Custom Health Option and Individual Care Expense Arrangement Act

Floor Speech

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Ms. FOXX. Madam Chair, I yield myself such time as I may consume.

Madam Chair, I rise today to support the House Republican package to alleviate rising healthcare costs for small businesses. I am proud that the Committee on Education and the Workforce has taken a leading role in this effort.

Healthcare cost is the number one issue facing small businesses today. In fact, according to the NFIB, it has been their top issue for over 30 straight years. Through the dot-com bubble, the Great Recession, the COVID-19 pandemic, and record inflation, small businesses have consistently identified healthcare costs as their greatest concern.

House Republicans recognize that these small businesses are the engines of the American economy, and this package is the first step toward much-needed relief.

I will take a moment to discuss the two pieces of this package from the jurisdiction of the Education and the Workforce Committee. First, this package incorporates Representative Good's Self-Insurance Protection Act. We passed the Self-Insurance Protection Act through committee because small businesses are being squeezed. There is no other way to put it.

On the one hand, premiums are skyrocketing, and it is costing small businesses a fortune to cover their employees. Single-coverage premiums cost about $8,000 per year now, and they are drastically outpacing inflation. The bottom-up inflationary pressures have inevitably forced small businesses out of the insurance marketplace, and more and more are deciding to self-insure. Experts predicted this when the ACA passed, and it has held true.

On the other hand, the government is coming from the top down and telling small businesses they cannot access stop-loss insurance. Stop- loss insurance is a financial tool that self-insured businesses typically buy to protect themselves from catastrophic costs, but the government overreaches, overregulates, and denies many small businesses this critical tool.

For example, in New York, insurers are expressly prohibited from selling stop-loss insurance to employers with fewer than 100 employees. The New York State Association of Health Underwriters wrote regarding the law: ``Some groups have already lost their employer-provided health coverage altogether and have had to go into the New York health insurance marketplace exchange to obtain coverage, only to find that their new coverage has higher copays, larger deductibles, greater total out-of-pocket annual limits, narrower in-plan healthcare provider networks, and fewer out-of-network medical specialists.''

Like in a pincer maneuver, the government is coming from both sides and trapping small businesses in the middle with no options.

The Self-Insurance Protection Act is the solution. It provides a lifeline to small businesses and hardworking Americans who are being squeezed by the soaring cost of traditional health insurance. It would stop Federal and State overregulation of stop-loss insurance, allowing self-insured small businesses a way out of the government's two-sided trap.

Next, this package also incorporates Representative Walberg's Association Health Plans Act, which is perhaps the single best cost- saving tool at our disposal. The Association Health Plans Act would offer immediate relief for everyday workers, taxpayers, and job creators. I know this because it has been tested.

In 2019, before the courts stopped President Trump's association health plan, AHP rule, America got a chance to see and feel the impact of deregulation. AHPs produced savings of up to 29 percent on average. At the upper limit, groups saved 50 percent with their newly formed AHPs.

AHPs achieve these savings by allowing small businesses to band together to increase their bargaining power when purchasing health insurance. Currently, many regulations restrict small businesses and individuals from doing so.

Enabling small economic actors to pool resources is critical to their competitiveness in the market. In healthcare, big companies enjoy large economies of scale, and only more so with each passing year.

Countless studies and evidence point toward this worrisome trend of market consolidation. Three pharmacy benefit managers own 80 percent of the market. Physician practices and hospitals are merging at a rapid pace. Thankfully, hospital mergers have slowed during and after the pandemic, but it is not enough. This bill helps mom-and-pop shops and self-employed workers fight back.

I should also clarify that this bill does not turn healthcare into the Wild West, like some Members claim. Important regulatory guidelines exist to make sure enrollees would not be defrauded under AHPs.

For example, every AHP must have a board consisting of at least 75 percent employer membership. This ensures that AHPs are maintained in good faith.

They are also required to abide by existing consumer protections, such as prohibitions against discriminating based on an individual's health status and prohibitions against using preexisting conditions to deny coverage, increase premiums, or impose waiting periods.

The benefits of the Association Health Plans Act can be summed up in the words of Trump's DOL: ``AHPs are about more choice, more access, and more coverage.'' I agree.

Let's help small businesses get the relief they need and working Americans the coverage they deserve.

Madam Chair, I urge passage of this healthcare package, and I reserve the balance of my time.

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Ms. FOXX. Madam Chair, our colleagues are opposed to freedom in choosing healthcare. They want everyone in government-controlled healthcare and are quite willing to mislead the American people on what these bills do.

Madam Chair, I yield 3 minutes to the gentleman from Michigan (Mr. Walberg), a member of the Committee on Education and the Workforce.

