[Congressional Record Volume 171, Number 200 (Monday, December 1, 2025)]
[House]
[Pages H4957-H4962]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       MEDICAL BILLS ARE TOO HIGH

  (Under the Speaker's announced policy of January 3, 2025, Ms. 
McClellan of Virginia was recognized for 60 minutes as the designee of 
the minority leader.)


                             General Leave

  Ms. McCLELLAN. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous material in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Virginia?
  There was no objection.
  Ms. McCLELLAN. Mr. Speaker, today is December 1. At midnight and 30 
days, at least 5 million Americans could lose access to their health 
insurance, and 22 million Americans who benefit from enhanced premium 
tax credits under the Affordable Care Act--as they began open 
enrollment 1 month ago--started to see their health insurance premiums 
spike.
  Last week, in honor of Prematurity Awareness Month, I stood on this 
floor

[[Page H4958]]

to talk about how the Affordable Care Act expanded insurance to 
millions of Americans, how Medicaid expansion expanded insurance to 
millions of Americans, and how critically important that health 
insurance coverage is to a full-term birth with a nonfatal outcome for 
mother and child.
  In the middle of the week, with several other mothers of preemies, I 
talked about my birth story.
  Ten years ago, when I woke up one morning and my placenta ruptured 
and after almost bleeding to death, my daughter, Samantha, was born by 
emergency C-section. It was the scariest moment of my life. The hardest 
moment was the fact that I could not hold her, see her, or touch her 
for 24 hours, as she was in the NICU, and then the moment when I walked 
out of the hospital and had to leave her in the NICU for 6 more weeks.
  I don't remember how much that NICU bill was because I was one of the 
lucky ones who had health insurance to cover that stay. On average, a 
NICU stay is $70,000 a day. That is more than a single person who 
qualifies for the enhanced premium tax credits under the Affordable 
Care Act at the maximum rate of 400 percent of the Federal poverty line 
makes in a year. That person makes $62,600. The average NICU stay is 
$70,000.

