Sen. Alexander Issues Speech on Health Insurance Premium

WASHINGTON, Dec. 7 -- The office of Sen. Lamar Alexander, R-Tennessee, issued the following floor speech:

"Mr. President, let me tell you a story.

"Yesterday I was in Nashville and I went to Chick-Fil-A on Charlotte Avenue at about 2:00 p.m. in the afternoon and I ordered six chicken nuggets, some mac and cheese and some waffle fries.

"And I was about to leave, and a lady walked up to me and said, "Senator, thank you for what you're doing to help me with insurance."

"I said, "Well, what do you mean?"

"She said, "My name is Marty Parish. I'm a self-employed farmer. And the year before Obamacare, started, my monthly insurance premium was $300. Next year it's $1,300, and it's very hard for me to afford."

"I said, "I guess you're one of those Americans who work hard and you don't get any government subsidy to help you pay for your health insurance.

"She said, "That's exactly right. I have to pay for the whole thing myself."

"I said, "Well, Marty Parish, I've got a Christmas present for you."

"If Congress can pass by the end of the month legislation that would lower your premiums in the year 2019 by 18 percent-- that's according to Avalere-- which is one of the leading health consulting firms in the country, which made the announcement yesterday. So if your premiums are $1,300 a month, that's a couple thousand dollars less you'll have to pay. That's still way too high. Or if the Senate and the House agree on a tax bill that removes the individual mandate and the Congressional Budget Office is right, that will put upward pressure on those same rates but only a maximum of 10 percent.

"So you're still going to get an 8 percent decrease in your rates in 2019, and that's about $1,000 in your pocket. Those are real dollars.

"Marty Parish, has seen, if she's like the average Tennesseans, her premiums rise 178 percent over the last five years and she has seen them go up an average this year of 58 percent more.

"So a very good Christmas present for Marty Parish, and men and women like her across this country, would be for this Congress, before the end of the month, to pass what we call the Alexander-Murray and the Collins-Nelson legislation which will lower premiums by 18 percent.

"More than that, that Christmas present, which is all wrapped up in a nice package and sitting in the White House waiting for anybody who wants to consider it, according to the Congressional Budget Office, it will not just reduce premiums, it will reduce the amount of federal tax dollars that go to pay for Obamacare subsidies. Because if the premiums are lower, the subsidies are going to be lower. And if the premiums are lower and the subsidies are lower, the federal debt is going to be lower.

"So here you've got for my friend who I met yesterday at Chick-Fil-A, an 18 percent on average reduction in her 2019 insurance premiums, less of her tax dollars going to pay for Affordable Care Act subsidies and less federal debt for her and her family.

"And because the president has said he won't put up with it and because Senator Murray, the Democrat who is ranking on the HELP committee and I agree on this, there will be no bailout of insurance companies in these proposals.

"Now who would support something like this?

"Well, President Trump supports it. He told us that last week. In fact, he asked for it. He called me specifically a few weeks ago and said I don't want people hurt in the next two years while we're still debating what to doing long term about health insurance. Why don't you work with Senator Murray and see if you can put together a bill that keeps people from being hurt, that stabilizes the market so premiums don't go up so much.

"I said, Mr. President, we're already working on that. I've talked with him a half dozen times about that. I met with him at the White House, talked with him the other day. He has said publicly and privately that he supports the Alexander-Murray legislation and he supports the legislation supported by Senator Collins -- a Republican -- and Senator Nelson -- a Democrat. So that's one, a pretty big one.

"Senator McConnell, the Republican Majority Leader, he supports it. He said that publicly and privately he supports both of them.

"Senator Schumer, who is the Democratic leader, said two or three weeks ago that every single Democrat in the Senate would vote for Alexander-Murray and that it had 60 votes and Senator McConnell should put it on the floor as soon as possible and he thought it would pass with a lot of votes.

"The bill hasn't changed except in one way. It's gotten better from the point of view not just of Democrats, but of Republicans. The idea that Senator Collins and Senator Nelson have come up with, the idea of creating an invisible risk pool, or a reinsurance fund, or a stability fund to allow states to do that would permit those states to do what Maine has done and what Alaska has done and what Minnesota is trying to do.

"And it's this: Alaska created such a fund, they call it a reinsurance fund. Maine calls it invisible risk pool. They put money in to take care of the very sick people in the individual market in Alaska. And once they did that, they're able to lower rates for everybody else by 20 percent.

"Now, Mr. President, that's in addition to the 18 percent that Avalere talked about that's in our bill in addition to that. Maine did a similar thing in a little different way in their state.

"And who else likes this idea?

"Well, Republicans in the House of Representatives like it. They, of course, are a full partner in this exercise. They'll have to consider it and decide whether they're for it. I think it would be pretty easy for them to support Collins-Nelson because it was in the repeal and replace bill for the Affordable Care Act that the house passed and voted for.

