BREAK IN TRANSCRIPT
Ms. JACKSON LEE. I thank the distinguished gentleman.
Today, Mr. Speaker, I rise to save lives and to ensure that the Affordable Care Act does what it was intended to do and what it is already doing: lifting the lifetime caps, providing preventative care, taking away the discrimination against women and other ethnic minorities by eliminating health disparities.
This is a bill that has seen eons of hearings not only in the underlying committee, but also in the Judiciary Committee and other committees and ad hoc hearings and briefings over and over again. I remember sitting and hearing the painful stories of families whose children had died because they could not get access to health care. But the Upton bill comes today disguised as a sheep in wolf's clothing. It discriminates against people with preexisting conditions; it restores annual caps on the amount of care you can receive; and it forces women to pay more than men for the same coverage.
This bill is not a fix. It is a dissolver of a good bill.
By the way, Mr. Speaker, let me inform my colleagues that there was nothing in the Affordable Care Act that dictated to insurance companies that they had to send cancelation letters. Why don't we hold a hearing and call the CEOs of the insurance companies and ask them why they didn't send the normal letter indicating that you have the opportunity to have a modified policy that will comply with the Affordable Care Act and that your policies are not canceled because those individuals did not pay their premium? Ask that question.
I will tell you that there are health professionals and organizations that believe this particular bill will not work, such as the American Cancer Society and the American Diabetes Society.
I agree with my colleague that there should have been an open rule. And the reason that there should have been an open rule is because I had an amendment that indicated that the conditions specified in the subsection for health insurance insurer, they must notify enrollees eligible for such continued coverage. I am glad that the President yesterday put that language in and also said that you can opt in to your old policy.
We have answered the call and concern of the American people, but we have not taken away from them the right to have consumer protections and insurance coverage that will make their lives better.
I would also suggest that my amendment indicated health insurance companies are making decisions based on their bottom line, their self-interests, and have decided to terminate insurance plans that are not profitable in the new, highly competitive marketplace for health insurance or want to end insurance for those who are ill and thereby increase their profit margin by keeping only the healthy and marginally healthy while discarding the ill, and the amendment should have been included, because we need to speak to our friends in the health insurance industry that we are here working together and that those letters were not necessary.
Mr. Speaker, I want to save lives. I want consumer protections. I want women not to be discriminated against. Tomorrow, in Houston, we are opening the doors for enrollment in a health fair that we hope thousands will come to.
My friends, the Upton bill does not answer the question. Let us save lives today.
BREAK IN TRANSCRIPT
Ms. JACKSON LEE. I thank the gentleman for his courtesy.
This is what we lived in preceding the Affordable Care Act:
18 percent of the underinsured postponed getting care or treatment, and some of those people died;
15 percent of the uninsured had problems paying their medical bills, hounded, hounded, hounded because they didn't have the resources and even went bankrupt;
10 percent of the uninsured needed prescription drugs but they could not afford them;
8 percent were hounded by collection agencies because they had to pay for their mortgage or their food;
6 percent did not seek treatment at all.
Do you know what that equals to? One hundred percent of those individuals suffering bad health care.
Let us vote down the Upton bill, vote against the underlying rule, and let's promote the Affordable Care Act and fix it like the President has done.
Mr. Speaker, I rise in strong opposition to the rule and the underlying bill, H.R. 3350, the so-called ``Keep Your Health Plan Act of 2013.'' I oppose the rule and the underlying bill for two reasons.
First, the bill will not save lives. Second, the legislation is unnecessary in light of the action taken yesterday by President Obama, which should satisfy the proponents of this legislation while at the same time minimizing the risk to the health and safety of underinsured Americans, who are persons who have insurance but spend more than 10% of their income on out-of-pocket medical expenses.
Were it to become law, H.R. 3350 would jeopardize the life and health of those underinsured who purchase these plans it protects, even though health insurance plans are available that would in nearly every case provide more health coverage for less.
Mr. Speaker, researchers have found the following disturbing facts regarding the underinsured:
Eighteen percent of the underinsured postpone getting care or treatment;
Fifteen percent of the underinsured had problems paying medical bills;
Ten percent of the underinsured needed prescription drugs but could not afford them;
Eight percent were hounded by collection agencies for nonpayment of medical bills; and
Six percent did not seek treatment even though they needed it.