                              {time}  1930

  I was lucky not only because I was able to take my daughter home 6 
weeks later, but that entire 6 weeks I didn't have to worry about how I 
was going to pay that bill. All I had to worry about was her and my 
recovery. There are a lot of people that aren't that lucky.
  There are a lot of people trying to decide right now whether to start 
a family. There are people right now who are in the process of starting 
a family who wonder if they will be able to afford their health 
insurance come January 1. They are having to make really tough 
decisions now, as they are in the middle of open enrollment, as to 
whether or not they can continue to afford health insurance.
  Tonight, members of the Congressional Black Caucus will bring you 
stories from our constituents, from the States that we represent, of 
people who will be priced out of the insurance market, who will be one 
illness or accident away from economic devastation if Congress does not 
act to extend the enhanced premium tax credits beyond December 31.
  Mr. Speaker, I yield to the gentlewoman from New York (Ms. Clarke), 
our chairwoman and the Representative from New York's Ninth District, 
to tell some stories.
  Ms. CLARKE of New York. Mr. Speaker, I thank the gentlewoman from 
Virginia for her steadfast leadership and for hosting our Special Order 
hour this evening.
  Mr. Speaker, good evening. I am Representative Yvette D. Clarke, 
chair of the Congressional Black Caucus, proudly representing New 
York's Ninth Congressional District, located in Brooklyn, New York.
  I thank my colleague, Congresswoman Jennifer McClellan, for anchoring 
this Congressional Black Caucus Special Order hour.
  I rise tonight with my colleagues of the Congressional Black Caucus 
to bring awareness to the fast-approaching ACA tax credit funding 
deadline, 30 days to go, and to give voice to everyday Americans who 
will be harmed by the Republican-led healthcare crisis.
  The enhanced ACA tax credits are set to expire on December 31 unless 
congressional Republicans join Democrats to extend them.
  Without an extension of the ACA tax credits, tens of millions of 
individuals and families can expect to pay significantly higher health 
insurance premiums for marketplace plans.
  Without these tax credits, Americans will see their healthcare costs 
skyrocket, increase by hundreds if not thousands of dollars per month, 
which will force families who are already struggling with the cost of 
living to face unaffordable premium spikes or lose coverage altogether.
  The ACA tax credits have ensured that families, seniors, young 
adults, and workers in every CBC district could afford quality 
healthcare.
  In our districts, we have heard from countless constituents who 
receive their healthcare on the ACA marketplace who are now worried 
about the cost of their healthcare going up.
  One of my constituents, Lilah Wilson, a small business owner who 
depends on the ACA marketplace said: ``My heart dropped when I got an 
email earlier this month stating that I might lose my insurance 
benefits. I already struggle to afford the city that I have grown up in 
and contributed to as a small business owner.''
  She continued: ``Shopping for health insurance through the 
marketplace created by the Affordable Care Act was the first time that 
I had assurance of affordable, good insurance. We must protect this 
program. It is a matter of survival.''
  At every turn, Republicans have turned their backs on the American 
people. President Trump and congressional Republicans promised the 
American people that they would take swift action on day one to address 
our Nation's affordability crisis by lowering the high cost of living.
  Well, instead, they unleashed the most aggressive assault on our 
Nation's healthcare in history, and the damage has been devastating.
  Across the country, we are already seeing hospitals, nursing homes, 
and clinics that serve our communities closing their doors, and now 
Republicans' refusal to extend ACA premium tax credits is driving up 
costs and pushing coverage out of reach for many in our communities.
  The CBC and House Democrats stood united for more than 40 days to 
prevent exactly this outcome while Republicans refused to negotiate and 
left working families to bear the consequences.
  We are calling on our Republican colleagues to join us in putting the 
well-being of the American people above partisanship, to put people 
over politics.
  This is not an abstract policy debate. It is about real lives. It is 
about parents deciding whether to fill a prescription or pay the rent. 
It is about seniors choosing between a doctor's visit and groceries. It 
is about young adults, gig workers, caregivers, and small business 
owners who depend on the ACA marketplace for the coverage that keeps 
them healthy and financially secure.
  Let me be clear: Allowing these tax credits to expire is a choice. It 
is a choice of greed. It is a choice of cruelty. It is the wrong 
choice.
  Ms. McCLELLAN. Mr. Speaker, I thank our chair for those remarks.
  Mr. Speaker, I yield to the gentleman from Georgia (Mr. Johnson), the 
Representative from Georgia's Fourth District.
  Mr. JOHNSON of Georgia. Mr. Speaker, I thank Representative McClellan 
for running point on this Special Order hour for the CBC. She is a 
legislative champion both in the State house and in the Federal House. 
It is good to be with her tonight, and I thank her for recognizing me.
  I also give a shout-out to our beloved leader of the CBC, 
Representative Yvette Clarke, who is doing a fine job leading us 
through these difficult times.
  These are difficult times for us. We here in Congress are having a 
difficult time. You see it. But the difficulties we face are nothing to 
what you face out there. You are the ones who are struggling to put 
food on the table. You are the ones who are struggling to keep a roof 
over your head as the head of your family. You are the ones struggling 
to work 8 hours a day for an honest day's wage only to come up short 
and having to work second and third jobs in order to make ends meet 
while you see others living lavishly surrounded by gold ornaments on 
everything that they can touch, building ballrooms for the rich and 
wealthy after knocking down the historic east wing of the White House, 
and doing it without anybody's consent, just waking up and deciding I 
am going to do this.

                              {time}  1940

  We live in a democracy, not someplace where a king is in charge, and 
that king is playing politics with the people.
  The other day, he floated the idea that he wanted to extend the 
Affordable Care Act tax credits, or ObamaCare tax credits. He floated 
that idea but got some pushback from a few Representatives on the 
Republican side of the aisle, and so he snatched it back.
  He doesn't realize that real people are depending on those tax 
credits in

[[Page H4959]]