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Ms. FOXX. Madam Chair, I yield 3 minutes to the gentleman from Virginia (Mr. Good), who introduced this resolution, and is chair of the Health, Employment, Labor, and Pensions Subcommittee.

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Ms. FOXX. Madam Chair, I yield 3 minutes to the gentleman from Georgia (Mr. Allen), a member of the Committee on Education and the Workforce.

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Ms. FOXX. Madam Chair, I yield myself the balance of my time.

Madam Chair, my colleagues have explained that many things that our colleagues across the aisle have said about these bills are not accurate.

I am not going to say it again, but I think it is important that we say that these bills are going to do good things for the American people. It is going to provide choice and it is going to provide lower costs.

I am certain of two things: one, healthcare costs present a significant burden on small businesses; and, two, inaction is not going to cut it.

This comprehensive small business healthcare package is a proven first step on free market principles and reducing government interference. By empowering small businesses with choice in competition, we can lower healthcare costs and increase access to high- quality care.

I hope the other side of the aisle gives this legislation the serious consideration it deserves. I often hear complaints that Republicans don't have a plan to fix healthcare costs. Here it is.

Let's reduce healthcare costs together and pass this package.

Madam Chair, I yield back the balance of my time.

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Ms. FOXX. Madam Chair, I rise in opposition to the amendment.

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Ms. FOXX. Madam Chair, I yield myself such time as I may consume.

Madam Chair, I am pleased my Democratic colleagues are finally expressing some concern for rising healthcare costs, particularly the burden those costs can impose on our Nation's seniors.

I remind my Democrat colleagues that Medicare is expected to become insolvent in 8 years. Increasing access to AHPs may be a lifesaving option for these seniors if Congress does not address Medicare's insolvency issues.

Unfortunately, for seniors, premiums of older Americans have risen drastically thanks to ObamaCare. In fact, health plans in New York just requested rate bumps of up to 40 percent.

The percentage of healthcare costs paid by a health insurance plan is known as the actuarial value, AV. On average, the AV of an individual employer-sponsored plan is 83 percent. When compared to the 70 percent AV of a silver plan and even the 80 percent AV of a gold plan on the Affordable Care Act exchanges, employer-sponsored plans provide affordable and more comprehensive coverage than ACA plans.

Employer-sponsored plans also have lower average deductibles: $1,763 for an individual employer-sponsored insurance plan compared with $5,155 for an individual ACA exchange silver plan.

I will repeat that: $1,763 on an employer-sponsored plan, for an individual employer-sponsored insurance plan, compared with $5,155 for an individual ACA exchange silver plan.

Individual employer-sponsored plans have lower average out-of-pocket costs than ACA exchange plans.

Madam Chair, $4,355 is the average maximum for an individual- sponsored insurance plan compared with an average maximum of $8,519 for an individual marketplace silver/ACA plan.

Clearly, our government-run and government-subsidized healthcare programs are facing incredible fiscal challenges. I urge my colleagues to be more concerned with the older adults enrolled in those programs than those enrolled in large group employer plans.

This amendment is an insincere attempt to delay implementation of commonsense policy that will increase health coverage options for all Americans. Instead, AHPs and the coverage options provided under this bill give older Americans more affordable coverage options.

Madam Chair, for these reasons, I urge my colleagues to vote ``no'' on the amendment and ``yes'' on the underlying bill, and I reserve the balance of my time.

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Ms. FOXX. Madam Chair, I believe I have the right to close, so I reserve the balance of my time.

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Ms. FOXX. Madam Chair, again, our colleagues continue to try to mislead the American people about what this bill does. These plans cannot cherry-pick, cannot exclude, and must cover preexisting conditions.

The opposition to this bill from our colleagues across the aisle, unfortunately, is to freedom of choice. The title of this bill is the CHOICE Arrangement Act, freedom of choice, which would allow people to stay out of the non-affordable care act, known as ObamaCare, but still have affordable health insurance.

This bill is about choice, freedom, and good healthcare coverage, and we should approve the bill without this amendment.

Madam Chair, I ask my colleagues to vote ``no'' on the amendment, and I yield back the balance of my time.

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Ms. FOXX. Madam Chair, I appreciate Mr. Molinaro's amendment. I support it, and I appreciate his working to make a good bill better.

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Ms. FOXX. Madam Chair, I move that the Committee do now rise.

The motion was agreed to.

Accordingly, the Committee rose; and the Speaker pro tempore (Mr. Self) having assumed the chair, Mrs. Wagner, Acting Chair of the Committee of the Whole House on the state of the Union, reported that that Committee, having had under consideration the bill (H.R. 3799) to amend the Internal Revenue Code of 1986 to provide for health reimbursement arrangements integrated with individual health insurance coverage, had come to no resolution thereon.

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