Continuing Appropriationsby Senator Orrin G. Hatch
Posted on 2013-10-01
HATCH. Madam President, I would like to quickly begin by saying
that last night at the stroke of midnight the government faced its
first partial shutdown since 1996. There has been a lot of partisan
talk back and forth about who is to blame, but our constituents are
demanding action and rightfully expect us to resolve this situation. We
need to act swiftly to get the government up and running again.
Let me turn to another matter. Today's date is October 1, 2013. Since the passage of the so-called Affordable Care Act in 2009, millions of people have looked forward to this day, probably with more dread than anticipation. That is because today is the day the ObamaCare health insurance exchanges--where millions of Americans will be required by law to purchase health insurance--are open for business.
Perhaps I should say they are supposed to be open for business. President Obama, in his futile effort to sell his health care law to the American people, has been trying to paint a rosy picture about what will happen starting today. He has claimed that today will mark the first step in a process that will provide health coverage for millions of Americans. Sadly, now that we are here, the picture is much cloudier than the President would like to admit. Indeed, as the exchanges begin to go live, we have more questions than available answers. We know the exchanges have been met with significant delays--delays for large businesses, delays for small businesses, and even some delays for some of the State exchanges themselves. We know about other technical and logistical problems facing the exchanges. I will talk more about those in a few minutes.
What we don't know is what will happen to the average American trying to sign up and navigate his or her way through the ObamaCare exchanges. I wish to take a few minutes to talk about that today and, in doing so, I wish to talk about someone we met during the 2012 election campaign. Her name is Julia. We all remember Julia. She was the faceless character created by the Obama campaign to symbolize the cradle-to-the- grave support women would receive under President Obama's administration, including under ObamaCare. She was supposed to be the embodiment of President Obama's compassion for women and his opponent's lack thereof.
Unfortunately, President Obama's ``Life of Julia'' outline was short on some details, particularly when it came to Julia's efforts to obtain and keep health insurance through the ObamaCare exchanges. Today I will try to fill in some of those details. However, it will be difficult because, as I said, there is still much we don't know about how the exchanges are going to work.
As we follow Julia into the exchanges, the first question that comes to mind is: What brought Julia to the exchange in the first place? Is she one of the millions of Americans who will [[Page S7080]] end up losing employer-provided health insurance as a result of ObamaCare? Is she now a part-time worker after her employer had cut her hours to avoid the employer mandate? Perhaps she was laid off so her employer could keep their number of employees below the threshold required to be considered small business under the law.
In any event, Julia has come to the exchange looking for health insurance because that is what the law requires her to do. The next question is, Who will explain to Julia how she is to sign up for insurance under the exchange? What we know is that she will be assigned to a navigator, a person employed by a private organization tasked with assisting the uninsured in determining what type of coverage they qualify for. This person, who is not a government employee, will have access to her personal information, including her Social Security number and household income data.
Sadly, there is no telling whether this person will steal that information and use it for nefarious purposes. That is because the administration, in the drafting of the rules for the certification of navigators, cut corners on things such as training and background checks, putting consumers and patients at increased risk for fraud and identity theft.
I came to the floor to discuss this a couple of weeks ago. This was something that Members of Congress warned the administration about months ago. Sadly, our warnings have been ignored. So the bottom line for Julia is that before she even enters the exchange, an unqualified navigator or perhaps an imposter posing as a government counselor may have easy access to her private personal information, allowing them to steel her identify and create a nightmare for Julia to fix. Somehow, I do not think the authors of ObamaCare had this in mind when they created the navigator program.
The next question Julia will face is whether the exchange in her State will be ready. This, of course, will depend on where Julia lives. Not all of the State exchanges will be ready to launch today. Idaho, Minnesota, Oregon, Colorado, and the District of Columbia have already announced they will be delaying the launch of their exchanges.
The New York Times ran an article about the delays and glitches facing the exchanges this past weekend. According to the article, ``Many of the 16 directors of State-run exchanges are describing October as a soft launch period when Americans can start exploring their coverage options--but on Web sites that may be incomplete, vulnerable to glitches, and perhaps not ready for an onslaught of customers.'' In other words, Julia, depending on where she lives, may not even be able to sign up for insurance today because of the problems and delays--problems and delays many of the exchanges are now facing. But for the sake of discussion, let's assume Julia is able to sign on to the exchange and select a health insurance plan. Now that she has picked a plan, the question is, Will her personal information be secure? In order to sign up and purchase an insurance plan, Julia will have to hand over a virtual mountain of personal information, including her Social Security number, her tax return, and the like. All of this data will be entered into the Federal services data hub, a new information- sharing network that allows State and Federal agencies to verify her information.