order to make insurance affordable for them. People like Vivian in my 
district, who I had a phone conversation with recently about the rising 
cost of her healthcare premiums due to the Republicans' cruel refusal 
to extend ObamaCare tax subsidies, are depending on those tax credits.
  She told me: That is just an amount I simply cannot afford.
  Mr. Speaker, her premiums are going from $50 a month all the way up 
to $1,260 a month. From $50 a month to $1,260 a month. There is no way 
that she can afford that.
  Vivian has suffered from psoriatic arthritis since she was 27, and 
she now has vision problems in one eye. She relies on specialty 
medications to deal with her conditions.
  While Vivian faces skyrocketing healthcare costs, her husband is 
dealing with cancer. Luckily, he is on Medicare and is receiving the 
care that he needs, but if Vivian is cut off from her access to care, 
there is no way that she can keep going and take care of him at the 
same time.
  She said: Without the ObamaCare subsidies, my quality of life will be 
nonexistent.
  Vivian told me that without healthcare and access to her medications, 
she would lose vision in one eye, and because the medications help keep 
her arthritis at bay, it allows her to do seemingly simple things, such 
as to tie her shoes or walk without pain.
  She said: ObamaCare subsidies have saved my life. I don't know what I 
will do without it. People are people. Access to quality, affordable 
care shouldn't be a partisan issue.
  I agree. Americans like Vivian who are out there, those are the 
people who Democrats are fighting for.
  In the wealthiest country in the world, no one should have to worry 
about affording medical care. That is why I will work with anybody in 
Congress, including Marjorie Taylor Greene, who believes that access to 
quality healthcare is a human right and not a privilege reserved only 
for those who can afford it.
  Mr. Speaker, I have a number of other testimonials from people in my 
district, the Fourth District of Georgia, who have written and emailed 
what their situations are all about. They are many, and they are 
excruciatingly painful to listen to.
  Over 1.5 million Georgians are in the health exchange, in the 
marketplace, and 340,000 of those, or about one-quarter will lose their 
coverage if we don't do something about these expiring tax credits.
  A family of four earning $82,000 a year will see their annual 
premiums double to around $7,000 per year. It is just unsustainable for 
people to have to go through this month after month, and so we need to 
do something.
  Mr. Speaker, I appreciate our caucus for hosting this Special Order 
hour.
  Ms. McCLELLAN. Mr. Speaker, I thank the gentleman for his words.
  To hear more stories from Georgia, I now yield to the Representative 
from Georgia's Seventh District, Congresswoman Lucy McBath.
  Mrs. McBATH. Mr. Speaker, I thank the gentlewoman for yielding me 
time.
  Mr. Speaker, I rise today to speak out on the rising costs of 
healthcare, which are putting undue burdens on the American people. I 
thank my colleague Representative Jennifer McClellan for consistently 
continuing to elevate the voices of the Congressional Black Caucus 
members as we talk about the stories of our communities and the stories 
of our people and those who we represent, highlighting the needs of 
those in our Nation who are suffering right now.
  I thank our chair of the Congressional Black Caucus, Yvette Clarke, 
for her earnest, continued work to also make sure that the 
Congressional Black Caucus is standing on the front lines and trying 
each and every day to make sure that we are defending people's rights 
to exist in this country freely and fairly without these undue burdens.
  Earlier this year, we watched as this Republican congressional 
leadership reached historic new lows in their inability to work in a 
bipartisan fashion to meet the needs of the people who we were elected 
to serve.
  For 43 days, Speaker Johnson refused to come to the table and extend 
the healthcare subsidies which will prevent premiums from skyrocketing 
for the millions of Americans who get their insurance from the 
Affordable Care Act marketplace. That is approximately more than 70,000 
people, constituents, in my district alone.
  During that same time, we watched President Trump and his 
administration play politics with Federal food assistance, jeopardizing 
benefits for hungry families.
  I heard a story in my district in Georgia from Rich about the impact 
that these cost increases would have on his livelihood. I have heard 
many stories, but this one really struck me.
  He writes: I am the self-employed, sole provider for a family of four 
where two of us have preexisting conditions. If the Republicans get 
their way and remove the subsidies, my very basic catastrophe plan-
style HMO will literally increase tenfold. I am currently spending 39 
percent of my income on healthcare, including the subsidized ACA 
policy. Removing subsidies will ultimately lead me to financial 
bankruptcy.
  There are more stories just like this, and they are a window into how 
the chaos and unpredictability of this administration is making it 
harder on working families to succeed and thrive.
  Since January, we have dealt with the uncertainty and the chaos that 
has been brought by this second Trump administration. From the 
unpredictability of the tariffs, the rising costs of healthcare, and 
the increasingly unattainable goal of homeownership, what is going on 
in Washington should concern every single American in this country.

  Congress and the Trump administration should be doing more to lower 
costs and improve outcomes for our hardworking families.
  As I have continued to do since I first came to Congress, I have been 
committed to addressing the concerns of the families who I am very 
honored to represent. No family in this country should ever be forced 
to choose between paying their insurance premiums or for prescription 
drugs over paying their mortgage. That is unconscionable, and that is 
most definitely un-American.
  We must identify solutions to put the dream of homeownership back 
into reality for young Americans, and we must make it less expensive 
for Americans to get the skills necessary to provide a decent life for 
themselves and for their families, but they can't do that if they are 
sick. They can't do that if they can't go to work. They can't do that 
if they can't pay their bills, such as their hospital bills or other 
medical bills.
  I am a two-time breast cancer survivor myself, and not a day goes by 
that I don't think about how egregious not extending these ACA tax 
subsidies is to the American people. I am a lucky person.

