[Congressional Record Volume 171, Number 152 (Wednesday, September 17, 2025)]
[Senate]
[Pages S6701-S6702]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               HEALTHCARE

  Ms. CANTWELL. Mr. President, I appreciate my colleague from Wisconsin 
talking about her own healthcare experience and why those in Wisconsin 
want to see us take action to help keep insurance affordable.
  I rise today because Americans are facing a massive wave of 
healthcare costs. Those increases are swamping the family budget, and 
they are hurting our healthcare system by increasing uncompensated 
care.
  But before I did that, I wanted to make a comment on today's HELP 
Committee hearing with the former CDC Director, Director Susan Monarez, 
who was fired by Secretary of Health and Human Services Robert F. 
Kennedy because she refused to rubberstamp what he wanted to have 
happen.
  Dr. Monarez basically confirmed what we already knew today, and that 
was that instead of basing vaccines on hundreds of years of science, 
instead the Secretary of Health is trying to replace that with a 
pseudoscience. He is basically trying to say, instead of 100 years of 
evidence about vaccines for measles and other childhood diseases, that 
now a new group is going to come up with recommendations and, thereby, 
I think, confusing people.
  So I am glad that the West Coast Alliance of scientists today put out 
a statement talking about, what is the science that has been the basis 
for the United States for several years. Those are important things to 
understand, but this is an assault on our healthcare system if we don't 
continue to follow science in the most specific way.
  So I appreciate Dr. Monarez basically coming before the Senate today, 
making sure that people understand that she was fired because she 
didn't want to go along with this, and I think that she made some 
important statements today about saying that we need to base science on 
evidence and not ideology. I agree with that, and I think people in the 
Northwest want to see this alliance in our State and, in California and 
Oregon, continue to advocate for good science when it comes to 
vaccines.
  But I wanted to also talk tonight about our healthcare system and the 
assault on it. Last week, the Washington State Office of the Insurance 
Commissioner approved a 21-percent increase in the 2026 ACA marketplace 
insurance premium.
  So what does that mean? It means that our State said that insurance 
rates could go up. Why are they saying they could go up? Because this 
is the largest single increase since 2018, nearly double last year's 
increase. And why are they saying this? Well, they are saying this--
insurers in Washington are saying this because they are pointing to a 
couple of things: the Trump tariffs, the rising cost of the delivery 
system, and most importantly, the failure of our colleagues to extend 
the tax credits that would make health insurance more affordable for 
about 22 million Americans.
  In our State, 80,000 Washingtonians are expected to drop their health 
insurance coverage because they will no longer be able to afford it. 
That is a tragedy because we don't want to see people losing health 
insurance because, when they do, it means there is just a lot more 
uncompensated care and it means the cost of health insurance goes up 
for everybody. For everyone else, they will pay an average of $129 more 
per month, or $1,548 per year, just to keep the same health insurance 
plan.

[[Page S6702]]

