[Congressional Record Volume 171, Number 165 (Tuesday, October 7, 2025)]
[Senate]
[Pages S6990-S6992]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           GOVERNMENT FUNDING

  Mr. SANDERS. Madam President, we are now approaching day seven of the 
government shutdown. The Republicans control the House. They control 
the Senate. They control the White House. They run the government, and 
they have the responsibility to keep the government open.
  And in that light, it might be a good idea and a radical idea, but in 
the midst of the crises that we are facing, it really might be nice for 
Speaker Johnson to actually bring House Members back to Washington 
after their 18-day vacation.
  The American people are nervous about this shutdown. Federal 
employees are deeply disturbed. People are frightened. Republicans in 
the House should return to work.
  As we all know, Senate rules require a 60-vote majority in order to 
pass a budget--60 votes. And that means that passing a budget requires 
bipartisan support. That is why, decades ago, the rules were 
established. It is very rare that one party has more than 60 votes.
  So if you need 60 votes, it means that you have to compromise; you 
have to negotiate.
  When Democrats were in power, they had to work with Republicans to 
get the 60 votes. When Republicans, in the past, were in power, they 
had to work with Democrats to get the 60 votes. That is the way it 
worked.
  But not now. This time around, the Republicans have refused to 
negotiate. Basically, what they are saying is it is their way or the 
highway, take it or leave it. So within that context of Republicans 
refusing to negotiate, what is the shutdown about? What are the major 
issues that separate the parties?
  Well, it is not complicated. As everybody in America knows, our 
healthcare system today is broken; it is dysfunctional; it is cruel. We 
are the wealthiest country in the history of the world, but we are the 
only major country not to guarantee healthcare to all people as a human 
right.
  And, in fact, our healthcare outcomes are worse, in most cases, than 
other major countries. It is a broken system.
  Today, in the richest country on Earth, 85 million Americans are 
uninsured or underinsured, and that results in some 60,000 Americans 
dying every single year, unnecessarily, because they can't afford to go 
to a doctor.
  We pay the highest prices in the world for healthcare. It is 
unbelievable and unsustainable. We are now spending over $14,000 for 
every man, woman, and child. When you throw in Medicare, Medicaid, 
employer-covered healthcare, individual costs--over $14,000. That is 
insane, almost twice as much as other countries around the world.
  We pay, by far, the highest prices in the world for prescription 
drugs. One out of four Americans can't afford to go and fill the 
prescription their doctors write. In America today, in our great 
country, we don't have enough doctors. People all over America--Vermont 
and all over America--have to wait months to get in to see a 
specialist. We don't have enough nurses--massive nursing shortage. We 
don't have enough dentists. We don't have enough mental health 
counselors. And our life expectancy--how long we live--is substantially 
lower than other major countries, despite the fact that we spend so 
much more.
  Now, given that reality, given that our healthcare system is broken, 
one might think that the issue we are debating today is, How do we 
improve it? How do we make sure that in America we appreciate 
healthcare as a human right? Which it is. How do we guarantee 
healthcare to every man, woman, and child in a cost-effective way?
  In my view, that is moving toward a Medicare for All, single-payer 
system. If other people got ideas, bring them forward. Healthcare is a 
human right.
  But that is not the debate we are having now. The debate we are 
having now is not how we improve a broken healthcare system but how we 
prevent a broken healthcare system from becoming even worse. And I will 
tell you, as the ranking member of the Health, Education, Labor, and 
Pensions Committee, somebody who has studied this issue for a while, I 
feel very much that if we do not stop Trump's attack on the American 
healthcare system, the entire system could collapse.
  We are on the verge of that right now. People can't afford 
healthcare. People can't find doctors. People can't find mental health 
counselors. People can't afford prescription drugs. We have a drug 
epidemic. We are on the verge of collapse.
  What this debate is about in Florida, in Vermont, and all over this 
country is, if the Republicans get their way and if Democrats cave in, 
health insurance premiums will double for over 20 million people on the 
Affordable Care Act. Yes, you heard right--20 million people will see a 
doubling of their healthcare premiums. You can't afford healthcare now? 
Of course, you can't. It is outrageously high.
  That is not Bernie Sanders talking. That is the Kaiser Family 
Foundation study. That is one of the most conservative Members, 
Republican Members, of the House, Marjorie Taylor Greene, making that 
point. A doubling of health insurance premiums.
  Does any Member of the U.S. Senate want to go home to their district 
and explain why you are going to double premiums?
  It is not just raising the outrageous cost of healthcare in America 
even higher, as a result of Trump's Big Beautiful Bill, 15 million 
Americans are going to be thrown off of the healthcare they have 
because Trump and the Republicans made the largest cuts to Medicaid and 
the Affordable Care Act in American history.
  Let us be very clear. These cuts not only impact 15 million 
Americans--that would be a tragedy unto itself--they will devastate 
nursing homes.
  Right now, the situation on nursing homes in Vermont and I expect 
many other States in this country is a disaster. They are understaffed. 
Nursing homes, in an aging society, are shutting down. Where will 
people who are old and can't take care of themselves, who are 
disabled--what happens to them if the nursing home industry collapses 
in America?
  Community health centers are something that I have worked on for many 
years to increase funding. Over 32 million people access community 
health centers. They provide primary health care, dental care, mental 
health counseling, lower cost prescription drugs. They will suffer 
enormously, cut back on services, and perhaps shut down because of that 
legislation if we do not deal with that.
  Rural hospitals. Republicans say: Oh, we put $50 billion into rural 
hospitals.
  Yes, but you cut $150 billion. All over this country, rural hospitals 
are teetering on the edge. Many of them have already closed down over 
the years. So if you live in rural America--the State of Vermont--and 
you want a hospital nearby? Well, that hospital may not be there.
  Now, why did Trump and the Republicans make these massive cuts to 
Medicaid and the Affordable Care Act? The answer is not complicated. It 
was important for them to provide $1 trillion to the top 1 percent--$1 
trillion. Massive cuts to healthcare; $1 trillion in tax breaks to the 
1 percent.

