Health Care

Floor Speech

Mr. MURPHY. Madam President, last week the House of Representatives voted for the 53rd time to repeal or undermine all of--or aspects of--the Affordable Care Act. This is beginning to sound like a broken record. I was in the House of Representatives for a period of time, so I had the privilege to vote on 30 or 40 of those different pieces of legislation.

Republicans, of course, shut down the government a year ago because of their pique over the health care law. There are those who still have a desire to shut down the government again.

The other day one of our colleagues said they were hopeful that among the
Republicans priorities--should they increase their numbers in the Senate this fall--would be, once again, to repeal the health care bill. It is a story we have heard over and over despite an absolutely overwhelming array of data points which tell us only one story, and that is that the Affordable Care Act is working.

I don't deny that my colleagues can come down to the floor of the Senate or House and tell stories of people who have had poor interactions with the health care system. In fact, some people have had poor interactions with the Affordable Care Act. But those are stories. Data and information tell us something fundamentally different.

At the very least, I am glad that our Republican colleagues say they are still focused on this very vague idea of repeal and replace. But here is the problem: We have had 53 votes in the House of Representatives to repeal the law and not a single vote to replace it with anything of any substance. So it is one thing to just say you want to replace the health care law, and it is another to actually put together a plan to do it.

I wish to credit three of our Republican colleagues in the Senate. They are the only ones who have outlined an alternative. It is only an 8-page summary, but it is important for people to know what it would do. It would allow insurance companies to go back to their old ways of imposing annual limits on coverage, charge women more than men, provide little coverage for individuals with preexisting conditions, and effectively charge millions of Americans more by capping the tax exclusion for health care benefits. It is just an 8-page summary, but it is not pointing the way to a better health care reality for thousands of Americans.

Frankly, Republicans are not listening to what the American people are telling us. Over and over polls tell us that the American people don't want this law repealed. They want changes and so do Democrats and Republicans, but they don't want to repeal it.

A recent poll from Bloomberg, which I think is the most recent on this subject, found that two-thirds of Americans want the new law to either be left alone entirely or given the chance to work with small improvements. That is the reality of where people are in this country.

Why is there growing support for the law, and why is there diminishing support for repeal? Well, because 10.3 million uninsured Americans--as outlined by the New England Journal of Medicine--now have insurance thanks to this law. The uninsurance rate among 18-to 64-year-olds, which is our target audience, fell from 21 percent in September of 2013 to 16 percent in April of 2014. I will say that again. In a 6-month period of time, the uninsurance rate in this country dropped by 5 percentage points. That is an absolutely stunning achievement, and there is only one reason for it--the Affordable Care Act. The people who have this insurance are using it.

According to the Commonwealth Fund, nearly 2 in 3 newly covered consumers who went to the doctor or filled a prescription said they would not have been able to afford or access those services if it were not for the new coverage.

In a moment I will talk about what is happening when it comes to rates and health care expenditures. But the theory of the case is this: If you get people insurance, they are going to use it for preventable coverage rather than wait until their illness is so serious that they go to the emergency room, which would require much more expensive interventions. It is bad for them, and it is bad for the taxpayers and ratepayers as well.

We are seeing record low rates of increase in health care spending. Premiums--probably for the first time in my lifetime--are stable from year to year, and that is because the theory of the case is actually working out in practice. People are getting insurance, using preventive coverage, not getting as sick, and as a result health care is costing less.

The Kaiser Family Foundation said that in the 16 major cities they surveyed, families will pay less on average to enroll in a health care exchange in 2015 than they did in 2014. I don't mean they will have a premium increase in 2015. They will actually pay less. The cost of the plan in the exchange will be less in real dollars than they were in 2014.

I will talk about Connecticut in a second. We are an example of that trend line.

It is not just the exchange that has stabilized. Employer-sponsored coverage has stabilized as well.

I get it. There are outliers here. There are examples where health care insurers are still passing along big increases to employers. So the information I am giving is the average across the country. There are always outliers on the high side--but also on the low side.

Kaiser's study also says that the average premium for family coverage through employer-sponsored coverage care increased by 3 percent in 2014, tying 2010 for the slowest rate of increase on record for employer-sponsored premiums. That is the
reality of what is happening. More people have coverage, and the growth of health care spending is at a historic low. Medicare's 2019 budget is about $95 billion less than it was projected to be 4 years ago.

We are saving $100 billion a year on just Medicare alone, and that is on top of all the money that is being saved through relatively low rates of increase on exchanges. That $100 billion--just to give you some perspective, because I know it is hard to get your head wrapped around what it means to save $100 billion--is greater than the total amount of money we spend as a country on unemployment insurance, welfare programs, and Amtrak combined. It is a lot of money to save as a government.

