Providing for Congressional Disapproval of a Rule Submitted By the National Labor Relations Boardby Senator Christopher Murphy
Posted on 2015-03-04
MURPHY. I ask unanimous consent that the order for the quorum
call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. MURPHY. I ask unanimous consent to speak for up to 15 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
Affordable Care Act Mr. MURPHY. Mr. President, today is a make-or-break day for millions of Americans who are better off because of the Affordable Care Act. As we speak, the Supreme Court is hearing [[Page S1271]] oral arguments on a case known as King v. Burwell to decide whether Americans have access to health insurance subsidies through their State exchanges or whether opponents of the law--the very same people who continued to push for over 40 votes in the House of Representatives to repeal or undermine the Affordable Care Act, the same people who shut down this government last year because of their obsession with repealing the law--will win out with a paper-thin legal argument. It would not only be a devastating blow to millions of Americans who are currently receiving subsidies for their insurance, but it would destroy the individual health insurance markets in those States and would represent an incredible power grab by the Supreme Court that would undercut the impartiality of that Court.
At the heart of this case is the Affordable Care Act, both the text and congressional intent. The question is, Did Congress intend to allow all Americans to benefit from affordable quality coverage across this country, whether they are in a State exchange or a Federal exchange? To answer that question, you don't have to leaf through many pages of the Affordable Care Act; you can stop at the very first title, which is on the very first page. The first section reads: ``Title I. Quality, Affordable Health Care for All Americans.'' All Americans--not some Americans who live in a State that set up an insurance exchange like AccessHealthCT, but all Americans.
Before I go into a little bit of detail on this case, I wish to speak about this little boy. His name is Devin, and I was fortunate to meet with him just this last week. He is 8 years old. This picture is from maybe 1 or 2 years ago during one of his first trips to Washington. He lives with his parents and younger sister in western Connecticut.
Devin is one of about 20,000 people with hemophilia in this country. To stay healthy and to support his active life, which includes baseball, karate, and snowboarding, Devin has to take an injection every other day. The injections cost about $4,000 per dose, about $50,000 per month. Despite the challenges his disease presents, Devin was all smiles when we talked about what he liked to do, about school, and about how much you need to walk when you come to the Capitol to lobby, as Devin has the past couple of years.
The benefits of the Affordable Care Act are very clear for Devin and his family. His family will never have to worry about annual or lifetime limits on his health care. He won't have to worry, nor will his parents have to worry about him being denied insurance over the course of his life just because of his condition.
It isn't hyperbole to say that an adverse decision by the Court would be life-threatening for Americans like Devin who rely on these new insurance protections.
Obviously, Devin and his family aren't the only ones to benefit from this law. Just last week HHS released the final report on enrollment and showed that 8.84 million people have signed up for coverage in healthcare.gov States--Federal exchange States. An additional 2.8 million signed up through State-based marketplaces, such as in Connecticut, for a total of 11.6 million people who have private health care insurance because of the Affordable Care Act and its subsidies which are being spread across the country. By the way, add another 10 million people who are on Medicare because of the Affordable Care Act and we see why the uninsurance rate in this country is spiraling downward.
The tax credits the law provided for people making less than 400 percent of poverty are critical to the success of this law because they make coverage affordable. According to an HHS report from earlier this month, nearly 8 in 10 consumers are getting coverage for $100 or less after these tax credits.
In my home State, we had a goal to enroll 70,000 new individuals through private insurance and Medicaid, and we hit over 200,000. But the good news doesn't stop there. According to a new report since the ACA was passed, 9.4 million people with Medicare saved $15 billion on prescription drugs, an average of about $1,600 per beneficiary. For preventive care, there are 39 million people with Medicare and Medicare Advantage who took advantage of at least one preventive service with no cost sharing in 2014. That is why the Times, USA TODAY, the Washington Post, the Wall Street Journal, and Politico are saying the simple message that now, more than ever, Americans understand the Affordable Care Act is working.
Yet despite the fact it is working, opponents of the law are continuing to try to tear it down. So let us be clear about what a negative decision from the Supreme Court would mean. It would mean that anywhere from 8 to 10 million Americans would lose their health care coverage and another 5 million children could lose their coverage as well.
Subsidies are important because the law envisions three interlocking sets of provisions: insurance protections to fix the abuses within our old system, the individual coverage provision to ensure we have a viable risk pool inside insurance, and, finally, tax credits to help people purchase insurance. Subsidies are the glue that holds all of that together.
