Providing for Congressional Disapproval Under Chapter 8 of Title United States Code, of the Rule Submitted By the Secretary of the Treasury and the Secretary of Health and Human Services Relating to ``State Relief and Empowerment Waivers''

Floor Speech

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Mrs. SHAHEEN. Mr. President, since President Trump was sworn in, he has made it his mission to dismantle the Affordable Care Act. Last Congress, time and again, we saw the House and Senate majorities try-- and fail--to repeal the law of the land, the Affordable Care Act.

After their attempt to repeal the Affordable Care Act failed in the Senate, the Trump administration made it abundantly clear that they would do everything possible to sabotage the act through regulations and administrative action. Through this sabotage, the administration has undermined the critical protections healthcare provides for people with preexisting conditions.

I just want to reiterate my support for the Congressional Review Act disapproval resolution that I worked on with Senator Warner, and I congratulate him for his leadership. What that resolution points out is that preexisting conditions and short-term insurance plans, also known as junk plans, are inconsistent. I am proud to support the disapproval resolution that we will vote on this week that would reverse this administration's so-called 1332 waiver rules.

Those rules allow for the use of taxpayer dollars to subsidize junk insurance plans. These waiver rules are part of the Trump administration's ongoing attempt to make an end run around Congress and dismantle the Affordable Care Act through the regulatory process.

I think it is important to understand the shortcomings of these junk plans that the administration is promoting. These plans are allowed to deny coverage to someone who has a preexisting condition. They also allow insurance companies to charge higher premiums if somebody has a preexisting condition. They are not required to cover the Affordable Care Act's essential benefits, such as maternity care, substance use disorder treatment, or prescription drugs. In New Hampshire, where we have a real challenge with the opioid epidemic, without coverage for substance use disorders, we have thousands of people who would not be able to get treatment for their substance use disorders.

These plans are allowed to place arbitrary limits on the dollar value of services that will be covered annually, and they also don't have to comply with the Affordable Care Act's caps on how much insurers can require that patients pay out of pocket. In short, these junk plan policies are often not worth the paper they are written on, but for some reason, these are plans that are favored by this administration.

The administration's 1332 waiver rules effectively rewrite the law to allow the Affordable Care Act premium tax credits to be used to purchase junk plan coverage. So rather than help subsidize comprehensive healthcare coverage as was intended in the act--coverage that will actually allow people to get the healthcare services they need--what the Trump administration waiver does is have those taxpayer subsidies cover junk plans that generally do not provide the care that people need.

Allowing taxpayer dollars to subsidize junk plan coverage is not only dangerous for consumers, who can be duped into purchasing junk plans, but it also poses a threat to the stability of the insurance market. By aggressively pushing enrollment in junk plans, this administration is seeking to split the insurance market into two: one market for younger and healthier individuals and a second, much more expensive market for older individuals and people with chronic health conditions. This is not the outcome that people in New Hampshire and patients across this country want or deserve.

That is why I intend to vote in favor of the Congressional Review Act resolution, which will overturn these rules that are sabotaging the Affordable Care Act.

Unfortunately, the waiver rules are not the only grave threat that this administration is posing to access to healthcare coverage and protections for people with preexisting conditions. In addition to the sabotage of the ACA that is going on, the Department of Justice--our Nation's highest law enforcement authority--continues to refuse to defend the law of the land, the Affordable Care Act, in Federal court. Instead, the Justice Department has argued that the Affordable Care Act should be struck down, resulting in the loss of coverage for millions of Americans. The estimate is that if the Affordable Care Act is struck down, 20 million Americans will lose their healthcare.

In New Hampshire, approximately 90,000 Granite Staters have obtained health insurance coverage through either the Affordable Care Act or Medicaid expansion. Across the country, more than 17 million Medicaid expansion enrollees and 11 million people in the marketplace health plan depend on the ACA for their coverage. So these families can see their coverage ripped away if the Department of Justice gets its way in the courtroom.

If the Department is victorious in its litigation, they will also take away the best tool we have for combating the opioid epidemic--the Medicaid expansion. In New Hampshire, more than 11,000 people have substance use treatment thanks to Medicaid expansion. Access to those services will be gone without the Affordable Care Act. At a time when so many families are struggling with sky-high prescription drug prices, a victory by the Department of Justice in this case would increase prescription drug costs for Granite State seniors, who currently save an average of $1,100 a year thanks to the ACA's Medicare Part D drug discount program.

That is not all. If the courts strike down the Affordable Care Act, insurers would once again be able to exclude coverage for prescription drugs, and the FDA's approval pathway for less expensive biosimilar medication would be invalidated.

I have been watching these ads on behalf of President Trump and the administration that talk about his commitment to lowering prescription drug prices and the importance of the pathway for biosimilar medications that are basically generic drugs for biologics. Yet this pathway to approve those less costly biosimilar medications would be invalidated if the Affordable Care Act gets struck down.

The stakes are really just too high for us to continue the partisan bickering around the Affordable Care Act. We should be coming together to tell the Justice Department to defend the law of the land. That is why I filed an amendment to the Commerce, Justice, Science appropriations bill that would prohibit the Justice Department from using Federal funds to argue against the Affordable Care Act in court. That is why we need to support the Congressional Review Act vote that we will have this week, which would ensure that people with preexisting conditions are not going to be cut off of their health insurance when they are tricked into buying junk plans through this administration's deceptive advertising.

This Friday is the start of the 2020 open enrollment season for the Health Insurance Marketplace coverage under the Affordable Care Act. At this important juncture, we should be sending a very clear message that the Department of Justice should defend the law of the land and that the administration's promotion of junk plans should not continue. If we fail to do so, we are going to be endangering vital access to care for millions--tens of millions--of Americans.

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