Affordable Care Act
Floor Speech
Mr. COURTNEY. Madam Speaker, yesterday Virginia District Court Judge Henry Hudson's decision striking down one provision of the Affordable Care Act has generated a lot of noise in the last 24 hours.
Opponents of health care reform are celebrating as if the whole law was struck down, even though Judge Hudson refused the Commonwealth of Virginia's request to strike down the entire law and Judge Hudson refused the Commonwealth of Virginia's request to stop implementation of the health care bill which has been proceeding since last March.
Thank goodness the judge had enough common sense not to stop the health care bill's important protections for families and patients that have been implemented since last March, such as age 26 dependent coverage which employers all across America have been implementing since last July, giving families the opportunity to keep children covered on their family's health insurance plan up to age 26; such as protections like the elimination of insurance company rescissions of coverage, the practice of denying claims after the fact, many times after patients have had surgery or have had treatment; such as the $250 payments, which seniors who fell into the part D doughnut hole received in 2010; such as the 50 percent discount for brand-name medications, which seniors in the doughnut hole will start to receive starting on January 1; such as the new Medicare coverage for annual checkups, cancer screenings, smoking cessation, vaccinations for flu, which the new health care bill will provide starting on January 1; such as the early retiree reinsurance program, which employers all across the country, private employers as well as public employers, are using to stabilize age 55 and up retirement health benefits, including 96 plans just in the Commonwealth of Virginia alone.
For all the crowing and boasting by opponents of health care reform, there was less there than meets the eye. But there is no doubt that the judge did strike down an important part of the bill, namely, the shared responsibility provision, the requirement that nearly all Americans carry health insurance, a provision which two other district court judges, one in Virginia and one in Michigan, upheld as a proper exercise of Congress' power to regulate interstate commerce.
Judge Hudson ruled that this provision doesn't ``fit within the letter or spirit of the Constitution.'' Well, Madam Speaker, there is a long, long history of Supreme Court cases which have held exactly the opposite of what Judge Hudson wrote.
Indeed, Antonin Scalia, the leader of conservative forces on the U.S. Supreme Court, himself, wrote that Congress has the authority to enact a regulation of interstate commerce, and it possesses every power needed to make that regulation effective.
Using Justice Scalia's interpretation of the commerce clause, it is clear that this bill's provision to eliminate preexisting condition exclusion, the practice by insurance companies for denying coverage for people with cancer, high blood pressure, diabetes, chronic conditions, which require a pooling mechanism which the shared responsibility requirement was designed to accomplish, clearly fits within Justice Scalia's definition of the commerce clause. In fact, we know this from real-life experience.
Seven States tried to enact a guaranteed issuance law requiring insurance companies to insure all people regardless of preexisting conditions, and what happened was that rates went through the roof. Only one State was able to implement a prohibition on preexisting condition exclusions, that was the State of Massachusetts, which was coupled with a shared responsibility mechanism. And, as a result, insurance premiums fell in the individual market by 42 percent.
The impact on interstate commerce in terms of what is happening in the health insurance market could not be clearer. In fact, the trade organization representing America's health insurance industry back in 2008, after the election, made it clear that a shared responsibility mandate requirement is essential to actually executing and performing real reform in the insurance market. Allowing people to enter the market and exit the market when they get sick and when they get better is like insuring a burning building. And the fact of the matter is that the judge's decision, despite the fact that conservative judges like Antonin Scalia have recognized Congress' ability to regulate interstate commerce, which the health insurance industry clearly falls under, would allow for the Congress to set up the real mechanism to make sure that its goal of eliminating preexisting conditions can actually take place. And the health insurance industry knows over the last 5 years the collapse that has been occurring within the marketplace because of rising premiums.
I come from the State of Connecticut. We have Aetna, we have CIGNA, we have United Health Care. These are the largest plans in the country that are selling to employers, and they have seen the percentage of their coverage across America decline, not since the passage of the health care bill, but going back to 2005. And this measure is designed, in fact, really just to stabilize that private health insurance market.