                              {time}  1950

  I am very grateful that I had the ability to have private insurance, 
group insurance, where I could pay for all of my healthcare and didn't 
have to sit there and worry about how I was paying the bills while I 
was getting healthy and well.
  There are people all over this country who, if they ever get sick, 
that is the absolute demise of their ability to be able to live in this 
country and care for their families, and that is un-American.
  I am so grateful to Chairwoman Clarke and my fellow CBC member, 
Representative McClellan, for convening us again tonight as we look 
ahead to the year 2026. I truly look forward to working with every 
single one of my colleagues to build a better life for the hardworking 
families that we are privileged to represent, but I honestly pray every 
single day that everyone here, every one of us in this Chamber, truly 
is committed to the same ideals.
  Ms. McCLELLAN. Mr. Speaker, I yield to the gentlewoman from Florida 
(Mrs. Cherfilus-McCormick), who represents the 20th District.
  Mrs. CHERFILUS-McCORMICK. Mr. Speaker, I thank Representative 
McClellan for hosting this tonight and for hearing the cries of our 
district, what they are suffering and the political anxiety that they 
are living in just thinking that healthcare for them and their families 
will be stripped from them.
  Mr. Speaker, I rise today for a woman named Maria. Maria lives in

[[Page H4960]]

Broward County. She is a home health aide who works full time, raising 
two children, and still cannot afford health insurance without the tax 
credit from the Affordable Care Act.
  Because of those credits, Maria can take her blood pressure 
medication, and her son can see a specialist for his asthma. These are 
not extras. These are basic human survival and dignity matters.
  If these credits expire, Maria's premiums will more than double. She 
will be forced to choose which child sees a doctor and which child 
stays home and waits to get better.
  Mr. Speaker, that is not a choice any mother should have to face. 
That is not freedom. That is fear.
  Maria is not alone. In Florida's 20th District, more than 200,000 
people depend on these tax credits, and many are already dealing with 
serious gaps in their healthcare.
  This is not a policy debate. This is not a question of who we choose 
to value. This is a question of dignity for all Americans and their 
right to survive.
  I am calling on every Member in this House to look beyond party 
politics, party games, and trying to get the limelight to actually put 
human beings' lives front and center.
  The shutdown may be over, but our responsibility to protect the 
health and dignity of the American people is not.
  If we do not pass the ACA tax credits, we will be guilty of political 
malpractice for each person who goes without healthcare and has an 
unfortunate demise.
  Once again, I stress to every Member in this body to make sure we 
retain healthcare and the dignity of all Americans in this country and 
their right to have healthcare and survive like anyone else.
  Ms. McCLELLAN. Mr. Speaker, I yield to the gentleman from Maryland 
(Mr. Ivey), who represents the Fourth District.
  Mr. IVEY. Mr. Speaker, I thank my colleague from Virginia for 
yielding to me and for putting this together. I appreciate the fact 
that she took the leadership and initiative to bring this forward. I 
also thank my colleagues in the Congressional Black Caucus, as well, 
for taking a stand on this issue and the House Democratic Caucus 
overall.
  This is the issue that we fought about with respect to the government 
shutdown. This is the issue that has not gone away. I suppose the White 
House and my Republican colleagues were hoping that it would, but it is 
worse now than it was even then.
  In fact, the Republicans knew this problem was coming all the way 
back on January 20 when Mr. Trump first took office. To much fanfare, 
they began moving forward with his legislative agenda, the big, 
beautiful bill and other pieces of legislation. I don't even know how 
many executive orders they put together and put out undermining the 
government from the standpoint of government employees and making 
damaging impacts across the board.
  They failed to address this particular issue. In fact, I will come 
back to that in a moment. Not only did they not address extending the 
tax credits for the Affordable Care Act, but they made the problem even 
worse. The big, ugly bill that they passed included a $1 trillion cut 
to Medicaid.
  The healthcare safety net in this country, to the extent it is a 
safety net, was damaged terribly by what they have done, and it is 
about to get infinitely worse when these tax credits expire at the end 
of the month.
  I know my Republican colleagues have been fighting against ObamaCare 
for years now. I can remember back when it was first passed 15 years 
ago in this Chamber. There were over 60 votes to repeal and replace the 
ObamaCare piece of legislation. They kept going year after year after 
year. Somewhere along the way, about 5 years in, they found out that 
the American people actually like ObamaCare. They don't call it 
ObamaCare. They might call it the Affordable Care Act, but they kind of 
liked not having pregnancy treated as a preexisting condition, and they 
kind of liked having the ability to have their kids stay on their 
family insurance plans until they turned 26.
  The efforts to repeal it not only failed, but it has gotten stronger 
over the years because people have come to realize that without it, 
they might not be able to afford healthcare at all.
  I have decided to bring in a couple of comments from people in my 
district. There are too many to read all of them, but this one is from 
Beth, who lives in Greenbelt, Maryland, which is in my district. She is 
looking at her premiums going up $9,372 this year. She has major 
health conditions that require ongoing healthcare that she can't avoid. 
They were brought on by a major surgery that she underwent several 
years ago.