Mr. Speaker, this is the cost of underinsurance in America--and this is what we can expect more of should H.R. 3350 become law. The express purpose of this bill is to allow underinsured persons to retain an inadequate ``health insurance'' plan on the ground that supposedly it is the plan the person ``wants to keep.''
Unfortunately, there is nothing in this bill that would provide consumer education on the inadequacies of the plan and that something much better is available. For example, there is no requirement in this bill for the insurer to notify the insured that health insurance provided through the exchange that provides more and better coverage for less money.
This means that under H.R. 3350 people will still have problems paying their medical bills, they will have high bills, and they will not be able to afford prescription medication or be hounded by medical bill collectors.
The second reason for opposing this rule and bill is that it is unnecessary in view of the actions taken yesterday by President Obama. As the President announced, insurers will be
permitted to offer consumers the option to renew their 2013 health plans in 2014, without change, allowing them to keep their plans. This should satisfy the proponents of the bill.
But the President went further than that because he recognizes that inadequate insurance is really no insurance at all. That is why the President conditioned the ability of insurers to offer plan renewals upon the following:
1. That insurers notify enrollees that they can purchase coverage through the Health Insurance Marketplace where they can potentially qualify for premium tax credits; and
2. Those insurers must inform consumers of the protections they are giving up to keep the plan they have.
Taken together, President Obama's actions are a tempered and measured response to the alleged problem that this bill seeks to remedy.
I fully applaud what the President has done and I offered an amendment that would achieve precisely the same results but the Rules Committee did not make my amendment in order. The text of Jackson Lee Amendment #1 provides:
(C) CONDITIONS FOR CONTINUED OFFERING OF COVERAGE.--The conditions specified in this subsection for a health insurance issuer offering continued coverage under subsection (a) are as follows:
(1) The issuer must notify enrollees eligible for such continued coverage that they can purchase health insurance coverage through the Health Insurance Marketplace where they can potentially qualify for premium tax credits.
(2) The issuer must tell consumers what protections they are giving up to accept the continued coverage they have.
(3) The issuer must provide notice by mail of the offering of such continued coverage to each affected enrollee; and post these notices on the issuer's website.
The Jackson Lee Amendment, like the action announced by the President, is practical, efficient, and addresses the concerns of those who received cancellation letters from their insurance companies.
It should be noted again that Jackson Lee Amendment #1, and the President's actions, are each superior to H.R. 3350, which contains no provision or requirement that consumers who received these notices be advised by their insurers that they may receive lower insurance rates with better coverage by shopping online or calling the toll free number.
Now there may be some who think the availability of the types of health care insurance that H.R. 3350 would protect is sufficient for
Americans. I do not. Neither does President Obama. The majority of the American people do not. We believe, and the Affordable Care Act ensures, that healthcare should be available, accessible and adequate.
Mr. Speaker, adequate health plans have in common the inclusion of certain minimal benefits and services. The second amendment I offered to the legislation before us documented the differences between adequate and inadequate health insurance plans. Unfortunately, the Rules Committee elected not to make my amendment in order. The text of Jackson Lee Amendment #2 is as follows:
SEC. 2. FINDINGS.
Congress finds the following:
1. Health Insurance companies are making decisions based on their bottom line self interest and have decided to terminate insurance plans that are not profitable in the new highly competitive market place for health insurance, or want to end insurance for those who are ill and thereby increase their profit margin by keeping only the healthy or marginally healthy, while discarding the ill.
2. Insurance companies make huge profits when they take premiums and pay little to no benefits.
3. The plans offered by some insurance companies called ``health insurance'', in fact offered little if any health care protection should people with these policies become seriously ill or involved in an accident that required hospitalization.
4. Catastrophic health plans sold to Americans as insurance were not first dollar or even the first thousand dollar policies; some required the first $5,000 to $10,000 of health care costs to be paid by the holder of the insurance plan whose income was not sufficient to incur an expense of this magnitude.
5. These plans did not provide many of the minimal benefits of the Affordable Care Act, such as ambulatory patient services, that provide treatment using advanced medical devices or technology like an MRI X-ray.
