Executive Session

Floor Speech

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Mr. MURPHY. 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 brought 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 is the reason why. The insurer didn't need to cover preexisting conditions. Short-term plans do not need to cover things we traditionally think of as healthcare insurance today. The protections of the Affordable Care Act require that insurance cover you regardless of whether you are diagnosed with a serious disease, but short-term plans don't need to cover you for those things.

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 preexisting condition if she wasn't diagnosed with breast cancer until she was on this 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. So even though she didn't know she had cancer and even though she hadn't been diagnosed with cancer, because she technically had cancer before she got the insurance plan, she had a preexisting condition, and, thus, they would not cover her.

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 doesn't cover much of anything.

One Golden Rule plan excludes pregnancy and provides a lifetime maximum benefit of $250,000. That is, by the way, an incredibly low amount of lifetime coverage--$250,000. 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 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 are not going to get coverage on those 2 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 6 years? He had been paying it and paying it for 6 years. Because they are 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.

What they said--just as they did for the woman in Atlanta--was this: Because you had signs of kidney disease when you were insured with us a year ago, we are not going to cover you now because, technically, you are on a new plan.

He had been getting a plan every 6 months every year. He didn't have any gaps in insurance, but because he technically was signing up for short-term plan after short-term plan, he didn't get covered for his kidney disease.

Over and over, 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, and all sorts of backbending activity to try to stop people from getting coverage for illnesses.

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 for these junk plans, and that is what I wanted to come 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 is going to cover a set of things like hospital stays on weekends and coverage for your cancer diagnosis, but these junk plans don't cover those things.

The administration has decided to use a section of the Affordable Care Act that was designed to strengthen our healthcare system and, instead, use it to weaken the healthcare insurance system by providing for more and more of these junk plans.

Here is a little bit of legislative history. There is a section of the ACA that was set up so that you could apply to the 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 are going to do is going to provide health coverage that is just as comprehensive as what is required under the ACA, that you are not going to cost consumers any more than what they are paying under the ACA, that the number of people who are insured under the ACA in your State isn't going to down--it is going to stay stable or go up--and you are 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 preexisting conditions, and even if they result in fewer people getting insurance.

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 preexisting conditions and others wouldn't.

So, today, we have more and more of these junk plans available to individuals and more people who are vulnerable to all of the old abuses that used to happen left and right in the healthcare insurance system, largely to people who have pretty serious illnesses.

Now, 130 million Americans have a preexisting condition. In my State, over a half million people have some sort of preexisting condition. If they sign up for one of these junk plans--either because they were 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 went to-- they are at risk of not getting covered for their preexisting 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 and people who don't have any preexisting conditions 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; the junk plans are going to have prices that are lower, in most instances, than the plans that cover basic healthcare services. In the short term, that might be OK 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 preexisting conditions, who can't sign up for the junk plans, and who need to be on the plans that are regulated by the Affordable Care Act, their premiums are going to skyrocket.

This is health insurance 101. As more healthy people go to the junk plans, leaving behind on the Affordable Care Act plans folks who have these preexisting conditions, their prices will go up.

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 healthcare insurance, but it is also really terrible news for the 130 million Americans who have preexisting conditions, who are likely going to see their insurance rates skyrocket.

Next week we are going to have a vote on the floor of the U.S. Senate, a vote on a resolution of disapproval for the administration's junk plan guidance. I have listened for a long time to Members of the Senate on both sides of the aisle talk about how the one thing we agree on is that we need to protect people with preexisting conditions, and though many of our Republican colleagues might not support the Affordable Care Act, they do agree that we should support people with preexisting conditions, which I generally read to mean that we should make sure we don't pass legislation and we don't let the administration do anything that will make it even harder than it already is to live with a cancer diagnosis or a diagnosis of serious heart disease.

Yet it is completely clear that the Trump administration's guidance is going to make life a lot worse for people with preexisting conditions, for those who go on the junk plans, and for those who stay behind.

Here is a quote from an article in The Atlantic magazine, which did a summary of these junk plans and what they are 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 systemwide costs.

That is the story of junk plans. They are 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 a 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.

It is time for everybody in this body who has stood up and said that they support individuals with preexisting 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 the House of Representatives will join us, we now have the chance to actually do something about it and stop this erosion of healthcare for people with preexisting conditions before it is 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 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 I talked to in Connecticut who are still struggling with serious illnesses--about our ability to make sure the protections for preexisting conditions, which were a lifeline for millions of Americans when we passed the Affordable Care Act, are not undermined by this President. We have a chance to step up and do something about it next week.

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