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Protecting Volunteer Firefighters and Emergency Responders Act of 2014

Floor Speech

Location: Washington, DC


Madam President, I rise to talk a little bit today about the Affordable Care Act and its benefit to America's women. I want to thank Senators Murphy, Boxer, and Whitehouse who have organized a few of us to come to the floor today. They will be on the floor later this afternoon.

But with so much discussion in the news about the recent completion of the March enrollment period--over 7 million people enrolled in the Affordable Care Act through the exchanges--I feel it is a good time to look at some of the benefits of the ACA, but also where there is more work to do.


The ACA is helping women and families in all circumstances, people who are working in low-income jobs and cannot afford insurance or people who are well off like me but need protection from the former practice of denying people for preexisting conditions.

Here are some ways the ACA works for women in particular. The law eliminates the ability of insurers to charge higher rates due to gender. Do you know that the unfair practice of charging women more, a gender rating system, was resulting in women in this country paying $1 billion more in annual premiums than men prior to the passing of the ACA. That is now illegal. Nearly 30 million women are receiving free coverage for comprehensive women's preventive services, including diabetes, cancer screening, contraception, and family planning. That is an important benefit for women.

Thanks to the Affordable Care Act, both women and men are free from lifetime annual limits on insurance coverage in 10 essential health benefits, like hospital visits and prescription drugs. It is not only about health, the ACA is also helping the financial health of women and families. Insurance companies under the ACA are now subject to a national rate review provision if they want to increase premiums higher than 10 percent. In 2012 alone, those rate reviews saved 6.8 million Americans an estimated $1.2 billion in premiums just in 1 year.

Insurance companies are also required to spend their premium dollars in a smart way. They have to spend at least 80 percent of premium dollars on patient care and quality improvement. That is at least 85 percent for large insurers. In 2013--just in calendar year 2013--8.5 million Americans received rebates averaging $100 per family because of this particular provision.

An estimated 3.1 million young Americans are able to stay on family policies--that is also affecting my family in a positive way--up until age 26. Families with incomes between 100 and 400 percent of the poverty line are eligible for tax credits. So as an example, a family of four in Virginia making $50,000 can access a health plan with premiums as low as $48 a month--health care for your family for less than your cell phone bill, for less than your cable bill. This is remarkable. Plans are required to limit family's out-of-pocket health care costs to less than $12,700 a year.

Like the Presiding Officer, I am a fixer; I am not a repealer. I think there are a lot of fixings that are still needed in the Affordable Care Act and, frankly, in our health care system generally, not just in the ACA. There is more that we can do to make the ACA work better for women and families.

Medicaid expansion is an example, a critical step that my State, Virginia, has yet to take. Without Medicaid expansion, uninsured women will face a coverage gap. With Medicaid expansion, over 400,000 Virginians will receive health care coverage. The ACA was designed to provide subsidies and tax credits to individuals and families who are making between 138 and 400 percent of the poverty level. But without Medicaid expansion, it is these families--working people--who remain uninsured.

We also have to work on some proposals to continue to improve affordability and choice for all consumers. The Presiding Officer has led an effort with others to put a number of positive reforms on the table. Let me mention a couple that I am very excited about: The Expanded Consumer Choice Act, S. 1729, would create a new tier of coverage, copper plans, and would give people shopping for health insurance more options to meet their family's needs.

Everybody's financial and health situation is different. So more options are great because that gives people more ability to meet their particular needs. That is a very important piece of legislation. The Presiding Officer played a leadership role in it.

I supported expanding the small business tax credit to incentivize more businesses to participate in the tax credit program, to make it easier to access and easier for the small businesses to use. One I am particularly focused on is that we need to close the family glitch loophole. That is not a technical term, the family glitch loophole. The Affordable Care Act says an employee is eligible for subsidized health coverage through the new exchanges if their employer does not offer ``affordable coverage'', which is defined as more than 9.5 percent of the employee's household income.

But the way the law is written, the affordability definition only applies to the price for the employee, not for the family coverage that an employer may offer. So if an employer does not offer affordable family coverage, there is no eligibility for a subsidy for that particular very important coverage, since most people's families are covered through their employer plan. I think that is an important thing we should fix.

So look. There are plenty of things to fix. There are plenty of things about our health care system outside of the Affordable Care Act that we ought to be focusing on and fixing. But repealing the Affordable Care Act, as some colleagues in this body and in the House continue to advocate, would mean turning back on all of these advances: Letting women be discriminated against because of gender, letting families be turned away because of preexisting conditions, saying to folks: Do not worry, you are not going to get a rebate; we can charge whatever premium we want.

The last thing we need to do is repeal the ACA or to go into the homes of nearly 10 million Americans who have received coverage and yank that coverage back from them and put them back out into the wilderness of the individual market where they were not protected before. What we need to do is to be embrace the good and embrace the fixes to make it better. That is what I certainly intend to do working with my colleagues.


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