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Employment Non-Discrimination Act of 2013--Motion to Proceed-- Continued

Floor Speech

Location: Washington, DC


Ms. MURKOWSKI. Madam President, I request permission to speak as in morning business.

The PRESIDING OFFICER. Without objection, it is so ordered.


Ms. MURKOWSKI. Madam President, this morning in the HELP Committee we had an opportunity to hear from the administrator of the health exchanges, Ms. Tavenner, who came before the committee to talk about where we are in the process now with the exchanges that have been set up through the Affordable Care Act. It was an opportunity, in the 5 minutes we have allocated to each of us, to pose questions and to speak to the situation in Alaska as it relates to the exchanges.

I come to the floor this afternoon because there was so much that I as one Senator had to say that you cannot possibly condense into a 5-minute exchange. But it did cause me to want to take a moment to speak about what is happening on the ground in the State of Alaska.

I think it is probably not an unfair assessment to say that most of the constituents I am hearing from are not supportive of the Affordable Care Act and have been very skeptical about what benefits may come to our State.

We are a high-cost State--high cost when it comes to health care and high cost when it comes to our insurance premiums. Right now we are No. 2 in the Nation in terms of the premiums that Alaskans pay. So as much as Alaskans might not like the Affordable Care Act, I hear very clearly their expressions of concern about making sure we are working actively and aggressively to reduce the cost of health care, to increase access to providers, and to increase access to insurance that is affordable.

But affordability is such a key factor in what we face. I had a chance to query Ms. Tavenner about the situation we are seeing in the State of Alaska right now with regard to enrollments within the exchange. The State of Alaska has opted not to have its own State exchange. They are part of the Federal exchange, an organization called Enroll Alaska which was established to provide for outreach, education, and enrollment of Alaskans into the federally facilitated marketplace.

I met with a representative from Enroll Alaska about 10 days or so ago. It was October 27, I believe. At that point in time, I was informed that there was one Alaskan who had been successfully enrolled. I met with the Alaska Native Tribal Health Consortium, United Way, and Enroll Alaska. They confirmed that no one had been successfully enrolled at that point in time.

Moving forward to yesterday. As of yesterday, it has been confirmed that Enroll Alaska, the entity that has been set up specifically to advance enrollment within the exchanges, has been able to enroll just three individuals and has not been able to confirm that anyone else in the State has been successfully enrolled. So as folks are talking in different parts of the country about what is happening, they are using numbers: several thousand, several hundred initially. But it has been not only surprisingly slow, astonishingly slow, to the point where people are saying: Is it even open?

Let me suggest that in Alaska things are not open right now. Enroll Alaska made a determination last week that--they had discovered that the FFM, the federally facilitated marketplace, was calculating the subsidy for Alaskans incorrectly, so due to this they suspended all their enrollments until this issue was resolved.

I brought this up with the Administrator in committee this morning. She acknowledged that, in fact, they had learned that perhaps the calculation was incorrect and that they were ``working on it.'' Well, in the meantime, you have folks who are interested in signing up, wanting to avail themselves of the Affordable Care Act, or one of the 5,600 who received a letter on Friday telling them that their insurance with Premera was going to be canceled at year end and being told: Well, you can, in fact, sign up for what Premera is going to offer. But in looking at this, they are learning that not only are their premiums going to increase, but in many cases they may double and the deductible will increase.

So they want to know: Am I going to get a better deal on the exchange? Our problem is not being able to access, to utilize, to gain the information, when the entity that has been set up to help facilitate this says they have suspended all enrollments until this issue is resolved, and further going into their letter that was received last week, they say: We asked for the Obama administration to pull the Web site down, rebuild it, and redeploy it.

Again, these are entities that are banking on the exchanges to work. They want to help facilitate it. Things are so confused and complicated and, quite honestly, a mess with the exchange up north that they are saying: We are not going to push further if we are not certain that the subsidy is being calculated correctly. It is not right to tell people that you can sign up in the State of Alaska right now.

So the exchanges, we recognize, are a mess. They need to be addressed. I think we have recognized that at some point in time they will be addressed, they will be corrected. The Administrator has indicated that between 1 a.m. and 5 a.m. eastern standard time the exchanges are going to be down so they can work on them, so they can be addressing these software glitches.

Well, 1 a.m. to 5 a.m. eastern standard time, for those of us who are living on the west coast, is about the time when the dinner dishes are done, the kids' homework is done, they are in bed, you can actually sit down at your computer and go on line and try to figure out what might be the best option for you on an exchange. But we are being told that the exchange is going to be down between the time that most Alaskans, and certainly Hawaiians, who are a 5 hour time difference instead of just the 4 hours Alaskans are, are not even going to be able to go on line to address it there.

That is one aspect of where we are with the exchanges and what that is going to mean if we are still going to continue with the deadlines that have been put in place by the administration in terms of when you have to sign up by, and when you may be assessed a fine or a penalty for failure to successfully enroll.

I mentioned that on Friday there were some 5,600 Alaskans who actually--excuse me, 5,360 Alaskans who received discontinuation notices from Premera. Premera is the largest health insurer in Alaska. This represents about 60 percent of the folks whom Premera insures within the State in terms of its individual members. So when you think about these folks who have now received their letters this weekend, recognize that the policies they have had for a period of time are not going to be available to them, they read in the news and they see on the evening news that the ability to get on line and to better understand what is going on with the exchange is not available to them because the exchanges are down while they are working on them here in Washington, DC, or wherever they are working on them, and that the entities, the navigator, the Enroll Alaska, those who have been put out there to help them navigate this process, are effectively saying: We cannot enroll you right now and we will not until there is a greater assurance that the system is up and running and working.