Madam Speaker, in a few short weeks, new Members of Congress are going to be sworn into office. They are going to be given a PIN that gets them into the building, they are going to be given a voting card, and they are also going to be given an opportunity to enroll in the Federal Employee Health Benefit plan, a purchasing exchange which Members of Congress can participate in, get a nice comprehensive package of benefits, taxpayer subsidies, affordable rates. And on page 29 of this booklet, it makes it very clear that preexisting conditions will not be imposed against them.
The people of this country deserve the same type of coverage. And it is my hope, as the appellate courts review that decision yesterday, that they will uphold the Affordable Care Act's provision to stabilize the private health insurance market.
[Press Release, Nov. 19, 2008]
Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate
Washington, DC.--Health plans today proposed guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate.
Under the new proposal, health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance.
Health plans also said that premium support for moderate-income individuals and broad spreading of risk was necessary to promote affordability and maintain premium stability in the individual health insurance market.
To ensure that all Americans can access coverage, health plans also reiterated their long-standing support for making eligible for Medicaid every uninsured American living in poverty and strengthening the Children's Health Insurance Program.
``No one should fall through the cracks of our health care system,'' said Karen Ignagni, President and CEO of America's Health Insurance Plans (AHIP). ``Universal coverage is within reach and can be achieved by building on the current system.''
The announcement follows a nationwide listening tour conducted by AHIP as part of its Campaign for an American Solution. Concerns about coverage for pre-existing conditions, continuity of coverage for those between jobs and maintaining affordability for those with insurance were raised repeatedly across the country.
``AHIP's Board of Directors is responding to the concerns of the American people by offering a workable solution to ensure that no one is left out of the health care system because of their health, age, income or employment status,'' said Ignagni.
The new proposal builds on the series of comprehensive reform plans that AHIP's Board of Directors began releasing in November 2006. Further reform proposals addressing the affordability, accessibility and quality of health care are anticipated in the weeks ahead.
SUMMARY OF AHIP'S PROPOSAL TO GUARANTEE COVERAGE FOR PRE-EXISTING CONDITIONS AND PROMOTE AFFORDABILITY IN THE INDIVIDUAL INSURANCE MARKET:
Guarantee-issue coverage with no pre-existing condition exclusions;
Establish an individual coverage requirement with an insurance coverage verification system, an automatic enrollment process and effective enforcement of the requirement that all individuals purchase and maintain coverage;
Promote affordability by: providing refundable, advanceable tax credits for moderate-income individuals and working families; and promoting tax equity whether coverage is obtained through an employer or the individual market; and
Ensure premium stability for those with existing coverage through a broadly funded reimbursement mechanism that spreads costs for the highest-risk individuals.
BACKGROUND ON THE INDIVIDUAL MARKET AND GUARANTEE ISSUE
AHIP's survey of the individual market shows that individually purchased health insurance is far more affordable and accessible than is widely known. The survey found that 9 out of 10 applicants undergoing medical underwriting were offered coverage. The plans commonly purchased by consumers provided substantial financial protection and a wide range of benefits, including coverage for behavioral health, prescription drugs and preventive services.
Some individuals are unable to purchase individual health insurance coverage in the private market because of their health status. One approach taken by states to address this issue has been the enactment of guarantee issue legislation requiring health plans to offer coverage to all applicants. These well-intentioned reforms have often resulted in severe unintended consequences, including significantly higher costs for all policyholders.
A report by Milliman, Inc. found that enactment of guarantee issue laws in the absence of requirement that individuals purchase coverage may incentivize people to defer seeking coverage until they have health problems--a situation which unfairly penalizes those who are currently insured. According to the report, states that implemented these laws saw a rise in insurance premiums, a reduction of individual insurance enrollment and no significant decrease in the number of uninsured. To learn more about the individual market survey and the Milliman report, please visit www.ahip.org.
Source