[Congressional Record Volume 164, Number 168 (Wednesday, October 10, 2018)]
[Senate]
[Page S6767]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
S.J. RES. 63
Ms. COLLINS. Mr. President, earlier today I voted in support of the
resolution offered by Senator Baldwin to roll back rules adopted in
August by the Trump administration that would allow individuals to
purchase so-called short-term, limited duration health insurance plans
for up to 1 year. The Obama administration had previously limited the
duration of such plans to 3 months. I rise now to explain why I chose
to support the resolution and, beyond that, to note the critical need
to take action to protect individuals who have no other affordable
health insurance option.
First, as proponents of the resolution have noted, short-term limited
duration plans do not provide protections for enrollees who suffer from
preexisting conditions. As I have often emphasized, it is essential
that individuals who suffer from preexisting conditions are covered. In
June of this year, I wrote to Attorney General Sessions urging him to
reconsider his decision not to defend provisions protecting individuals
with preexisting conditions in ongoing litigation challenging the
Affordable Care Act in Federal court in Texas. As I noted in my letter,
striking down these protections is no small matter:
``In 2016, the Kaiser Family Foundation estimated that 27 percent of
American adults under age 65 have pre-existing conditions that would
leave them uninsurable in the individual market. More recently, 57
percent of Americans responding to a poll said that they, or someone in
their household, suffers from a pre-existing condition. These numbers
include 590,000 Mainers, roughly 45 percent of the state's
population.''
Mr. President, I ask unanimous consent that my letter be printed in
the Record immediately following my remarks.
At the same time, we cannot ignore the fact that many individuals
lack an affordable health insurance option. For example, individuals
who earn more than 400 percent of the Federal poverty level--about
$49,000--are not entitled to the ACA's premium tax credits and must
shoulder the full cost of plans they purchase in the exchange. For a
64-year-old male living in Caribou, ME, this amounts to about $9,500
for the cheapest bronze plan--or nearly 20 percent of his income--far
too expensive. Based on the statistics I have already cited, there is a
better than even chance that this individual suffers from a preexisting
condition.
Individuals who lose their jobs and their healthcare coverage along
with it may also benefit from these plans. If someone is struggling to
pay rent or a mortgage and trying to keep up with other bills, a short-
term plan can help them achieve some measure of coverage without
compounding their financial worries. There is a role for these plans,
and I believe that we should work together to address these real-world
situations.
The underlying flaw in the Affordable Care Act is that it does not
provide affordable coverage, but I believe this flaw can be addressed
without jeopardizing protections for individuals with preexisting
conditions. In fact, earlier this year, I offered legislation with my
good friend Lamar Alexander that would have done exactly that. Our
bill, would have funded cost-sharing reductions, reformed the section
1332 waiver program, and provided $30 billion over 3 years to support
State reinsurance or invisible high-risk pools--methods proven to
reduce rates without discriminating against those with preexisting
conditions. Furthermore, healthcare experts at Oliver Wyman projected
that our bill would have lowered individual health insurance premiums
in the individual market by as much as 40 percent compared to what
people would otherwise pay, while also expanding coverage to an
additional 3.2 million individuals.
Unfortunately--and incredibly--when we tried to advance this
legislation, the Democratic leaders blocked it.
I remain deeply disappointed that members on the other side of the
aisle chose to derail legislation that could have lowered rates for the
18 million Americans who get their health insurance coverage from the
individual market. I am also disappointed that we again find ourselves
in an ``all or nothing, take it or leave it'' situation. I can only
hope that some of the energy now stoking partisan animosity will be
redirected soon toward finding healthcare solutions that work for all
Americans.
There being no objection, the material was ordered to be printed in
the Record, as follows:
U.S. Senate,
Washington, DC, June 27, 2018.
Re Texas v. United States, No. 4:18-cv-00167-O (N,D. Tex.).
Hon. Jeff Sessions,
Attorney General, U.S. Department of Justice,
Washington, DC.
Dear Attorney General Sessions: I am writing regarding the
Department's recent decision not to defend critical consumer
protections in ongoing litigation challenging the Affordable
Care Act (ACA) before the United States District Court for
the Northern District of Texas. I urge you to reconsider your
position and to defend these critical protections for
individuals with pre-existing conditions like asthma,
arthritis, cancer, diabetes, and heart disease.
In your June 7, 2018. letter to Speaker Ryan explaining the
Department's decision, you argue that the ACA's provisions
protecting people with pre-existing conditions are not
severable from the individual mandate, and cannot survive if
that provision is struck down as unconstitutional.
Respectfully, I disagree,
This is no small matter. In 2016, the Kaiser Family
Foundation estimated that 27 percent of American adults under
age 65 have pre-existing conditions that would leave them
uninsurable in the individual market. More recently, 57
percent of Americans responding to a poll said that they or
someone in their household suffers from a pre-existing
condition. These numbers include 590,000 Mainers, roughly 45
percent of the State's population.
I want to make clear that my concern is to protect
individuals with pre-existing conditions, not to defend the
individual mandate. Data show that the individual mandate is
highly regressive--80 percent of those who pay the fine make
less than $50,000 per year. The Supreme Court was right to
find that the individual mandate is not within the powers
granted to Congress under the Commerce Clause, and Congress
was right in eliminating the individual mandate's penalty
through the passage of the Tax Cuts and Jobs Act, P.L. 115-
97.
I do not dispute your contention that the individual
mandate will cease to be constitutional as a tax when it no
longer produces revenue, beginning in 2019. But it does not
follow that eliminating this penalty requires that important
consumer protections--such as provisions ensuring that
Americans with pre-existing conditions have access to health
insurance--must also fall. In my view, the severability
argument you outlined in your letter is focused on the wrong
period of time: severability should not be measured by
Congress's intent in 2010, when the Affordable Care Act was
passed into law, but rather by Congress's intent in 2017,
when Congress amended it through the Tax Cuts and lobs Act.
It is implausible that Congress intended protections for
those with pre-existing conditions to stand or fall together
with the individual mandate, when Congress affirmatively
eliminated the penalty while leaving these critical consumer
protections in place. If Congress had intended to eliminate
these consumer protections along with the individual mandate,
it could have done so. It chose not to.
Your letter states that it is ``rare'' for the Department
to forgo defense of duly enacted statutes. The Department
should do its duty and defend the important consumer
protections in the ACA, particularly those that ensure that
people with pre-existing conditions can secure insurance.
Sincerely,
Susan M. Collins,
United States Senator.
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