"In fact, the so-called compromise by Representative Meadows and Representative MacArthur included an invisible risk pool of up to $15 billion to allow states -- this is pretty good Republican philosophy -- to allow states to make their own decision about doing this, and decide as Maine did, as Alaska did, as Minnesota is trying to do, to say we're going to create this fund and we're going to take care of the very sick people who use most of the money we spend on healthcare--and when we do that we lower the rates for everybody else.

"And in the Alaska case, because it lowered the rates for everyone else, again, premiums went down, subsidies went down, and Alaska was able to pay for 85 percent of its reinsurance fund without any new federal dollars going to Alaska.

"So that's what happens when you allow states to use their own good judgment. And that's why Senator Collins, a Republican, and Senator Bill Nelson, a Democrat, have suggested it over here.

"The other thing that the House of Representatives did in its Republican repeal and replace bill is it continued the cost sharing payments for two years. Now cost sharing payments are payments that the federal government makes so that low-income Americans won't have to make them when they buy their insurance.

"It makes them to the insurance companies, but the benefit is supposed to go to the individual consumer or to the taxpayer from the lower rates.

"The House of Representatives in its repeal and replace bill understood just as the distinguished presiding officer, Senator Cassidy, and Senator Graham and Senator Johnson understood, is if they are able to repeal and replace Obamacare or make any significant major changes to it, it will take a couple of years to get into place and you don't want people to be hurt in the meantime.

"That's exactly what the president said to me when he called me a few weeks ago. He said I don't want people hurt during this two year period. So the House of Representatives put in their repeal and replace bill two years of cost sharing payments. Not to bail out insurance companies, it doesn't bail out insurance companies, the benefits go to individuals. They wanted to make sure the rates stayed down and people didn't get hurt.

"So the proposals we're talking about-- the Christmas present I talked about to the young farmer in Tennessee--both have fundamentally been a part of the House repeal and replace bill, which is why while I can't speak for the House of Representatives, what they do is there business, I believe that as they study Alexander-Murray and Collins-Nelson, they'll find they like it because they've already voted for it once this year.

"The House of Representatives created the invisible risk pool. That was a real breakthrough in their ability to pass a bill.

"And then, second, they wanted to make sure that during this interim, between the time that we tried to change the individual insurance market in this country, that people aren't hurt.

"So I've come to the floor today, Mr. President, just to say there's a lot going on today and next week. It involves defense spending. It involves the amount of money we can spend for the next year in our government. It involves a tax bill the Senator from Georgia has just talked about it, a historic tax bill that I hope we can pass.

"But there's also an opportunity for every single one of us to give a Christmas present to the nine million Americans who have been hammered by skyrocketing insurance premiums. We don't need to debate whose fault that is.

"I don't need to say it's all the fault of the Affordable Care Act. Democrats don't need to say its President Trump sabotaging it. Let's forget that for a moment.

"Let's just say the fact of the matter is that in Tennessee, premiums will go up in 2018 by 58 percent and they're going to go up more the next year if we don't do something about it.

"And we have two bills here that will say to the self-employed farmer in Tennessee or Iowa or Louisiana, or the songwriter or businesswoman, we hear you, we know you can't afford these rates, and if you're paying $1,300 for two of you, that's way too high, and we can begin to take those rates down. According to Avalere, 18 percent in 2019.

"According to Congressional Budget Office, if we don't take this action to pass the cost sharing payments, rates will go up 25 percent.

"So if the present that we've got includes lower premiums, less debt, less money going to Obamacare subsidies, and it doesn't bailout insurance companies, why should we not pass that? I think we will pass it.

"I think it will be pretty hard to explain-- I don't want to run into Marty Parish between Christmas and New Year's and say, I'm sorry about that Christmas present. I could have lowered your rates 18 percent, I could have done it in a way that didn't run up your federal debt - but I just couldn't get it done.

"She would say, isn't the president for it? I would say yes. Hadn't the House already voted for it once? I would say yes. Didn't the Democratic leader say that the Democrats are for it? I would say yes. And then she would ask, why didn't it pass?

"I would have a hard time coming up with that answer.

"I hope over the next few days we are able to do what the Democrats and Republicans have suggested and what 12 Democratic Senators and 12 Republican Senators have offered to the Senate in Alexander-Murray, and what Senator Collins and Senator Nelson have offered in Collins-Nelson.

"Both ideas are very much like two provisions already voted on this year by the House of Representatives. Let's realize it's the Christmas season and a very nice Christmas present for nine million hardworking Americans who don't get any government help to pay for their skyrocketing health insurance premiums would be these bills into law so they can count on insurance premiums in 2019 that are on average 18 percent lower.

"I thank the President. I yield. The floor."