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Public Statements

Making Continuing Appropriations for Fiscal Year 2014

Floor Speech

Location: Washington, DC


Mr. FRANKEN. Madam President, I wish to talk a little bit about health reform.

Soon over 1 million Minnesotans will have the opportunity to buy their health insurance on MNsure, Minnesota's health insurance marketplace.

Minnesotans who buy their own insurance in the health insurance marketplace, including Franni and me, will have the opportunity to compare plans and choose the coverage that works best for their families.

Not only will MNsure make the options clearer and more accessible, but the health care reform law is also making sure that Minnesotans feel secure in their health care coverage. That is because insurers can no longer cap the amount of benefits you can get over the course of your lifetime, they can't drop you if you get sick, and they cannot discriminate against you based on a preexisting condition.

There is a lot in the health care reform law that a lot of Americans don't even know about yet. For example, I championed a couple of key provisions that are improving the quality and the value of health care coverage that we all rely on. I authored a provision requiring health insurers to provide a good value for your premium dollars, and I helped to establish a national fund for health care prevention.

Why is this especially important right now? Because the House of Representatives passed a continuing resolution to fund the budget that also defunds the health care reform law. So before we decide on that measure, I wish to make sure we remember what is in this important law.

First, we are requiring insurance companies to give their customers good value for their premium dollars. One thing many Americans don't know is that millions of Americans are getting rebates from their health insurance companies when those companies don't provide that value. I wrote the provision that does this. It has the catchy name ``medical loss ratio,'' which is sometimes called the slightly more catchy 80/20 rule. Because of my medical loss ratio provision, which is based on a Minnesota State law, health insurance companies must spend at least 80 percent of their premiums on actual health care--not on administrative costs, not on marketing, not on profits, not on CEO salaries. If insurance companies don't meet the 80 percent for individual and small group markets or the 85 percent for large group policies, then the insurance company has to rebate the difference.

The fact is my provision is working. Last year, nearly 13 million Americans benefited from checks from their insurers, and this year about 8 1/2 million Americans benefited from rebates that were sent out in July of this year. That is a good thing--fewer people getting rebates. This year is a good thing because that means insurers were saving you money on the front end instead of rebating you the money on the back end.

That is part of why health care costs have risen in the last 3 years at a slower rate than at any time in the last 50 years. Is that entirely due to the Affordable Care Act? No. But in contrast with what is being put out here and there, we are not seeing the cost of health care spike. In fact, the opposite is true.

I will say it again: Health care costs have gone up less--have risen at a slower rate--in the last 3 years than at any other time in the last 50 years. The bottom line is that my provision is making insurance companies more efficient at helping keep health care costs in check for people, and I am very proud of that.

People also don't know how much we did to improve access to preventive health care in health care reform. Anyone who has ever gotten a flu shot knows an ounce of prevention is worth a pound of cure. Along with former Republican Senator Dick Lugar of Indiana, I fought to get the National Diabetes Prevention Program included in the health care reform law, and it exemplifies the benefit of this kind of reform to our health care system.

This program, which was piloted in St. Paul, MN, by the Centers for Disease Control and Prevention, involves structured nutrition classes and exercise at community-based organizations such as the YMCA. It has been shown to reduce the likelihood that someone with prediabetes will be diagnosed with full-blown type 2 diabetes by nearly 60 percent. That is pretty good.

The program doesn't just make people healthier, it also saves everyone money. The Diabetes Prevention Program costs about $400 per participant, as compared to treating type 2 diabetes which costs more than $7,000 every single year. That is why United Health, the largest private insurer in the country--that also happens to be headquartered in Minnesota--is already providing the program to its beneficiaries. In fact, the CEO of United Health told me that for every $1 they invest in the Diabetes Prevention Program, they save $4 on health care costs later on.

This homegrown program is funded out of the Prevention and Public Health Fund, which is another program in the health care reform law that is designed to invest in evidence-based health care prevention in communities across the country. In Minnesota, the Prevention and Public Health Fund has supported tobacco cessation programs, it has helped to prevent infectious diseases, and it has expanded our desperately needed primary care workforce. Preventing disease while saving money--preventing disease while saving money--is smart reform.

We did a lot of other things in the health care law too. I worked with several of my colleagues to develop a value index which will change the way Medicare pays physicians to take into account the quality of the care the doctor provides--reward quality instead of quantity.

My home State of Minnesota is the leader in delivering high-value health care at a relatively low cost. Yet, traditionally, we have been woefully underreimbursed for it. For example, Texas gets reimbursed almost 50 percent more, on average, per Medicare patient than Minnesota.

This isn't about pitting Minnesota against Texas or Florida. It is about rewarding those States to become more like Minnesota. Imagine if we brought Medicare expenditures down by 30 percent around the country. It would bring enormous benefits not just to Minnesota but across the country because it will bring down the cost of health care delivery nationwide.

I am working very hard to make sure health care reform works for Minnesota. The implementation of any major reform is going to be a challenge, but I don't think Minnesotans or Americans want us to keep looking backward. They want us to move forward and to implement the law as best we can. They do not want the House of Representatives to waste precious time and vote to repeal the law--for the 42nd time.

The fact is, if the law is repealed, a lot of things Americans like will be taken away from them. Americans don't want seniors' prescription drugs to go back up. They do not want children with preexisting conditions to be kicked off their health plans. Those are just a couple of things that would happen if the law were repealed.

Last year, more than 54,000 seniors in Minnesota got a 50-percent discount on their covered brand-name prescription drugs when they hit the doughnut hole in Medicare Part D. This discount resulted in an average savings of $644 per person and a total

savings of more than $34 million in Minnesota alone and we are not done. By 2020, the doughnut hole will be closed completely. But the closing of the doughnut hole would go away if we repealed the health care reform law.

Thanks to a provision that allows young adults up to the age of 26 to stay on their parents' health insurance, 35,000 young people in Minnesota and more than 3 million young people nationally were able to keep their health care coverage. Those young people would be kicked off of their coverage if we repealed the health care law.

Health care reform also ended insurance companies setting lifetime limits on the amount of care an individual can receive. So if you or a loved one gets sick, you can never be told by your health insurer: That is it, no more coverage for you. Go ahead and file for bankruptcy. Guess what. If Congress repealed the health care reform law, that would go away too.

I am not saying the law is perfect. But if there are problems, the American people want us to work together to fix them, not refight old fights. That is what I hope to do--move forward by implementing the law, making any changes we need to make along the way.

Millions of Americans across the country are already experiencing the benefits of this law. I urge my colleagues to join me in supporting the implementation of the important provisions I have outlined.

I yield the floor.


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