The Administrator has confirmed to us today that, well, we are working on it. But in the meantime, we still have these deadlines that folks are facing. The emails that have been coming to my office of late, though, have not been concerned with the exchanges themselves. What we have seen in the past few weeks has been a concern, an outcry, about what people will be expected to pay for their insurance once all aspects of the Affordable Care Act come into play. I mentioned already that Alaska faces the second highest premiums in the country. We are high for a lot of things, though. Our energy costs are some of the highest in the Nation. Our transportation costs are some of the highest in the Nation. Our food costs are some of the highest in the Nation. Our health care costs are some of the highest in the Nation. Now our premiums are going to be some of the highest in the Nation.

But we recognize that to live in Alaska--it is expensive. So when you look at the average wages of an Alaskan, they are a little bit higher than you might see in other parts of the country. That is a good thing. That is going to help you pay for your transportation, for your fuel, for your food. But when we are talking about any level of subsidy, this is a concern we are seeing around the State. The higher income levels are going to kick you out of being eligible for any level of subsidy. So we have got Alaskans who are trying to be diligent about their health care and the insurance, wanting to be able to provide for their family. They are trying to figure out: Well, where do I go?

I have got a letter here from a gentleman in Fairbanks. He runs a small knife and tool shop there. He has indicated that he was on Premera. He got the notice that they were not going to continue his coverage. The new policy with them, the least expensive he could get, was going to cost $1,260, up from $575. This is over a 60-percent increase he is going to experience. On top of that, his deductible is also going up from $5,000 to $6,000, an increase of about $2,700.

We got an e-mail from a woman who is in the 55-and-above age bracket, she said. She says: We make a decent income, so we will not be eligible for the subsidies. We have looked at this. But she said they are going to be seeing premiums of over $1,500 a month. She says: This is more than our mortgage. This is like taking on a second mortgage. And also in her situation, she says: My deductible has gone from $5,000 to $6,300. So deductibles are going up, premiums are escalating.

This woman said: You know, am I going to be in a situation where it is just going to be cheaper for me to pay the fine?

So I started going back through the binder I have utilized to collect the emails from Alaskans over the past few weeks here. A woman in Anchorage says her rates are going to increase 23 percent from last year. A woman from Talkeetna says: It is an increase of 47 percent with 1 fewer member in the family insured, a $10,000 deductible. But she is going up by 47 percent.

Out in Wasilla, this woman has indicated: I calculated we are expected to have an increased monthly premium of 224 percent. Our premiums will be exceeding our mortgage by more than $300 a month.

William in Anchorage says his health insurance has gone up 115 percent. Out in Anchorage, a woman is facing an increase in premiums of 45 percent. Again, she has indicated that she has been informed she is not going to be eligible for any level of subsidy.

The gentleman in this email, Anthony, out of Valdez, has said he is looking at an 85-percent increase in his premium, and that is just over the past 4 months when he started out. He is a single guy. He is 41 years old. He says: I am healthy. I have got money in my health savings account. But he has got a situation where he is going to be paying an 85-percent increase in his medical insurance premiums.

I go through these. These are not statistics. These are addressed to--I know this is not about you, Lisa Murkowski, but about representation for the people of Alaska.

Address this. They are asking me to help them out because they can't afford the Affordable Care Act.

I go through each of these, the folks in Petersburg, such as the 25-year-old male, nonsmoker, who had a $10,000 deductible. He was paying $102 per month. Now he will have to pay $281 with a $6,300 deductible; a 35-year-old male, nonsmoker, paying $159 per month now has to pay $340; a 63-year-old male, nonsmoker, paying $525 per month, as of January paying $827. We go through these stories. These stories are people we represent, whether it is Tom or Wenda or Teresa or Chris or Mark, they are saying I thought what was coming our way with health care reform was reform that was going to increase my access and decrease my costs.

Frustration with the Web site is one thing, and I am hopeful we will get on the other side of that very soon. The people of Alaska are done holding their breath on this. They are basically saying call me when you have it fixed.

What they are concerned about is they are going to get that call, we will be up against the end of the year, and they have already received their notices saying: We are not going to continue this coverage. They are worried about what happens if we do have a family medical emergency in early January and this all hasn't knitted together. I didn't get a very satisfactory answer from the Administrator this afternoon in response to that question.

I want to be able to have the right answers for these people, but I am extraordinarily concerned that as we address the issues with the Web site, the issues that the people in Alaska, who already face some of the highest costs for living in the nation, are going to be seeing increased insurance costs that will be out of their range, out of their ability to pay. The subsidies that would make a difference are not available to them.

We have a great deal of work to do in this Congress to address health care reform. Alaskans are asking what are we going to do to address the concerns in my family when I am trying to figure out how I knit it all together. They want to know how have we reformed health care. How have we made our costs lower and increased our access?

I suggest we have much more work to do. I stand ready to work with my colleagues on both sides of the aisle, and in the other body. We can fight and argue about whether the Web site and the exchanges are going to work or are going to fail on their own or whether we need to push deadlines out. This is only a part of what we are talking about.

We have to do a better job when it comes to reining in the cost of health care itself, and how we deal with the delivery system. We haven't addressed these issues or how we deal with rural markets, such as Alaska because we don't have a very attractive market--it certainly would help us if we could purchase our insurance across State lines--and how we work to make sure that when we have payment structures, the incentives are in the right place so we are encouraging efficiencies in our healthcare system.

I encourage us to not lose sight of what we have to do in resolving our issues to bring down the cost of health care.

I note that my colleague from Tennessee is on floor. I thank him for his leadership as the ranking member on the HELP Committee and the very thoughtful issues he raised this morning.

I yield the floor.


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