WASHIGNTON—U.S. Senator Chris Murphy (D-Conn), a member of the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee, on Monday delivered a speech on the U.S. Senate floor on the importance of protecting pre-existing conditions and the Trump administration’s continued efforts to sabotage the American health care system. Next week, the U.S. Senate will vote on a Congressional Review Act joint resolution to roll back changes by the Trump administration to the Affordable Care Act’s Section 1332 waiver policy.
“I get that the country and this Congress are rightly consumed with the ongoing scandal surrounding the impeachment inquiry and the recent, heartbreaking unconscionable events in Syria. But that doesn't mean that folks in our states are as concerned with those headline grabbing issues as we are,” said Murphy.
Murphy continued: “They still have to make their budgets balance every single month. And they are deeply worried, at least those families that I talked to in Connecticut who are still struggling with serious illnesses, about our ability to make sure that the protections for pre-existing conditions, which were a lifesaver, a lifeline for millions of Americans, when we passed the Affordable Care Act, are not undermined by this president.”
In June, Murphy offered an amendment to the Lower Health Care Costs Act during the HELP Committee markup requesting that the Trump administration provide information for states and Congress to better understand the potential consequences of repealing the ACA. Murphy also published an op-ed in the Hartford Courant on this in July and in Modern Healthcare last month.
A full transcript of Murphy’s remarks are below:
“Thank you very much, Mr. President.
“Mr. President, I want to tell you a quick story about a woman from Atlanta. Her name is Dawn Jones. Dawn bought what is commonly referred to in the insurance industry as a short term health insurance plan. She bought it from the Golden Rule Insurance Company, which is a unit of UnitedHealth and she needed it because she needed some coverage in between jobs. She was then diagnosed with breast cancer, and she went through a heartbreaking experience trying to get her insurance company to cover her for her $400,000 medical bill. In the end, she could not get her short term health insurance plan to cover her breast cancer treatments and here's the reason why: the insurer didn't need to cover pre-existing conditions.
“Short term plans do not need to cover things that we traditionally think of as health care insurance today. The protections of the Affordable Care Act, require that insurance cover you regardless of whether you are diagnosed with a serious disease or not. But short term plans don't need to cover you for those things. So this short term plan didn't cover her breast cancer despite the fact that she wasn't diagnosed with breast cancer until after she signed up for the plan.
“So, you may ask why is that a pre-existing condition? If she wasn't diagnosed with breast cancer until she was on the short term plan? Well, the insurer in this case made a very innovative argument. It said that she actually had the cancer before she signed up for insurance. And so even though she didn't know she had cancer, even though she hadn't been diagnosed with cancer, because she technically had cancer before she got the insurance plan, she had a pre-existing condition and thus, they would not cover it.
“This is a pretty typical story about what happens on these short term insurance plans in this country. They are more commonly referred to these days as junk insurance plans. Because for millions of Americans who sign up for short term insurance, they find out that it really does cover much of anything.
“One Golden Rule plan excludes pregnancy, provides a lifetime maximum benefit of a quarter million dollars – that is, by the way, an incredibly low amount of lifetime coverage, a quarter million dollars. One hospital stay for a serious illness can be over $250,000. And the icing on the cake, this particular junk plan from Golden Rule, it doesn't cover a hospital room or nursing services for patients admitted on a Friday or Saturday.
“So good luck if you get sick on a Friday or Saturday because you're not going to get coverage on those two days of the week. These are junk plans because they don't cover what you need. And you, by and large, don't find out about that until you actually need the insurance.
“How about a gentleman from San Antonio, who actually had his short term plan for about six years, he had been paying it and paying it for six years. Because they're technically short term plans, he was renewing them over and over and over again. And when he was diagnosed with kidney disease, they wouldn't cover him. Because they went back to his medical records and found out that he had some blood work done earlier that had shown the initial signs of kidney disease but he wasn't diagnosed until later on. And what they said was, just like for this woman in Atlanta, because you had signs of kidney disease, when you were insured with us a year ago, we're not going to cover you now because technically you're on a new plan. He’d been getting a plan every six months, every year. He didn't have any gaps in coverage, but because he technically was signing up for short term plan after short term plan, he didn't get covered first kidney disease.
“Over and over again we hear these stories about individuals who go on these junk plans, and then find out that they can't get insured for anything. Can't get insured for hospital stays on Fridays and Saturdays, can't get insured for mental health treatment, no prescription drug benefits, no coverage for maternity, all sorts of back bending activity to try to stop people from getting coverage for illnesses.
“And yet these plans are becoming more and more prolific. Why is that? The reason is that the Trump administration is using [an] innovative method to try to get more Americans to sign up on these junk plans. And that's what I wanted to come down to the floor and talk about today. These junk plans are a nightmare for people who get on them and then find themselves on the outside of coverage. When you sign up for health insurance, you basically think it's going to cover a set of things: hospital stays on weekends, coverage for your cancer diagnosis, but these junk plans don't cover those things.
“But the administration has decided to use a section of the Affordable Care Act that was designed to strengthen our health care system and instead use it to weaken the health care insurance system by providing for more and more of these junk plans.
