Making Continuing Appropriations for Fiscal Year 2013--Continued

Floor Speech

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Mr. ALEXANDER. Thank you, Mr. President.

I congratulate the Senator from Missouri for his comments. Sometimes I think Republican Senators especially should begin and end every speech with an answer to the question, What would the Senator do if he were in charge? And the Senator from Missouri has said that very eloquently. It is not the first time what Republicans would do has been said on this floor. He mentioned that the law was passed 3 1/2 years ago. We counted it one time. We mentioned 173 times on this floor the Republican step-by-step proposal for a different approach to health care in this country.

We said: Don't expect Senator McConnell or any other Republican to come in with a 3,000-page Republican bill in a wheelbarrow. We don't believe in that. We believe in a different direction, a different approach. We don't believe we are wise enough in Washington to write 3,000 pages of rules to govern every aspect of our health care system in America that takes 18 or 19 percent of the economy.

We live in the iPhone age, where we want to increase the personal freedom of Americans to live longer, better, safer, and healthier. We want people to be able to do these things for themselves. We want to increase choice, competition, and in that way lower costs. If we lower costs, then more people will be able to afford to buy health insurance. That is the real way to expand health insurance in America--make it more affordable; make it so people can afford it.

So I am beginning these short remarks with a salute to the Senator from Missouri for talking about what we would do if we were in charge, and I am going to end in that way as well.

For the last couple of months, we have heard countless stories from constituents who are losing the health plans they purchased on the individual market.

According to America's Health Insurance Plans, there are 19 million Americans in the individual market. The Obama administration knew in 2010 that the rules it wrote for health plans would mean that 47 to 60 percent of those policies could not be legally offered under ObamaCare by 2014. Nevertheless, the President still said, ``If you like your health insurance, you can keep it.''

Now we all know that wasn't true. According to news reports collected by my staff, at least 5 million Americans, including 82,000 Tennesseans, will lose their individual plans starting January 1. That is an unwelcome Christmas present for those 82,000 Tennesseans. 16,000 Tennesseans are losing their Cover Tennessee plans; these are people who especially need help. There are also 66,000 Tennesseans who will lose their Blue Cross Blue Shield of Tennessee coverage.

I heard from a woman named Emilie, who is from Middle Tennessee. She is 39 years of age and has lupus.

She wrote:

I cannot keep my current plan because it doesn't meet the standards of coverage. This alone is a travesty. CoverTN has been a lifeline. ..... With the discontinuation of CoverTN, I am being forced to purchase a plan through the Exchange. ..... My insurance premiums alone will increase a staggering 410 percent. My out-of-pocket expense will increase by more than $6,000 a year--that includes subsidies. Please help me understand how this is ``affordable.''

Unfortunately, Emilie is not the only one experiencing rate shock. Millions of Americans are losing their insurance plans. They are being forced to buy new plans, many of them with higher premiums, deductibles, and coinsurance.

According to data from the Department of Health and Human Services, Tennesseans can expect to pay up to three times more on the exchanges being set up under ObamaCare for the health insurance they now have.

In 2013, a 27-year-old man in Memphis can buy a private insurance plan for as low as $41 a month. On the exchange, the lowest State average is $119 a month--a 190-percent increase.

Today, a 27-year-old woman in Nashville can buy a plan for as low as $58 a month. On the exchange, the lowest priced plan in Nashville is $114 a month--a 97-percent increase. Even with a tax subsidy, if she made $25,000 a year, the plan would be $104 a month--almost twice what she could pay today if the $58 plan was all she felt she needed.

Today, women in Nashville can choose from 30 insurance plans that cost less than the administration says insurance plans on the exchange will cost, even with the new tax subsidy.

In Nashville, 105 insurance plans offered today will not be available in the exchange.