6. Emergency services were not covered even though emergency room visits could cost tens of thousands of dollars depending on the nature of the emergency. Hospitalization coverage was not included in most of these insurance policies.
7. Maternity and newborn care was not covered nor were pediatric services so that a healthy birth did not mean that the newborn child would have a healthy childhood. Mental health, substance abuse disorder services, and behavioral health treatment were not covered by most of these insurance plans.
8. Prescription drug benefits and necessary laboratory tests also were excluded under these insurance plans. Also excluded under these plans were preventive and wellness services and chronic disease management.
9. Oral and vision care were not part of these plans, which meant that one tooth infection or change in eyesight could set someone back thousands of dollars if they wanted to get treatment.
10. Prescription drug benefits and necessary laboratory tests also were excluded under these insurance plans.
Also excluded under these plans were preventive and wellness services and chronic disease management.
12. Oral and vision care were not part of these plans, which meant that one tooth infection or change in eyesight could set someone back thousands of dollars if they wanted to get treatment.
Mr. Speaker, my constituents in the 18th Congressional District of Texas favor the Affordable Care Act because they understand the insecurity and feeling of helplessness of being uninsured or underinsured. My home state of Texas has the highest percentage of uninsured (27.6%) in the Nation, 4% more than Louisiana, the next state on the list.
The state of Massachusetts, in contrast, boasts the lowest uninsured rate in the country (4%). This is because Massachusetts several years ago adopted the health insurance system upon which the Affordable Health Care Act is based.
The Affordable Care Act when fully implemented will yield the same benefits for my home state of Texas. In fact, it has already begun to do so. Take the case of Lucy, who was insured--I should say underinsured--but had a $7,500 a year deductible. Thanks to the Health Insurance Exchange she is now much better off. Here is what Lucy has to say about the Affordable Care Act compared to the plan she had before:
I signed up at Healthcare.gov and I'm going to save $2,300 a year on my premium alone--and more, because my deductible will drop from $7,500 a year to $3,000 a year. It's still Blue Cross insurance, and I don't have to change doctors, either. I had a choice of over 30 plans and several different companies.
Mr. Speaker, health care coverage must be not only available and affordable but also adequate in order for consumers to have the health security and financial protection they need and deserve. The Affordable Care Act satisfies these criteria; the bill before us does not. That is why we should reject this rule and the underlying bill.
H.R. 3350 is nothing more than the House Republicans' newest variation on their very old theme, which is to repeal, impede or undermine the Affordable Care Act. This bill is the 46th attempt by the Republicans to deprive the American people of the security and peace of mind that comes with health care that is affordable, accessible and adequate.
Of course we should not be surprised. After all, it was the House Republicans who shut down the federal government for 16 days and cost the economy $24 billion while refusing to consider any legislation that would create jobs or address the real needs of the American people.
Mr. Speaker, the bill before us is strongly opposed by a coalition of some of the Nation's leading health and consumer organizations, including the following:
Paralyzed Veterans of America
American Cancer Society Cancer Action Network
American Diabetes Association
American Federation of State, County and Municipal Employees (AFSCME)
American Heart Association/American Stroke Association
American Music Therapy Association
The Arc of the United States
The Autistic Self Advocacy Network
Health and Wholeness Ministries, Disciples Center for Public Witness
Health Care for America Now
National Alliance on Mental Illness
National Association of County Behavioral Health & Developmental Disability Directors
National Council of Jewish Women
National Partnership for Women & Families
These groups oppose the bill for substantially the same reasons I have discussed. While sympathizing with consumers who are receiving notices from their insurance companies that their policies are not being renewed for next year because they do not comply with the ACA's consumer protections, the Coalition rightly observes that:
[T]he solution is not to allow for the continued sale of inadequate policies[.] Rather, we must educate consumers about their new health insurance options and ensure that notices being sent by insurers clearly inform them of the shortfalls with their current coverage and explain all of their options for finding better coverage.
I agree. Therefore, I urge all Members to join me in voting against this rule and the underlying bill.
November 13, 2013.
Hon. John Boehner,
Speaker of the House, House of Representatives, Washington, DC.
Hon. Nancy Pelosi,
Minority Leader, House of Representatives, Washington, DC.