“A little bit of legislative history. There's a section of the ACA that was set up so that you could apply as a state for a waiver to improve coverage. The waiver says that you can do some innovative things in the ACA so long as you prove that whatever you're going to do, is going to provide health coverage that’s just as comprehensive as what is required under the ACA, that you’re not going to cost consumers any more than what they're paying under the ACA, that the number of people who are insured under the ACA in your state isn't going to go down - it's going to stay stable or go up -, and you're not going to increase the federal deficit.
“Well, President Trump, in October of 2018, issued new guidance that essentially guts all of those protections for these waivers. President Trump basically says that these short term insurance plans can be approved, even if they cost people more, even if they don't cover things like pre-existing conditions, even if they result in less people getting insurance.
“And so this October 2018 guidance allowed for these junk plans to be sold in more states to more consumers. Even worse, the 2018 guidance said that these junk plans could be sold side-by-side with the Affordable Care Act plans right on the same web page, disguising the fact that some plans would actually cover you for your pre-existing conditions and others wouldn't.
“And so today, we have more and more of these junk plans available to individuals and more people who are vulnerable to all the old abuses that used to happen left and right in the health care insurance system, largely to people who have pretty serious illnesses. 130 million Americans have a pre-existing condition. In my state over a half a million people have some sort of pre-existing condition. And if they sign up for one of these junk plans, either because they marketed the plan under the belief that it would cover them or by mistake because they didn't notice the difference between the ACA regulated plans and the junk plans on the website that they go to, they are at risk of not getting covered for their pre-existing condition.
“It gets even worse than that. Because what economists tell us is that these junk plans, which cover very little, are admittedly going to be attractive to some people who are presently pretty healthy. Young people, people who don't have any pre-existing conditions, they may sign up for those junk plans because it doesn't really matter to them at the time that they don't get coverage for much at all. Because the junk plans are going to have prices that are lower in most instances then the plans that cover basic health care services. Okay, now in the short term that might be okay, for the people who are relatively healthy, until of course they get sick and find out that their junk plan doesn't cover anything. But for the people who have pre-existing conditions, who can't sign up for the junk plans, who you need to be on the plans that are regulated by the Affordable Care Act, their premiums are going to skyrocket.
“I mean, this is health insurance 101, as more healthy people go to the junk plans, leaving behind on the Affordable Care Act plans, folks that have these pre-existing conditions, their prices will go up. And so the Trump administration's junk plan rule is, frankly, bad news for a lot of people who are on junk plans if and when they actually need health care insurance. But it's also really terrible news for the 130 million Americans who have pre-existing conditions who are likely going to see their insurance rates skyrocket.
“And so, next week we are going to have a vote on the floor of the United States Senate. A vote on a resolution of disapproval for the administration's junk plan guidance. And, I have listened to members of the Senate on both sides of the aisle for a long time talk about how the one thing we agree on is that we need to protect people with pre-existing conditions. And though many of my Republican colleagues might not support the Affordable Care Act, they do agree that we should support people with pre-existing conditions. Which I generally read to mean that we should make sure that we don't pass legislation, we don't let the administration do anything that'll make it even harder than it already is to live with a cancer diagnosis or a diagnosis of serious heart disease.
“And yet, it's completely clear that the Trump administration's guidance is going to make life a lot worse for people with pre-existing conditions. Those that go on the junk plans and for those that stay behind. Here's a quote from an article in the Atlantic magazine, which did a summary of these junk plans and what they're like and, frankly, how important they are to insurance companies. The article says that these short term junk plans make up a high profit portion of the insurance industry's business ‘they are largely designed to rake in premiums, even as they offer little in return and even when they do pay for things, they often provide confusing or conflicting protocols for making claims. Collectively, short term plans can leave thousands of people functionally uninsured or underinsured without addressing or lowering real system wide costs.’ That's the story of junk plans.
“They're a pretty good deal for the insurance industry, which is why they have been pushing the Trump administration to allow more of these junk plans to be sold. They are good deal for the insurance companies because, ultimately, they don't require the insurance companies to pay out a lot in benefits, but they ultimately make a ton for the insurance companies in the premiums they collect. And so it's time for everybody in this body who has stood up and said that they support individuals with pre-existing conditions to vote that way.
“Next week, we will have an opportunity to stop in its tracks the Trump administration's rule allowing for more of these junk plans to be sold to consumers. Because we know that the House of Representatives will join us, we now have the chance to actually do something about it and stop this erosion of health care for people with pre-existing conditions before it's too late.
“I get that the country and this Congress are rightly consumed with the ongoing scandal surrounding the impeachment inquiry and the recent heartbreaking, unconscionable events in Syria. But that doesn't mean that folks in our states are as concerned with those headline grabbing issues as we are. They still have to make their budgets balance every single month. And they are deeply worried, at least those families that I talked to in Connecticut who are still struggling with serious illnesses, about our ability to make sure that the protections for pre-existing conditions which were a lifesaver, a lifeline for millions of Americans when we pass the Affordable Care Act, are not undermined by this president. We have a chance to step up and do something about that next week.
“I will yield the floor and I will note the absence of quorum.”