June 29, 2017 - Issue: Vol. 163, No. 112 — Daily Edition115th Congress (2017 - 2018) - 1st Session
MARKETPLACE CERTAINTY ACT; Congressional Record Vol. 163, No. 112
(Senate - June 29, 2017)
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[Page S3854] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov] MARKETPLACE CERTAINTY ACT Mrs. SHAHEEN. Mr. President, I am expressing sentiments for myself and on behalf of Senators Wyden and Murray, as a fair reading of the Affordable Care Act, ACA, makes clear, S. 1462, the Marketplace Certainty Act, is not necessary to provide a permanent appropriation for the payment of cost-sharing reductions under the ACA. The ACA already prescribes that such payments are to be made from such a permanent appropriation pursuant to 31 U.S.C. 1324. This is because an essential component of the ACA's system for ensuring the availability of affordable health insurance coverage is its two-part package of subsidies: tax credits and cost-sharing reductions. Whereas the premium tax credits make it more affordable for an individual to purchase health insurance, the cost-sharing reductions make healthcare more affordable by reducing the often daunting costs, such as copayments and deductibles, that even those with health insurance must pay to obtain healthcare, ACA, sections 1401, 1402, 26 U.S.C. 36B, 42 U.S.C. 18071. The ACA directs the Secretary of the Treasury to ``establish'' a single, integrated ``program'' to ``make advance payment'' of both subsidies to insurance companies, who are accordingly mandated to reduce individuals' premium payments to insurers, and their cost- sharing obligations to healthcare providers. To assure insurers and covered individuals that these equally essential funds will both be available, the act provides that requisite payments are to be jointly made from a permanent appropriation, 31 U.S.C. 1324, rather than be subject to the year-to-year whims of the annual appropriations process. Despite the fact that the current permanent appropriation in section 1324 plainly covers these cost-sharing reduction payments, pending litigation brought by the House Republican leadership--which is currently being held in abeyance in the D.C. Circuit Court of Appeals-- and the current administration's mixed signals as to whether it will continue to make these payments required by law, could generate instability in individual insurance markets. S. 1462 removes all basis for any further questions about what is already clear from a fair reading of the ACA as a whole: both subsidies are to be funded from the same permanent appropriation. In addition, the amendment includes provisions that will strengthen the existing subsidy provisions, and, in light of developments since the ACA was enacted in 2010, make insurance more affordable for beneficiaries and help stabilize State- level individual insurance markets. ____________________