  Her case isn't unique. In the State of Maryland, it is estimated that 
the impact will be on 14,000 or so members of my district. A 60-year-
old couple with an $82,000 income is looking at a 168 percent increase 
if these affordable care tax credits are allowed to expire. A family of 
four, ages 45, 45, 15, and 10, is looking at a 200 percent increase in 
their monthly premiums. Obviously, most families can't sustain that.
  I am going to pick one. I read an article in the Washington Post a 
little while ago. This is a gentleman in Altoona, Pennsylvania. That is 
not my district, obviously; that is the district of Congressman Joyce. 
Matt Hornberger is 61 years old and from Altoona, Pennsylvania. Monthly 
payments for him and his wife will rise from $670 to $2,054. He said 
this: ``Between the high deductible and $25,000 in premiums, this is 40 
percent of our income. I am just trying to live a life here and be able 
to go to the doctor when you need to go to the doctor.''
  He ought to be able to do that. In fact, every American ought to be 
able to do that.
  What have we gotten from our Republican colleagues in the 9 months or 
so since they took over the White House, the House, and the Senate? Not 
much. I remember the President saying in the debate that he didn't have 
a plan, that he had a concept of a plan. I am not sure we have gotten 
much past the concept point 9 months later, but he did talk about HSAs.
  I was looking at that, doing a little research, and an economist, 
Doug Holtz-Eakin, who works for the American Action Forum, a 
conservative think tank, said this: ``There is a place for health 
savings accounts to augment insurance and fill things out around the 
edges, but it can't be the core insurance product.''
  The reason for that is because it is not designed to be the core 
insurance product. As a matter of fact, we have HSAs in place now, but 
66 percent or so of these have only $1,000 or less in the account.
  As you heard from my colleague from Virginia, $1,000 doesn't go a 
long way in our healthcare system. It is $70,000 a day for the NICU 
system. I am a kidney cancer survivor. A thousand dollars sure wouldn't 
have covered my insurance for the surgery that I underwent. As a matter 
of fact, it wouldn't have even covered the MRI that allowed us to find 
it, fortunately, very early on.

                              {time}  2000

  Now, what is the path forward?
  Mr. Speaker, I have to complain a bit because we have been talking 
about this issue the whole time. I am a father. I have six kids, and 
this reminds me a little bit of one of them.
  He came home from school one day and he looked at his mom, of course, 
and said: Mom, will you help me with this project I have? She said: 
Honey, I am a little tied up right now. Can I help you out later? He 
said: We can't really wait on this. She said: Why not? He said: It is 
because it is a big part of my grade. It is a huge part of my grade. 
She said: Okay. I will help you out with it, but when is it due? He 
said: Tomorrow. She said: When did you know about this project?
  As it turned out, he knew he had this assignment months ago, but he 
hadn't done anything to get ready for it. He hadn't let us know that he 
needed the help to work on it, and he certainly hadn't done any work to 
prepare the project.
  That is what our Republican colleagues are doing right now. They came 
into office on January 20th knowing that these ACA tax credits were 
going to expire. They didn't do anything to address it. Not only that, 
but we brought it to their attention when this bill was moving through, 
the big, ugly bill. We tried to address it then, but they refused to 
extend the tax credits then. We tried to offer amendments at the 
committee level. I am on the Appropriations Committee. We offered four 
of those to try and amend