Dear Speaker Boehner and Minority Leader Pelosi: Health care coverage must be not only available and affordable but also adequate in order for consumers to have the health and financial protection they need from health insurance. The Affordable Care Act (ACA) was designed to ensure that, beginning in 2014, Americans would have access to health insurance that meets all three of these important objectives. Our organizations support these goals, and we are therefore opposed to H.R. 3350, legislation that would allow health insurers to continue to sell individual health insurance policies that are inadequate.
The number of people who are underinsured--meaning that their insurance does not provide adequate financial protection when they are sick--has been growing over the last decade. According to one study, the number of underinsured adults has increased 80 percent since 2003. More than 60 percent of all bankruptcies in 2007 were a result of illness and medical bills, and nearly 80 percent of those who filed for medical bankruptcy were insured. Many consumers with inadequate coverage do not realize how poor it is until they are diagnosed with a serious illness and the bills start rolling in. Only then do they find out that their coverage may have very low annual coverage limits or exclude coverage for important and costly services, such as those provided during a hospital stay.
The ACA includes a number of important protections in response to the large number of uninsured and to help guarantee that consumers have access to comprehensive coverage. The ACA minimizes bankruptcy risk and ensures that the full range of care consumers need in the event of a serious or catastrophic illness will be covered. We cannot afford to go another year without these protections. Among these protections that apply to non-grandfathered plans sold in the individual and small group markets are:
A ban on annual limits on coverage. More than 105 million Americans no longer have lifetime dollar limits on their coverage because of the ACA, but health plans would still be able to sell plans with annual limits under this legislation.
A requirement that plans cover 10 categories of essential health benefits, including doctor visits, hospital care, preventive care, maternity care, mental health care, prescription drugs, and rehabilitation services. Many of these critical benefits are not readily available in the individual market. For example, only 12 percent of health plans sold on the individual market cover maternity coverage, and only 6 percent in the states that do not have a mandate, leaving women without necessary coverage when they become pregnant.
A cap on consumers' annual out-of-pocket spending for their health care to help the nearly 10 million Americans with health insurance who are unable to afford their medical bills.
In addition, many consumers who are uninsured or do not have access to an affordable, adequate health plan from their employer are also eligible for a premium tax credit to help them buy such coverage through the Health Insurance Marketplaces.
Our understanding of this legislation is that it would also allow insurers to continue to market and sell these plans to new consumers through 2014, without complying with the rules that take effect for other plans on January 1. In other words, insurers marketing these plans outside of the Health Insurance Marketplaces could continue to refuse to cover people with pre-existing medical conditions or charge them higher premiums because of their age or health status. As a result, younger and healthier people would be more likely to remain on or newly enroll in these plans, and plans sold through the Health Insurance Marketplaces would end up covering mostly older and sicker people. This would drive up health insurance premiums in the Marketplaces.
We very much sympathize with consumers who are receiving notices from their insurance companies that their policies are not being renewed for next year because they do not comply with the ACA's consumer protections. In at least some instances, these notices have been very alarming and misleading for consumers because they fail to let them know that they may have better, more affordable insurance options available to them. At least one insurer was fined by a Department of Insurance for a letter that regulators called ``misleading.'' However, the solution is not to allow for the continued sale of inadequate policies, particularly now that more comprehensive coverage is available along with financial assistance to help make better coverage affordable. Rather, we must educate consumers about their new health insurance options and ensure that notices being sent by insurers clearly inform them of the shortfalls with their current coverage and explain all of their options for finding better coverage.
We look forward to working with you to help your constituents get information about their new options for fairer, more comprehensive, and more affordable health care coverage and to make adequate coverage more affordable to everyone.
American Cancer Society Cancer Action Network, American Diabetes Association, American Federation of State, County and Municipal Employees (AFSCME), American Heart Association/American Stroke Association, American Music Therapy Association, The Arc of the United States, The Autistic Self Advocacy Network, Community Catalyst, Families USA, Health and Wholeness Ministries--Disciples Center for Public Witness, Health Care for America Now, National Alliance on Mental Illness, National Association of County Behavioral Health & Developmental Disability Directors, National Council of Jewish Women, National Partnership for Women & Families, Paralyzed Veterans of America.
BREAK IN TRANSCRIPT