Making Continuing Appropriations for Fiscal Year 2014--Motion to Proceed--Continued

Floor Speech

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Mr. KAINE. In addition, I think I understood, and I agree with a comment the Senator made about potential reforms--that even the whole notion of health care provided through employers is a little bit of a historical anomaly that came up in the aftermath of World War II.

I was not sure if the Senator was suggesting that as part of a health care reform he would want to alter that norm of employers providing at least some health care provision for their employees.

Mr. CRUZ. I thank the Senator for that question.

What I was suggesting is we should do tax reform that encourages policies to be personal and affordable. Right now, Federal tax laws, Federal laws heavily favor employer-provided health insurance, and that creates some real failures in the market where when someone loses their job, they lose their health insurance. We would be better serving, I believe, our constituents if health insurance became like car insurance, something that went with you regardless of what job you were in.

Mr. KAINE. I say to the Senator, you engaged in a colloquy with the Senator from Illinois about a provision that I wanted to follow up on.

Prior to the passage of the Affordable Care Act, it was completely lawful and, in fact, common for insurance companies to turn down individuals for insurance because of preexisting health conditions. I do not think--but I want to make sure about this--I do not think the Senator was arguing that we should go back to that day and that we should go back to a status quo where children would be turned down for health insurance because of preexisting health care conditions.

Mr. CRUZ. I thank the Senator for that question.

Let me point out that preexisting conditions and the individual mandate of ObamaCare are integrally connected because the way the insurance market works--let me take an example that does not deal with health care. Let's talk about fire insurance, fire insurance on your home.

I suspect both our homes have fire insurance. Imagine if Congress were to pass a law that says fire insurance companies cannot take into account preexisting conditions, such as whether the home has already burned down in a fire.

If that were the law, what any rational person would do--we would both cancel our fire insurance policies because our house had not burned down, and if it did burn down, we could then buy a fire insurance policy and say: Please pay for my house.

Under that rule, the whole insurance regime collapses because the entire basis of insurance is you get people whose homes have not burned down to pay relatively small premiums to create a pool of capital that will be used to compensate--we do not know who, but somebody's home is going to burn down. If enough people whose homes have not burned down put in money in premiums, there will be a pool to pay for whichever unlucky soul faces their home burning down.

The health insurance market works quite similarly. If the rule is simply that for anyone, regardless of their medical condition, any insurance company has to cover them, no matter what, then the incentive is the same as with fire insurance; that if the Senator and I are healthy, it is, frankly, irrational to get health insurance, if the rule is, if I get sick, then I can get health insurance and they have to cover me. What you end up with is insurance that consists only of people who have sicknesses, who have grave diseases, and that bankrupts every insurance plan. If you have a mandate that you cannot take into account whether someone is already sick before giving them insurance, it means the insurance companies go out of business, and what it leads to is what Majority Leader Reid has argued for--it leads ultimately to single-payer government health insurance.

Mr. KAINE. Does the Affordable Care Act require that insurance be provided to folks despite preexisting conditions at the same rate across the board?

Mr. CRUZ. It restricts the terms at which the rates are given.

Mr. KAINE. So then, to make sure I understand, the Senator is opposed to the provision in the current Affordable Care Act that requires insurance companies to write insurance to individuals within those limitations, regardless of preexisting conditions.

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Mr. KAINE. If I could, let me ask: A reform in the Senator's view that might encompass a different solution for the preexisting condition or an ending of the ban on interstate purchasing of insurance, if we get through this week and we are into next week and ObamaCare has not been defunded and we have funded government operations going forward, the Senator could introduce a reform bill proposing to do just those things, could he not?

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Mr. KAINE. I say to the Senator, if we get to that point and he introduces affirmative legislation to reform the health care system--after we get through this debate--that would be legislation that would not be connected to the question, the existential question, of whether the government would continue to operate on October 1. So it would not be integrally wrapped up with sort of a threat to the economy that would be posed by a potential government shutdown, and it could be analyzed just on its own merits: Is this a good reform or a bad reform, without being wrapped around the question of whether we would shut down the government and do we lay off or put on some kind of furlough the nurses at Fort Belvoir Hospital who are taking care of wounded warriors every day. That would be a reform bill where we could dig into the reform and talk about the reform and analyze what is good and what is bad and what should be fixed and maybe what should not be, without it being wrapped around the question of a government shutdown.

Would the Senator not agree with that?

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Mr. KAINE. I ask the Senator, would he not agree that the best way to avoid a government shutdown or threats of a government shutdown or talking about the consequences of a government shutdown would be to separate out his question of what are the right reforms of the health care system from the funding of government operations?

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