[[Page H4961]]

this piece just to extend it. Let's try and fix it. If you have other 
things you want to do it with it, let's extend it now so it doesn't 
expire.
  They refused to do it. They voted it down four times on a party-line 
vote over and over again just like they had done over the previous 15 
years when they were trying to get rid of it. Maybe this is death by a 
thousand cuts in their minds, but something strange happened along the 
way.
  The American people started getting these notices in the mail that 
their premiums were about to double or triple. The American people, 
millions of them across the country, started realizing that there is no 
way they can afford to pay that. They are going to be forced into the 
choice of either dropping the insurance or take some other drastic 
measure like selling their house. One lady said she might have to pull 
her kid out of college to pay for this healthcare coverage.
  It is absolutely outrageous, but the failure to do something until 
the eleventh hour is a total abdication of their responsibility of 
leadership, not just in the House, not just in the Senate, not just in 
the White House but entirely across the board.
  The Republican Party didn't wake up to this until the American people 
started screaming in their ears. Well, now, here we are. What is the 
path forward?
  Senator Schumer back during the government shutdown at the end of it 
said: Tell you what. Why don't we just extend it for a year. Let's put 
a task force together to try and work out the differences because I 
understand the Republicans don't agree with everything. Let's take a 
year and extend it and try and work it out.
  Not only did the Republicans and the Senate reject that, they 
actually said: This is stupid. I can't believe he would propose this. 
Those were the types of comments he got from his Senate colleagues for 
proposing a 1-year extension.
  Right now, there is a 3-year discharge petition that would extend the 
tax credits for 3 years. I don't know if there are any Republicans who 
have signed on to that, but I think we have about 9 legislative days 
left. At least my kids were only in their early teens. However, if they 
want to do the big fixes they have been talking about with respect to 
healthcare, they are not going to be able to do it in 9 days.
  Now, I know they are going to try and do something to save face, but 
at the end of the day, the extension is really the only realistic way 
we have to go here.
  I have to say this: If they don't do the extension, it is going to be 
devastating for families across the country, millions of them.
  We were talking a little bit about how much these things could cost. 
The HSA is a thousand-dollar average. Look at the average cost for 
heart surgery. Just the surgery, not even the stay, is between $30,000 
and $200,000 just for the procedure. I don't even know how much my 
cancer surgery cost because I had health insurance. I didn't have to 
check it like that. We had to pay some deductible, but nothing 
dramatic. We wouldn't have been able to afford it. I wouldn't have 
gotten the surgery because I wouldn't even have known I had cancer 
because we wouldn't have gotten the MRI.
  That is where we are putting the American people right now. Actually, 
not we, the Republicans are putting the American people right now.
  It is time to end this. The clock is running out. The calendar says 
the time has come to do something and put some kind of proposal on the 
table.
  I have to say this, too, on the proposal piece. When the Speaker 
passed the bill, I think it was, if I recall correctly, July 25th, we 
left town for the August recess, came back, passed the bill, and then 
left town again. There was a stretch there where I think we had been in 
session between July 25th and when the government finally reopened, I 
think it was 12 legislative days.
  To my friends out there in the country, how many of you could only 
work 12 days in July, August, September, and October and still have a 
job and still get paid while you are out? That is what they did.
  Mr. Speaker, the time has come to get this done finally, to make some 
kind of an effort to reach a bipartisan solution and resolve this 
crisis that was created entirely by my Republican colleagues, that was 
totally avoidable, that they decided to run into the fire anyway.
  Let's fix this. Let's protect the American people. Let's allow them 
to go at least 1 year, maybe 3, so we can extend this so they can make 
sure that they continue to have healthcare coverage while we are 
working on this bill. Let's get it done.
  Ms. McCLELLAN. Mr. Speaker, may I inquire as to the time remaining.
  The SPEAKER pro tempore (Mr. McGuire). The gentlewoman from Virginia 
has 20 minutes remaining.
  Ms. McCLELLAN. Mr. Speaker, I will take a personal privilege to close 
this Special Order hour with some stories from Virginia, which I know 
you, Mr. Speaker, care a lot about. You and I served together in the 
State legislature there where we were able to find common ground across 
the aisle a little more easily than we are able to do in Congress.
  In Virginia, about 350,000 people benefit from the Affordable Care 
Act premium tax credits, enhanced premium tax credits, 30,000 in my 
district, the Fourth Congressional District.
  For a family of four that earns $129,800 a year, they are looking at 
premiums that will increase by $4,675. A family of four earning $64,000 
a year will see their annual premiums increase $2,571. A 60-year-old 
couple earning $82,800 a year will see their annual premiums increase 
$11,968. That is a 174-percent increase. That is what Virginians are 
facing if we can't find common ground to solve this problem, even 
temporarily.
  Our former colleagues in the General Assembly have predicted that at 
least 60,000 Virginians would end up canceling their insurance coverage 
due to affordability if they lose access to the enhanced premium tax 
credits.
  Mr. Speaker, last week, Cardinal News--which covers the Southwest and 
Southside, Virginia, both of us represent portions of that part of the 
Commonwealth--told several stories.
  There was one from Reagan Fisher Wyssbrod from Salem. Reagan and her 
husband, who is self-employed, have two children.