The problem with the data hub is that it has not gone under any independent review to determine if the data that is entered is secure. The administration announced that the data hub had passed internal testing on September 10, a mere 3 weeks before it was set to go live. Sure, they may claim the data hub is operational and ready to go, but no independent watchdog such as the Government Accountability Office, for example, has had a chance to verify the security operations or make recommendations to better safeguard the privacy of consumers.
Absent an independent review, there is simply no way of knowing whether the exchanges have adequate safeguards in place to protect enrollee's personal information. For Julia, this means her personal and financial records may be at serious risk of becoming available to data thieves or just plain crooks. Obviously, this is not something the Obama campaign mentioned about Julia when they planned out her life for her.
The next question for Julia is whether she will be eligible for premium or cost-sharing subsidies. Depending on her income, Julia may be eligible for a tax credit designed to defray the cost of purchasing health insurance on the exchange. These credits are both advanceable and refundable, meaning that the IRS will pay them first and verify them later.
My gosh, what a system. This is what some have referred to as ``pay and chase.'' The problem with this method of determining the eligibility for the subsidies is that there is an increased likelihood that applicants will receive larger subsidies than they actually qualify for. For Julia, that could mean, if she receives a subsidy, she could end up owing the IRS money next tax season. That is not a highly advertised element of the exchanges or the subsidy program, but that is the reality people such as Julia will be facing.
Once Julia's plan and potential subsidies are in place, the question then becomes will she have the same quality of health care she had before that she was promised by the President. The Obama administration has made some misleading claims on this front. According to the White House, consumers and States with Federal exchanges will have an average of 53 plans to choose from. However, this number does not tell the full picture. According to an analysis undertaken by my staff on the Senate Finance Committee, 75 percent of States with Federal exchanges will have fewer plans available than the average touted by the White House.
In addition, there will be fewer provider networks in the exchanges, because in an effort to keep the cost of premiums down, insurers are reducing the number of doctors and hospitals covered by the plans in the exchanges. For example, there is only one insurer in the New Hampshire exchange. Their plan will exclude--get that word ``exclude''--10 of the 26 hospitals in the State.
Another example is Blue Cross Blue Shield of California. Their exchange plan also covers only 53 percent of the doctors and 74 percent of the hospitals that are included in their broadest nonexchange plan. According to the New York Times `` . . . many insurers are significantly limiting the choices of doctors and hospitals available to consumers. . . . from California to Illinois to New Hampshire and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.'' In short, this means that on the exchanges, Julia may very well have fewer choices for health care providers, potentially leaving her with limited access to quality care.
The final question Julia will face on the exchanges is perhaps the most important. I call it the final question, but I am sure there are others. Will Julia have to pay more for her health insurance under the exchanges than she did before this wonderful ``Affordable Care Act''? This, once again, depends on the specifics of Julia's situation. If, like most Americans, Julia previously had employer-provided health insurance, she will likely be paying more for her insurance on the exchange than she did through her employer. While some enrollees may be able to find cheaper insurance through the exchanges, the majority of Americans will pay more for health insurance under the exchanges than they do now.
The Manhattan Institute found that individual market premiums will increase 99 percent for men and 62 percent for women nationwide with the exchanges in place. The bottom line for Julia is that depending on her plan, she may very well end up paying more out of pocket for her health care than she did before ObamaCare was in place.
As you can see, the reality of Julia's experience on the health insurance exchanges does not resemble the pretty picture President Obama painted for her during the campaign. She will almost certainly face a number of difficulties just navigating the process. I do not blame President Obama. He was just told what to say by so-called experts on health care. Those experts have been wrong, wrong, wrong too many times.
[[Page S7081]] In the end, it will likely end up costing Julia more to buy insurance on her exchange. Of course, Julia is not a real person. Her problems are imaginary. However, the problems that real Americans, including people from my State of Utah, will be facing as the exchanges open today are very real, as I have described them. Put simply, these exchanges are going live today with too many unanswered questions and too many unsolved problems.
We should have never gotten to this point. The Obama administration should have acknowledged the ample warnings, signs and problems in the exchanges and heeded the many calls for delay. The administration was all too willing to delay the pain businesses will suffer under ObamaCare. Sadly, the American people got no such special treatment.
All I can say is that those of us in Congress will be watching these exchanges closely. The American people will be watching them too. They will be experiencing them, which may not be very pleasant, in light of the promises that were made to them. If what we have discussed or witnessed so far is any indication, I do not think we or they or Julia will like what we see.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.