to cost of subsidies to pay the higher premiums, and up to 16 million Americans may live in counties where they are not able to buy any insurance in the individual market. So unless the cost-sharing payments, which the president says are illegal -- and I agree with him, the federal court in Washington, D.C., has told him they are illegal, not properly authorized by congress -- unless they are replaced with something else temporarily, there will be chaos in this country and millions of Americans will be hurt.

The president says there should be no bailout of insurance companies. I agree 100%. So does Senator Murray. She can speak for herself. And as I said to the president in our telephone calls, as I mentioned, four of them in the last 10 days, that if there is a way to improve the language in our bill, we would like to do that. We have a page and a half to make it clear that the benefits go to consumers not insurance companies. That can always be improved.

Some conservatives object to the idea of paying them at all, but I would ask what's conservative about unaffordable premiums.

What's conservative about $194 billion of new federal debt?

What's conservative about creating chaos so millions can't buy insurance?

Or at least failing to deal with the chaos that has already been created?

What's conservative about a four-lane highway that would be the chaos that leads to a single-payer solution for insurance in this country?

Do you really think that if 50 counties in Tennessee or Iowa or Kansas or any state are in a situation where no one can buy insurance in the individual market that government-sponsored insurance is not far behind? Of course it is.

That's why Senator Graham cosponsored, and Senator Cassidy have cosponsored our bill because our bill would have been part of the Senate Republican repeal and replace bills if budget rules had allowed it. Senator Graham and Senator Cassidy know that if we repeal and replace Obamacare in one year, or two years, or three years, it takes two or three years for it to take effect and we still need the cost-sharing payments for the interim and you can't pass those in the Senate with 51 votes. It takes 60.

So Democrats are for it, the Republicans House majority has voted it for it, the sponsors of the Senate repeal and replace bill are cosponsors of this agreement. It sounds like something that might actually become law before the end of the year.

Second, flexibility.

The biggest difference between the Senate Republicans and the Senate Democrats about health insurance in the individual market is whether Washington should write more of the rules or if states should write more of the rules. Our position has been states should.

We've had about 50 votes, maybe more, and we have lost them all, and we made thousands of speeches, and we have lost them all. We haven't moved an inch toward our objectives in the last seven years of giving states more flexibility in creating insurance policies in the individual market.

This agreement does.

It provides and authorizes states to offer a new insurance policy called catastrophic insurance for people of all ages that would keep a medical catastrophe from turning into a financial catastrophe.

It encourages interstate agreements among states in health insurance.

It streamlines the innovation waiver, section 1332 we call it, for states that want to do what Alaska did, which is to create a fund to pay for the very sick and reduce premiums for everybody else by 20 percent and use no new federal dollars.

And most important, it changes a law to make it easier for states like Iowa, Oklahoma, New Hampshire, Minnesota, Massachusetts, Tennessee, Alaska, and many others to use their creativity to write policies that offer more choices and lowers costs.

Some have said well that's not enough. Well that's more than we've gotten for eight years and it's the first step.

So I welcome anyone who wants to negotiate further with Senator Murray or Senator Schumer. That's what the legislative process is.

Now, I would like to add, because I forgot to do it when I listed the sponsors, and I'd like them to be added in the record. Senator Isakson and Senator Grassley to the sponsor list, which will be two additional Republican sponsors, I would say to Senator Murray. So that gives us a total of 13.

The presiding officer: Without objection

Mr. Alexander: No, that gives us a total of 12. I just overlooked Senator Isakson’s name, I apologize. We have a total of 12 I would through the chair to Senator Murray. That would give us 12 Republican sponsors and 12 Democratic sponsors. And I thank Senator Grassley for his willingness to do that.

The only thing I would say to those who want to negotiate further to get more flexibility is to keep in mind with the cost-sharing payments, you can't get most of those changes without 60 votes in the United States Senate.

Now, I want to thank Senator Murray for being an able and effective negotiating partner. We worked on many pieces of legislation together. She's tough and respected in her caucus and she does what she says she will do. And she's interested in getting a result. I respect that. And I thank her.

I want to thank President Trump for his encouragement. He's the one who called me ten days ago and called me again last Saturday and called me twice yesterday. I want to thank him for his encouragement to encourage someone to come up with a bipartisan agreement to cover these two years so people wouldn't be harmed, and his willingness to consider what we're offering today.

I want to thank Senator McConnell and Senator Schumer because they've created an environment in which Senator Murray and I could make this proposal, and I hope that they and our other colleagues will seriously consider it.

The president was right to suggest that we need a short-term agreement so people won't be hurt.

Now, some people are still objecting to the idea of continuing these temporary cost-sharing payments for two years, and the other provisions that would have as the objective keeping premiums from going up in 2018 and premiums begin to go down in 2019.

They're listing the groups around Washington, D.C.

I would suggest they listen to some other people. Listen to the waitress, listen to the songwriter, listen to the brick layer, listen to the small businesswoman. The people of America, there are 350,000 in Tennessee, who may be terrified by the prospect of increasing premiums or even the prospect of not being able to buy insurance at all.

These are people who don't get insurance from the government. They don't get it on the job. They might never know when they're going to lose their job and they'll be in this individual market.

We have a solution here. Senator Murray and I and 24 total of us United States Senators are offering it today. We are certain that it can be improved.

We look forward to working with those who would improve it. But I do not believe that Congress will want to fail to deal with a problem that will hurt millions of Americans if we allow it to continue.

I predict that this agreement that we're suggesting today with 24 senators will become law in some fashion before the end of the year. I think most senators and most House members will be looking around for a solution when they consider the consequences of a failure to act.

And when they look for a solution, I believe that this solution supported by 24 United States Senators, half Democrat, half Republican, will be the easiest solution to adopt. Because I believe all the Democrats want it. Almost all the House Republicans have already voted for it this year. And the senate Republican leaders who would prefer to repeal and replace Obamacare would put it in their bill if they could get it in there, but they can't because the budget rules won't allow it.

I thank the president. I yield the floor to Senator Murray.