According to HealthPocket Inc., a consumer-oriented health research firm, the average individual deductible for a bronze plan on the federally-run exchange is $5,081 a year. That is 42 percent more than the average deductible of $3,500 for an individually purchased plan in 2013. According to Deloitte, that is 348 percent more than the $1,135 average deductible for an employer health plan in 2013.

These are a lot of numbers, but Americans--millions of them--are getting familiar with these numbers because this has gone from being political to very personal.

According to Avalere Health, 90 percent of bronze plans require patients to pay 40 percent of the cost of their tier 3 and 4 drugs out of their own pockets, compared with 29 percent of employer-sponsored plans that most Americans currently use. Most silver plans also require patients to pay 40 percent. For cancer patients and those with chronic illnesses, this kind of cost sharing could mean they will pay thousands of dollars out-of-pocket or go without the drugs they need to stay healthy.

Americans had to wait until the exchanges opened on October 1 to find out just how much they were going to have to pay for insurance in 2014. With such dramatic hikes in premiums and out-of-pocket expenses, it is no wonder that Americans are outraged.

Then, just before Thanksgiving, we learned that the Obama administration is delaying open enrollment for 2015 until after the midterm elections in November. The only American consumers this change will help are Democratic politicians who voted for ObamaCare because it would delay disclosure of some of the law's most insidious effects until after the election.

Senators BARRASSO, ENZI, and I introduced today the Premium Disclosure Act. We want to change the open enrollment date back to October and provide Americans notice of their premiums and cost-sharing requirements

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30 days in advance so that they can plan for the future knowing their health care costs for the next year. This is a commonsense proposal that I hope my colleagues will support.
As my colleague Senator Barrasso likes to say, what we know now about ObamaCare is just the tip of the iceberg. Much of the media attention has focused on the disastrous rollout of the Web site and the 19 million Americans in the individual market. But just below the tip of the iceberg are 160 million Americans--nearly 10 times more than have individual policies--who the Congressional Budget Office says get their insurance through the job, employer insurance.

Think about issues such as restrictive grandfathered plan rules, limits on the number of hours employees can work and be considered part time, the mandate that employers provide government-approved insurance or pay a fine, and the millions of dollars in new taxes on health plans. All of these issues will have an impact on employer-sponsored health insurance in both the public and private sector. We are already seeing that. Employers such as Sea World, Trader Joe's, The Home Depot, and other companies have publicly said they are reducing worker hours or dropping part-time employee health benefits. The chief executive officer of Ruby Tuesday, a restaurant company, told me that the cost to implement ObamaCare would be equal to the profit his company earned all of last year.

In case you think these are isolated examples, the National Association of Manufacturers says that more than three-fourths of manufacturers cited rising health care and insurance costs as the most important business challenge. The U.S. Chamber also has a membership survey saying that 74 percent of businesses are reporting that the health care law makes it harder for their firms to hire new workers. This is at a time when jobs are supposed to be the principal concern in our country.

Many of these businesses self-insure, meaning they design and pay directly for the health plans they offer their employees. According to the Kaiser Family Foundation, more than 100 million Americans currently have employer-sponsored health plans that are self-insured.

Self-insurance is a method of providing health insurance that has worked well since its inception in 1974. It needs to be preserved. Last month Senators RUBIO, RISCH, McConnell, and I introduced a bill to make sure the Obama administration doesn't change that, doesn't change the rule that allows the companies to insure themselves against a medical claim that could bankrupt them. Any effort by the Obama administration to change the rule on companies that self-insure will break the President's promise to millions of Americans. It won't matter if they like their employers' health plans; they won't be able to keep them.

It is not only the private sector facing fiscal challenges because of ObamaCare. Our Nation's schools, colleges, and universities are also being hit hard. There is no shortage of examples in my State of Tennessee of local leaders dealing with the burdens of ObamaCare.

The Franklin Special School District has begun limiting substitute teachers to working 4 days a week in order to avoid paying between $1 million and $4.5 million more per year in health care costs.