The quality is getting better too--because that is what this is really about. It is about delivering a better quality of life and a longer life expectancy to consumers. Hospital readmissions--you go in for a surgery, you go back home, and then you have to come back in--are dropping like a stone. Hospital-acquired infections--one of the leading causes of death in this country--are dropping precipitously. Costs are getting lower, more people have insurance, and the quality is getting better.

Here is the Connecticut story. We have dropped the overall insurance rate in the country by about 25 percent--unbelievable news over the course of 6 months. Connecticut is double that. We cut our insurance rate in half in Connecticut. We are a small State with 3.5 million people and had about 285,000 uninsured individuals. Connecticut has taken the 250,000 people and put them into either the Medicaid expansion or the private health care exchanges and a little more than half of those people were previously uninsured.

A lot of my friends on the other side of the aisle say: That is great, but those numbers are illusory because over time people aren't going to pay those premiums; they are just going to drop off the plans. Well, here is Connecticut's experience: 80,000 people signed up for private plans on the health care exchanges, and 78,000 are still paying their premiums about 4 to 6 months in. Everybody is still paying their premiums. And we know why. Because it is largely affordable and because people need that health care.

People love the exchange and their interaction with the new plan in Connecticut. Tomorrow the Connecticut exchange will release data showing that about 83 percent of people who went through the exchange to buy private health care were satisfied with their experience. Of those who went through the program to get Medicaid expansion, over 90 percent were satisfied as well.

We are saving money. Medicaid in Connecticut is 2 percent lower this year than it was last year. We have cut our uninsured rate by half. We are spending less as a government. People are satisfied with it. Rates are stable.

Here are the three plans in Connecticut that submitted rate increases on the exchange, and, at least for our biggest insurer, they are also going to be the rates of increase outside the exchange. Our biggest insurer, Anthem, which is our Blue Cross Blue Shield: Rates are going down by an average of .1 percent. ConnectiCare is raising its rates by 3.1 percent. Our other insurer on the exchange, Healthy Connecticut, is reducing its rates by 8.5 percent.

Republicans have kind of moved the ball on this a little bit. They now say the way we judge a successful ACA is that health care rates go down from year to year--not that we are controlling the rate of increase but that the Affordable Care Act isn't succeeding unless rates are going down. I heard my colleague from Wyoming make this claim about Connecticut a few weeks ago in which I was talking about rates going up by 1 percent and the claim was made: Well, that is not good enough.

People have been used to 10-, 15-, Ð20-, 30-percent increases in premiums in Connecticut. They are pretty happy with a .1-percent reduction. Frankly, they are pretty happy with a 3.1-percent increase. That is because of the Affordable Care Act.

So there is all the data. There it is. That is just the tip of the iceberg. Costs are going down, more people have insurance, and quality is getting better. It seems as though we open the paper every week and there is some new piece of good information.

I get it. This needs to be better. This needs to be perfected. The law still has warts. The Senator sitting in the Presiding Officer's chair is leading the fight to make this law work even better for people. I look forward to being involved in that conversation. But that is where the conversation should be--perfection, not repeal. And we are reminded again that if Republicans were to win control of this body, at the top of their agenda would be this same old fight--53 different votes in the House of Representatives over the past several years--to repeal the law without any real tangible plan to improve it.

This morning I met with a good friend of mine whom I have spoken about on this floor before, but because she is here in town I wish to speak about her one more time, and that is Betty Berger. Betty is here with the American Cancer Society. We will see them all over the Hill today in their light-blue shirts. Betty is arguing for a lot of things to happen here, with research funding increases at the top of the list, but she is also here to make a very personal case to protect the Affordable Care Act.

Years ago Betty's family was faced with a terrible choice when her son was diagnosed with cancer. In the 1-week period of time her family didn't have health care insurance--her husband had one job and he switched jobs--in the 1-week period of time between when he went from the first job to the second job, the diagnosis of cancer came down and it became a preexisting condition not covered by the new employer. Betty's family was left to pay for their son's cancer treatments on their own. They eventually lost their home, they lost their savings, and they had to declare bankruptcy.

Unfortunately, Betty's story is pretty familiar. Half of all bankruptcies in this country are due to stories very similar to Betty's. A mistimed illness at a point where the family didn't have insurance results in them losing everything.

The reality is that the Affordable Care Act makes sure that Betty's story never has to be told again, that no family ever has to make the choice between declaring bankruptcy, saving their home, protecting their savings, or choosing to care for a loved one.

Let's talk about making this bill better, but let's recognize that the data, the numbers tell only one story; that is, the Affordable Care Act is working.

I yield the floor.

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