[[Page S6991]]

  Let me make the very radical suggestion that Elon Musk, who is now 
worth some $500 billion, does not need another tax break. Today, we 
have more income and wealth inequality than we have ever had in the 
history of America. Musk himself owns more wealth than the bottom 52 
percent of American households. The top 1 percent owns more wealth than 
the bottom 93 percent. Never before have we seen such income and wealth 
disparity.
  Republicans said ``We are going to massively cut Medicaid, ACA'' in 
order to give tax breaks to the richest people in America.
  But the issue that we are debating is not just healthcare, as 
enormously important as that is; what we are talking about is whether 
we are going to allow our country to move toward an authoritarian 
society run by a President who is a megalomaniac, who wants more and 
more power in his own hands, who does not respect the rule of law or 
the Constitution of the United States of America.
  It is not acceptable to me that our President is putting Federal 
troops on city streets throughout America without a request from a 
Governor or a mayor, trying to create provocations, trying to create 
disturbances so he can use military force against the American people.
  We cannot allow masked ICE agents to snatch people off of our streets 
without due process.
  We cannot continue to allow President Trump to undermine the 
Constitution and the rule of law by refusing to spend money 
appropriated by Congress. Unbelievable.
  The President says: Well, money was appropriated to States that 
committed a terrible crime.
  Do you know what their crime was? They voted against Donald Trump. 
And in this world right now, I guess if a State votes against Trump, 
maybe they are not going to get the Federal money that was 
appropriated, whether it is Vermont, New York, New Jersey, or other 
States.
  Is that really what the United States of America is about? A 
President says: You voted against me. You are not going to get your tax 
dollars back in Federal investments.
  According to every poll that I have seen, the American people by huge 
numbers do not want to see a doubling of their healthcare premiums. 
According to the Kaiser Family Foundation, 78 percent of Americans, 
including 59 percent of Republicans, want to extend the Affordable Care 
Act tax credits, and the polling numbers are equally high or almost as 
high on making sure that people are not thrown off of Medicaid.
  Tony Fabrizio, who is President Trump's own pollster--not just a 
general pollster; he is the pollster for the President. This is what he 
said:

       By broad bipartisan margins, voters want to see the [ACA] 
     tax credits extended rather than expire at the end of the 
     year, whether in the context of premiums doubling or 5 
     million families losing their health insurance. This includes 
     solid majorities of Trump voters and swing voters.

  That is the Republican pollster.
  Right now in the House, to the best of my knowledge, there are at 
least 14 Republicans in a very tightly controlled caucus who want to 
see the ACA tax credits extended. Here in the Senate, there is at least 
one Republican Senator who understands that in his State, his people 
cannot afford a doubling of premiums. My strong feeling is that there 
are many, many other Republicans who are not excited about going home 
and explaining to their constituents why their premiums are doubling.