  So how did we get here? Why are Americans facing this looming threat? 
When the Affordable Care Act passed in 2010, the health insurance 
through Medicaid, the marketplace exchange was now available to 
millions of Americans. By making coverage affordable year after year, 
we saw more and more people covered by insurance.
  The rate of those uninsured in the United States dropped from 15 
percent before the ACA to an alltime low of over 7 percent in 2023. So 
we basically cut that in half. We cut the number of uninsured in half. 
We could have done more, in my opinion; there were a couple of things 
we left on the table that would have lowered that uninsured rate even 
more significantly.
  But today, 44 million Americans get their health insurance through 
the ACA. That is about one in six people under the age of 65. In our 
State, it provides coverage for an additional 626,000 Medicaid 
recipients and nearly 300,000 beneficiaries on the exchange. In 2023, 
the uninsured rate in our State was just 4.8 percent. So that means 
people are covered. You don't have uncompensated care, you don't have 
emergency room visits, you don't have the problems that we are seeing.
  So what happens now, though, is that millions of Americans, as I 
said, are now facing these skyrocketing costs of healthcare. And that 
is because data shows, when more people have health insurance and our 
providers spend less on compensated care, the system is more 
affordable. But according to a Kaiser Foundation study, aggregated 
uncompensated care dropped by $20 billion in the 7 years after the 
Affordable Care Act passed. But the tax credits that help make coverage 
affordable for those who need it the most are essential to driving down 
the cost for everyone.
  So if you don't keep the tax credits, we are now going to face 
skyrocketing healthcare costs, unless we extend those subsidies. That 
is the point. We did a good job--we lowered uncompensated care, we 
lowered the cost of insurance, and instead, now we are facing basically 
the end of subsidies that we are now going to make that go up and cost 
all of us.
  As I mentioned, I have spoken to many of my constituents. One I just 
spoke to--Leslie, who has a connection to Three Rivers Hospital in 
Brewster, WA--she told me that her husband relies on the ACA premium 
credits to afford his marketplace insurance. Without the subsidy, his 
monthly premium would increase from $200 to $700 a month, and he will 
no longer be able to afford his insurance next year. He also needs to 
have surgery soon, so they are trying to figure out how to get that 
done fast. And Leslie and her husband run a small business. They don't 
have the luxury of waiting and paying more just to get basic healthcare 
in a very rural part of our State. She understands the healthcare 
system, and she knows that we need to fix this, so she is calling on 
all of us to step up and get a certainty to the ACA tax credit.
  I am worried about the additional 80,000 Washingtonians who are 
expected to lose access to checkups and preventive care. We know that 
people without healthcare insurance wait to get care until their 
condition worsens to a point where they end up in the emergency room. 
That costs them and everyone else more. And more people will also end 
up in the emergency department just because they can't afford 
preventive care or regular services. Treating a patient in the ER can 
be 10 times more expensive than treating a patient in a normal doctor's 
office, and these are costs that are being passed along in the form of 
higher healthcare premiums for all Washingtonians, no matter what type 
of health insurance they get.
  So these Republican policies making it harder for us to hold down 
healthcare costs should stop. According to the Bureau of Labor 
Statistics, the cost of the healthcare system has already risen 4.2 
percent in the last 6 months, much higher than the rate of inflation. 
So we see these costs compared to other costs in our system. Obviously, 
energy costs are rising, but in addition to the cost of food and 
household essentials, Americans are facing these higher bills in 
general. I think the Trump administration is ignoring these real life 
impacts on families.
  Congress should be working together to make healthcare less 
expensive, and we know that we, the Congress, in the Republican-passed 
bill also created a lot of uncertainty as to the Medicaid marketplace 
and what is happening, and we already met with hospitals today from 
rural parts of Washington, that are saying they are seeing the impacts 
already of that bill--on individuals not having certainty or, in one 
instance, basically a hospital needed to have some construction work 
done, and the person who was supposed to provide the construction and 
the financing of that said, ``Are you really going to have the money to 
even do this?'' So it is sending a ripple through the entire system.

  So we can't afford to go back to a situation we had before the 
Affordable Care Act, when one of every seven Americans didn't have 
health insurance. We can't afford the wave of uncompensated care costs 
that will hit hospitals and, eventually, all of us; and we can't afford 
the loss of lives and the medical bills that people are seeing every 
day.
  And we need Americans to understand that we should be listening to 
what they are saying. Seventy-two percent of Americans say they want an 
enhanced premium tax credit extension. That is those who are strongly 
in favor and somewhat in favor. That is what the American people are 
telling us. They want this healthcare to continue just like they want 
their Medicaid coverage to continue.
  So let's do our jobs. Let's quickly act to extend the ACA tax 
credits. Let's do everything we can to make health insurance more 
affordable. Let's make a bipartisan effort to show the American people 
that we hear them, that a very big percentage of them want more 
affordable healthcare--now, for all Americans, let's get it done.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan.

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