                              {time}  2010

  Wyssbrod works three part-time jobs to help support the family while 
keeping the flexibility needed for her children. She spends some days 
as a substitute teacher and as a business manager for a library 
association. She does some bookkeeping on the side. None of these jobs 
offer benefits.
  She has a bachelor's degree in psychology, roughly two decades of 
experience in health insurance and accounting, and she is willing to 
take almost any job that will offer benefits, she said, even if that 
means working at McDonald's because she doesn't want to let her 
children go without healthcare.
  Her projected monthly premium increase is $400, which would raise her 
monthly out-of-pocket costs to $1900. On top of that, her longtime 
doctor has moved out of network. It is astonishing, she said.
  She spent 3 weeks combing through plans and eventually found one that 
would save the family about $100 a month, bringing their premium down 
to $1,800, allowing her to keep her doctor, but it has a higher 
deductible. She said the worst case scenario is her out-of-pocket costs 
would be $20,000 on top of the monthly premium.
  Ultimately, it came down to: I don't go to the doctor that often, my 
kids don't go to the doctor that often, so we will just roll the dice.
  She said: We will wrap some bubble wrap around us, I guess.
  I don't think bubble wrap is going to help if they get in a car 
accident.
  Victoria Cassels, an accountant in Roanoke, worries about her adult 
daughter who lives in Richmond, who is a self-employed graphic designer 
with an autoimmune disease. Her condition limits how much work she can 
take on, and she depends on marketplace coverage. Her monthly premium 
rose by $400, about three times higher than it was last year.
  Cassels is going to do what she can to help her daughter cover the 
costs if she can't take on enough work to meet this new expense. 
Cassels prepares taxes for individuals and small businesses and says 
more of her younger clients are

[[Page H4962]]