  As the ranking member of the Health, Education, Labor, and Pensions 
Committee, I asked people across the country in the last few days what 
these healthcare cuts that the Republicans are pushing would mean for 
them. We just sent out emails, and we have gotten many, many, many 
hundreds of responses.
  We asked them: What would a doubling of healthcare premiums mean to 
your life and your family? What would it mean if you were one of the 15 
million Americans thrown off of healthcare through cuts in Medicaid? 
What would it mean to you if the rural hospital near you shut down 
because of these Medicaid cuts?
  In less than a week, we received responses--many hundreds--from 42 
States and the District of Columbia. Today, we are releasing a report 
that describes the devastating human impact of the Republican budget 
and its massive cuts to Medicaid and the Affordable Care Act. Here is 
just some of what we found:
  People are afraid that they could get sicker or even die.
  Laura--won't give her last name--from Wisconsin said:

       I live in fear of whether or not I will be able to afford 
     my life saving treatment. I have a rare kidney disease that 
     requires immunotherapy every 9 months. I'm terrified I'll 
     die.

  We got a lot of those--people who are dealing with very serious 
illnesses who, in fact, will die. They will die if they cannot afford 
health insurance, and they will not be able to afford health insurance 
if their premiums double or if they are thrown off of Medicaid.
  But it is not just the fear that people will die or get sicker 
because they lack healthcare; all over this country, working-class 
Americans will not be able to afford the food they need, pay their rent 
or their mortgage or their healthcare.
  Brittanie from Utah writes:

       I'm already living paycheck to paycheck. I have insurance 
     for myself and my two sons. Just bought a house that we can 
     barely afford.

  So she is hanging on the edge. If she has to pay more for healthcare, 
maybe she loses her house.
  Sebastian from Colorado writes:

       I don't make enough to afford rent and food and health 
     insurance. Only 2 of those things do I need to survive. These 
     cuts make it even more impossible to turn things around and 
     get a handle on health issues.

  In other words, 60 percent of our people are living paycheck to 
paycheck. Today, they can't afford housing. Today, they can't afford 
childcare. Today, they can't afford good-quality food for their kids. 
Today, they can't afford to send their kids to college. Double 
healthcare premiums, and these families are going to be in disastrous 
shape.
  Cara from Vermont said that she ``was shocked by warning about the 
loss of the advanced federal subsidy. Rather than a premium of $100 [a] 
month, I could be paying more than $1,200 [a] month or 35 percent of my 
income, and that's before deductibles and copays.''
  By the way, when we talk about a doubling of health insurance 
premiums, that is on average. Some people will pay less; some people 
will pay a lot more.
  Small business owners are concerned they will have to shut down.
  Joe from Pennsylvania writes:

       I am a small business owner and if my health care costs 
     continue to rise, I will be forced to close my business and 
     look for a job, if I can find one.

  Patricia from rural California writes:

       If our local clinics and hospitals close, as they are 
     likely to do with federal funding disappearing along with 
     health insurance becoming unaffordable, people will die.

  She is right.
  On average, healthcare premiums will double, but here is what happens 
when it is not average. If you are living in Virginia, your premiums 
could go up from less than $650 a month today to nearly $2,200 a month 
next year--$650 to $2,200. That is not a doubling, it is almost a 
quadrupling of what you are paying. If you live in Idaho, your premiums 
could go up from $283 a month to $407 a month. If you live in the State 
of Georgia, your family could see their premiums go up from $940 a 
month today to over $4,000 a month.
  At a time when people today cannot afford healthcare, the idea of 
doubling, tripling healthcare premiums is insane. It is unacceptable. 
No Member of the U.S. Senate should support that.
  So, no, I am not going to go back to Vermont and tell the people 
there that I have thrown 15 million Americans off the healthcare that 
they have at a time when studies indicate that would mean that tens and 
tens of thousands of people will die as a result. I am not going to do 
that.
  And I am not going to vote for a healthcare situation which doubles 
premiums for 20 million Americans.
  So we are where we are right now. And the time is now when the U.S. 
Congress has got to look beyond their campaign contributors, has got to 
look beyond the oligarchs that fund their campaigns, and has got to 
begin standing up for ordinary Americans.

[[Page S6992]]

  Our job is to improve a broken healthcare system and guarantee 
healthcare to all. Our job is not to throw 15 million people off 
healthcare and double premiums for more than 20 million, to shutter 
nursing homes, community health centers, and rural hospitals. The 
choice is clear. Let us stand with the American people.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wyoming.

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