Maury County Schools, south of Nashville, is also limiting its substitute teachers to no more than 28 hours a week for the same reason. One school board member told the local news:

Students struggle enough having one substitute teacher, but then now we're going to have to possibly split the substitute time between two substitute teachers. It just makes it hard on the students to learn.

Wilson County Board of Education wrote to tell me that ObamaCare's reinsurance fee will cost the district an additional $165,000 in 2014 alone.

At least eight other Tennessee school districts are reportedly limiting employee work hours or entire jobs, including Clarksville, Rutherford County, Johnson City, Carter County, Washington County, Oneida Special School District, Scott County, and Stewart County.

Cumberland University in Lebanon has adopted a new policy to limit adjunct faculty to no more than three courses each term, meaning they won't be able to offer a course even if they are the most qualified instructor available.

The impact of ObamaCare on education is by no means limited to Tennessee. Investor's Business Daily has identified well over 100 school districts and institutions of higher education nationwide that have made cuts or limited employee work hours because of ObamaCare. That number is climbing daily, again suggesting this is only the tip of the iceberg.

Remember, what we are hearing about today are individual policies. What we are going to hear about next year are employer policies being cancelled, new costs, and there are 10 times as many Americans with employer policies as individual policies. Who pays the price for this? Our children.

Cash-strapped schools simply don't have the money to absorb these costs, so they are forced to make difficult choices.

For these reasons--broken promises, higher costs, fewer choices--ObamaCare was an historic mistake. It expanded a health care delivery system that already costs too much and left Americans with fewer choices.

I said at the beginning of my remarks that I would like to end in the same way, and I will do that with an answer to this question: What would we do if we were in charge? What if we elected a Republican Senate and even a Republican President in 2016? We would replace ObamaCare, not by moving backward, but by moving in a different direction.

Remember, ObamaCare's real problem was it expanded a delivery system that already costs too much. What we would do instead is go step by step to introduce new ways to increase choices, to have more competition and to lower costs. We would make Medicare solvent, so seniors can depend on it. We would give Governors more flexibility with Medicaid so they can create programs with lower costs. We would repeal the ObamaCare wellness regulation--the Senator from Missouri talked about that--and replace it with one that makes it easier, not harder, for employers to give employees lower health insurance costs if they live a healthy lifestyle. We would let small businesses pool their resources and offer low-cost insurance plans for their employees. The Congressional Budget Office says that Senator Enzi's bill would allow coverage for 750,000 more Americans at a lower cost if we did that. We would allow families to purchase insurance across State lines. If there is a policy regulated by Kentucky that fits my needs, and I want to buy it, why shouldn't I be able to do it if I can afford it? We will expand health savings accounts. We would incentivize the growth of private health insurance exchanges. That is beginning to develop all across our country, giving more choices to employees. We would make it easier for patients to compare prices and quality of doctors and medical services. We would incentivize States to reform junk lawsuits. Those are the steps in the right direction where we would like to go.

When Irving Kristol died not long ago, James Q. Wilson wrote a tribute in The Wall Street Journal which struck me. He said when they began their association as neoconservatives--they were mostly Democrats--he said we were policy skeptics. He said that was mainly what our common view was. By that, I think he must have meant they did not believe Washington could, through a comprehensive piece of legislation, fix our whole health care system; that what Washington should do, particularly in this iPhone age, is to go step by step in a direction that gives more personal freedom to consumers, to Americans, so they can live longer, live healthier, live safer, and be happier.

That is what we would like to do. That is how we would like to change ObamaCare, and we would like to have that opportunity.

So unfortunately, an unwelcome Christmas present this year for 82,000 Tennesseans is that they are losing their individual policies. Even more unfortunately, an unhappy New Year is coming, in which hundreds of thousands of Tennesseans will lose their employer policies--the policies they get through their employers--because of ObamaCare. We are ready to go in a different direction and create a way for Americans to have more choices, more competition, and insurance they can purchase at a lower cost.
I thank the Chair, and I yield the floor.

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