talking about dropping health insurance all together because they just 
can't afford it.
  In the last few years, she has had a slew of clients in their 
twenties and thirties who have started their own businesses. Just 
getting started in life, they don't have the savings to afford the 
increasing cost of health insurance. Without health insurance, it is 
going to be very difficult for them to start a family.
  Ben Pearman, financial adviser from Bent Mountain in Roanoke, runs 
his own business which is well established, and he has a steady income, 
but higher monthly costs have led him to reconsider his options.
  As a single man in his fifties, he pays for his own health plan. Next 
year, his monthly premium will jump from $724 to $935. He can absorb 
the higher cost but is considering switching to concierge care, a model 
in which the patients pay a flat monthly fee, but that would leave him 
without insurance if an accident happens.
  Linda Bartlett, 64, entered semi-retirement last year, and now works 
part time at Roanoke's Mast General Store. She turned to the 
marketplace until she qualifies for Medicare. Her premium is about to 
double, bringing her monthly payment to $1,200, which is nearly all of 
her Social Security check.
  Mr. Speaker, I yield now to the gentlewoman from Illinois' Second 
District, Congresswoman Robin Kelly.
  Ms. KELLY of Illinois. Mr. Speaker, I rise today as the chair of the 
Congressional Black Caucus Health Braintrust to urge my colleagues 
across the aisle to extend the ACA tax credits.
  As you know, they are set to expire at the end of the year and will 
cause monthly health bills to skyrocket for millions of Americans. The 
rising cost of healthcare goes beyond the individual. It affects Black 
small business owners.
  A small business owner in my district owns several coffee shops and 
worries about her employees being able to afford healthcare. She feels 
responsible for her employees, but healthcare is a large expense for a 
small business. The ACA premium tax credits provide affordable care to 
her employees, allowing her coffee shop and her employees to thrive.
  Another small business owner in my district runs a wine production 
business that sells nationwide. Despite her success, she has to rely on 
her husband's job for healthcare. These are two small business owners 
who have created their own success, and through their businesses 
created jobs for other people.
  Republicans love to say they support our economy. It is time to 
actually support the healthcare of small business owners, who are the 
backbone of our economy. Republicans also love to say the best option 
for healthcare is a job.
  My constituents have a job. They also provide jobs for more people, 
but they all receive affordable healthcare through the ACA. Without the 
ACA tax credits, their employees may have no other option but to go 
uninsured or find another job. If they decide to leave, my 
constituents' businesses won't be able to run.
  It is simple: We all do better when we all do better. We are all 
healthier when we are all healthier. Let's extend the ACA premium tax 
credits. Let's make healthcare more affordable and accessible.
  Ms. McCLELLAN. Mr. Speaker, I want to put this debate in a larger 
context. I was in the State legislature where the Affordable Care Act 
passed. It wasn't perfect. Our healthcare system has never been 
perfect, but what it did, between the marketplace and expanding 
Medicaid, is it got the number of uninsured to record lows, at least in 
Virginia. I can't speak to nationwide, but in Virginia, we saw our 
uninsured rate go to record lows.
  We were able to expand Medicaid on a bipartisan basis because it 
didn't just benefit urban cores, but suburban centers and rural 
communities, rural communities that had high numbers of uninsured, that 
were worried about how their healthcare centers, their hospitals were 
going to have the volumes to stay open.
  We expanded Medicaid. During the--I call it the big, ugly bill, we 
put millions of Americans at risk of losing their health insurance 
through cuts to Medicaid. We saw a list of over 300 hospitals in rural 
areas identified as being at risk of closing.
  During the August recess, I traveled all over Virginia not just to 
talk to my constituents, but as one of only two members of the Energy 
and Commerce Committee to talk to a wide cross-section of Virginians. I 
visited a dental clinic in Abingdon. Eighty percent of their patients 
are covered by Medicaid, 80 percent. The other 20 percent are 
uninsured.
  Before that clinic opened, that community got dental services once a 
year when a mobile dental clinic showed up, and the line was incredibly 
long to get one day of dental service a year.
  When I visited this clinic, I didn't come in with any talking points. 
I just came to tour. I asked: What keeps you up at night? The director 
said: I don't know how we are going to keep our doors open with these 
Medicaid cuts.
  Two TV stations were there who were there when the clinic opened 
because they understood what a big deal this clinic was, not just for 
Abingdon, but the entire southwest corner of the Commonwealth. My 
colleague who represents that area in response to that visit said: 
Democrats are just fear-mongering.
  Well, lo and behold, less than a month later, three rural clinics 
closed, citing Medicaid cuts in H.R. 1. A hospital in Farmville closed 
its labor and delivery unit.
  I ran for office because I grew up listening to my parents tell 
stories when they grew up in the segregated South during the 
Depression. They saw the best of government and they saw the worst of 
government.

                              {time}  2020

  Mr. Speaker, the best of government was when people came together to 
solve problems and to help people who were hurting through no fault of 
their own. These were people who were working day in and day out and 
couldn't afford to put food on the table. They couldn't afford 
healthcare when they got sick. They couldn't afford a roof over their 
heads.
  The worst of government is when we sit here and focus more on: How 
can I score political points? How can I benefit the wealthiest 1 
percent on the backs of every other working American?
  As I traveled around Virginia in August and October, and in the 54 
days that we weren't doing our job here in Washington--not having 
committee hearings and not voting on the House floor--what I heard was 
people losing faith that our government knows how to be at its best. We 
have to get back to that.
  Our system is not perfect. That is why in the Constitution it says 
that our government was formed in order to form a more perfect Union. 
It is not a perfect union but a more perfect Union.
  The beauty of our form of government is when we listen to the people 
and see that they are hurting, we have an opportunity to do something 
to stop that hurting, an opportunity to feed the hungry, house the 
homeless, care for the sick, welcome the stranger, and visit the 
incarcerated. When we do for the least of these, we are at our best.
  We have gotten away from that, Mr. Speaker. We better get back to it 
because the American people are losing faith that this body, Congress, 
will do its job. We better do it. They are depending on us to. They 
have told us they are worried. We heard the stories tonight. This is 
just one thing people are worried about.
  We need to get back to our better nature. We need to come together, 
find common ground, and help people who are wondering: Come January 1, 
how am I going to afford this health insurance? What am I going to do 
when my kid burns his hand and ends up in the burn unit with a bill of 
$15,000 that I can't afford to pay? What am I going to do if my baby is 
born prematurely and has to stay in the NICU at an average price of 
$70,000 a day?
  People are wondering: Do we hear them, and are we going to act?
  Mr. Speaker, I yield back the balance of my time.

                          ____________________