That is why a victory for the plaintiffs would be devastating for everyone, not just those who receive subsidies in healthcare.gov. The individual markets in these States would fall into a death spiral if this law was overturned. If subsidies disappear, then people can't buy coverage. If they can't buy coverage, then the law says the individual mandate in those States has to disappear. If the individual mandate disappears, then healthy people don't buy coverage and the insurance protections, such as the ban on discrimination against people with preexisting conditions, simply cannot work. The insurance reforms either vanish or rates spike to catastrophic levels for people who decide to get coverage.
Don't take my word for it. The American Hospital Association warns that ``many more people will get sick, go bankrupt or die''--or die--if the Court finds for the challengers. The health insurance industry says taking away the tax credits would ``create severely dysfunctional insurance markets'' in nearly three dozen States.
Frankly, we don't even need to talk about the detrimental effects in these States because this is about congressional intent, and the intent is clear. Sometimes when we try to figure out intent we have trouble because the people who wrote the law aren't here any longer or they have passed away. Well, there are hundreds of people who voted for this law who are still in Congress. All we have to do is ask them. There is not a single person who voted for this law who will tell us they wrote the law in a way that would result in the denial of subsidies to people who are getting health care through the State exchanges.
The plaintiffs say this is a carrot-and-stick approach; that the intention was to deny subsidies to people in States that didn't set up their own exchange as a way to force them to set up their own exchange. Well, there is not a single Member of Congress who voted for the law who says that is how it was designed.
Frankly, we don't even need to get to intent. We don't even need to survey all the people who voted for it. We just have to look at the law itself. The plaintiffs focus on one line that says that subsidies shall go to State exchanges, but they ignore another line in the law that says if States don't establish their own exchange, then the Federal exchange becomes the State exchange. That is just as plainly written as the one line that is the foundation of the case.
But the entire structure of the law relies on States that don't set up their own exchanges getting Federal subsidies. Why would we even set up a Federal exchange if there weren't going to be subsidies associated with it? There would be no customers in the exchange if the intent of the law was to deny subsidies to people who bought into Federal exchanges. We wouldn't even have a Federal exchange.
Second, we would have established the insurance protections in a fundamentally different way. We would have said insurance protections apply to States that set up State exchanges and they do not apply to States that don't establish State exchanges, because again, as I said before, without those subsidies, the insurance protections simply don't work from an actuarial basis.
[[Page S1272]] But that is not how the Affordable Care Act is written. The act says the insurance protections apply nationally, regardless of whether it is a State or Federal exchange. Why is that? Because subsidies were going to flow to a State no matter what kind of exchange they established.
Lastly, when Congress has historically engaged in this kind of carrot-and-stick endeavor with States, we make it totally transparent. We lay out in the statute here is what we expect you to do, and if you don't do it, here are the consequences. We don't hide the consequences to be derived at through a Supreme Court case, as is the stated belief of the petitioners in this case.
Lastly, the plaintiffs say: Well, don't worry about it. If the Supreme Court overturns this, we will just fix it. Congress can just come back and fix that line. Well, Congress isn't fixing anything these days. We can't even keep the Department of Homeland Security open and operating. Republicans have had 6 years to provide an alternative to the Affordable Care Act. We haven't seen anything more than a memo or a press release. If the subsidies disappear, they are not coming back. Congress is not fixing this problem, and 10 million Americans will lose their coverage.
I want to finish by talking about one more story, and this is the story of a woman who lives in Westport, CT. She works as a massage therapist, but since she is self-employed she was uninsured and couldn't provide insurance for herself. Last year, when the Affordable Care Act was implemented, she found out she qualified for coverage in Connecticut and that coverage finally gave her the opportunity to see a doctor. She wrote the President and said: The cancer has been detected at a very early stage, which, with a 98 percent survival rate, has saved my life. Moreover, the cost of this screening and minor procedure will be far less than the cost of treating a more developed cancer. Thank you, Mr. President, for assuring the passage of this critical legislation. You have profoundly improved the quality of my life.
The facts are clear. The Affordable Care Act is working. The intent of Congress is clear: to provide subsidies to all Americans, no matter their ZIP Code. The language of the bill is clear. That leaves us with one conclusion. If the Supreme Court overturns this portion of the law, it will be a plain and simple political power play. It will usher in a new era in which the Supreme Court becomes just another legislative body. They will be calling the authors of this bill liars and replacing the authors' stated intent with their own political judgment.
For the sake of Devin and Ann and millions of others who would benefit from the Affordable Care Act and for the sake of American democracy, I hope they uphold the law.
I yield the floor.
The PRESIDING OFFICER. The Senator from Florida.