risen about 176 percent. But they have actually risen over 1,000--
almost 1,100--percent higher than they should have. To put it this way,
if they should have risen 176 percent, they have actually risen about
1,100 percent. These are premiums.
  Now, by the way, these premiums continue to rise after the passage of
the Affordable Care Act. Indeed, the rise became higher, faster after
the passage of the Affordable Care Act.
  And so, if you are a small business, you are trying to make ends
meet. Businesses contribute to the health insurance of their employees.
Typically, they may employ--it depends upon the business, but they may
give, oh, 100 percent. They may give 80 percent. They may give 60
percent. But whatever percent that the small business is contributing
to their employees is going up.
  The other thing to recognize is that, when it begins to rise too
much, then the employer pays less and less for the employees' health
insurance. This can be manifested in a couple ways. Instead of paying
80 percent of the cost of the policy, they may pay only 60 percent. Or
the small business may decide to get a less expensive policy, in which
case they increase the deductible.
  Now, the deductible is what we pay out of pocket before the insurance
kicks in. That is the problem.
  And so, if you look at, since about 2000, the amount of deductible at
a big business is about $1,700. At a small business, for a single
worker, among workers with a deductible, it is now about $2,600.
  So before the insurance begins to work for the employee, they have to
come up with, on average, $2,600 to pay before the insurance kicks in.
  Now, it may be something like a routine visit, which is covered. They
may have preventive care covered, like a mammogram or a screening
colonoscopy. But, typically, they have got to put up $2,600, on
average, if they go to the emergency room after a car wreck, and only
then does the insurance begin to kick in.
  Now, why is that important? Because most families have less than $500
of cash in order to pay for their healthcare.
  In previous speeches, I have talked about how people are putting
their healthcare expenditures on their credit card. And that credit
card debt factors into 60 percent of household bankruptcies. So they
have a $3,000 deductible, and they don't have the money in their bank
account. Their child gets sick, and they bring them to the emergency
room. They don't have the $3,000. So they put it on the credit card,
and that credit card debt mounts.
  Indeed, if you look at the percent of income that Americans are now
paying upon credit card interest, which means that they are carrying a
balance, it has risen from about 1 percent to 3.2 percent. So 3.2
percent of their income is going to pay for interest on credit cards.
  This shows that they are rolling these big credit card balances
forward. So with credit card balances not paid, but being the minimal
amount being paid, they are up to $10,000.
  Much of this relates back to: How do you pay for healthcare? I don't
have the money in my account. So I am going to use my credit card in
order to pay for these large deductibles.
  Well, I have got a way to address that, Mr. President. We call it the
MVP Act. Under our plan, we would give an advance, an income tax
credit, to the family--on average, for a family of four, about $2,000--
that would go into an account that they use to pay for their benefits.
  By the way, this is paid for. This is paid for.
  But they would prefund a health savings account.
  Now, we don't give it to the insurance company because, if you give
the money to the insurance company to subsidize the premiums, the
insurance company takes 20 percent of it for overhead and for profit.
You give it to the individual or family, and they are going to use 100
percent of it for the healthcare that they need.
  Now, we have coupled that. So it is money in your pocket. We couple
that by adding value, price transparency, so that the family knows the
price they pay before they go in for the service. That could be
powerful.
  I was up here in DC once. Actually, I remember we were having a
crawfish boil. Every year, Louisiana people have a crawfish boil. And
there was a woman who saw me on the street. She stopped me.
  She said: Hey, Dr. Cassidy.
  And I said: Yes.
  She said: I am from Texas, but I saw that you gave a speech about
price transparency, and that if I paid cash, it would be cheaper than
if I went through my insurance. So the doctor ordered an MRI on my
son's shoulder, and they told me it was going to cost $2,000. Well, my
deductible was whatever it was--say a thousand dollars. So I said: How
much, if I pay you cash? They said: Well, if you pay us cash, it is
only $600.
  In this case, paying cash was cheaper than paying her deductible.
  So if you know, if you have price transparency, if you say, ``Wait a
second; I am going to have at least a thousand dollars out of pocket
because of my deductible, but if I paid cash right now and don't go
through my insurance, it only cost me $600,'' you are going to bring
value to the patient.

  In this transaction, under the MVP plan, there would have been money
placed into her health savings account. She could have used--in this
case, she did it on her own--price transparency to find out the price.
So there is money and value for the patient.
  We take the power away from the middleman, the power away from the
insurance company to approve or disapprove of the care that the patient
knows that she needs; and, instead, we would give the money directly to
her, with the tools of price transparency to bring value to the
patient.
  Now, we are making steps on this. Right now in the HELP Committee--
the Health, Education, Labor, and Pensions Committee--of which I am the
chair, we are working on price transparency legislation. We hope to get
that passed in the next 2 weeks out of Committee, and we hope this
passes on the floor of the Senate. This is how we bring value to the
patient, by bringing the power of price transparency, as she chooses
what healthcare and where to get her healthcare.
  Now, we can get this done. Whenever there is a big idea like this,
how do we actually help the American people with affordability? How do
we actually put money in their pocket and couple it with tools that
would give them the power of price transparency, in order to bring
money in their pocket and value for the patient?
  People say: Oh, that is too big. We can't get that done--no way.
  But, folks, we have actually achieved a lot on healthcare in the last
few years. The No Surprises Act blocks about a million surprise medical
bills per month for the American people. A PBM reform bill, which was
signed into law by President Trump a few months ago but that was
negotiated by Congress--and it was tough, but we actually got it so
that the value to the patient in terms of lower drug prices, if you
will, cutting out or restricting activities of the insurance company in
the middle--we got that through. The administration is working on
TrumpRx, which allows patients to buy drugs without hidden costs.
  So if we are going to make healthcare affordable to the American
people, we have to build on that record, and we have to work together.
  So my challenge to the Senate, to the House, and to the President:
Let us come together. Let us get things done. Let us work for the
American people.
  Ask any Uber driver, ask our constituents: What is the biggest issue
right now?
  And they will say: Affording life.
  Affording life means to be able to afford healthcare.
  And, Mr. President, with the MVP health agenda, we help our
constituents afford healthcare.
  With that, I yield the floor.
  The PRESIDING OFFICER (Mr. Curtis). The majority leader.

                           EXECUTIVE CALENDAR

  Mr. THUNE. Mr. President, I move to proceed to executive session to
consider Calendar No. 738.
  The PRESIDING OFFICER. The question is on agreeing to the motion.
  The motion was agreed to.
  The PRESIDING OFFICER. The clerk will report the nomination.