[Congressional Record Volume 171, Number 202 (Wednesday, December 3, 2025)]
[Senate]
[Page S8465]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Mr. SCHATZ. Mr. President, when Republicans tell you over and over, 
over a period of generations, that they have no interest in protecting 
people's healthcare, you should take them seriously.
  For decades, since the days of Ronald Reagan, they have argued that 
Medicare is socialism, that Medicaid creates cycles of dependency, that 
the Affordable Care Act is making healthcare more expensive when, in 
fact, it is doing the opposite. So you should not be surprised that, 
given the opportunity to extend the Affordable Care Act tax credits and 
prevent people's premiums from more than doubling starting next month, 
Republicans do not have the votes to prevent that.
  Look, this is not complicated. If Congress doesn't act this month, 
millions of Americans will lose their healthcare next year because they 
simply will not be able to afford to pay hundreds of dollars more every 
month for the same healthcare, and tens of millions of people will be 
forced to cut back on groceries or afterschool activities for their 
kids just so they can keep seeing their doctors.
  The only way--the only way--to prevent the suffering that is about to 
happen is to pass a clean extension of these credits. There is no other 
plan. There is a lot of conversation--even on the left but also on the 
right--about how to reform the healthcare system. Nobody seriously 
thinks that can be accomplished in the month of December.
  If we want to have a bipartisan conversation about how to fix the 
American healthcare system, count me in. This thing is a mess, between 
managed care and all of the subsidies and all of the sort of rent-
seeking and the idea that most--maybe not most of the money but a 
substantial portion of the money in the American healthcare system goes 
to people and institutions and processes that don't deliver healthcare. 
There is utilization management. There is billing. There are 
pharmaceutical benefits managers. There are all kinds of rent seekers--
people in the American economy, institutions in the American economy, 
and publicly traded companies in the American economy that take a cut 
out of your money that should be going to healthcare. That is a very 
important point.
  If there were a bipartisan opportunity to fix that, count me in; 
count 47 of us in. But let's not kid ourselves: No one is getting that 
done by next week. So the question in front of us is a little more 
crisp and a little more uncomfortable than ``Does the American 
healthcare system work efficiently?'' Of course it doesn't. But these 
subsidies allow people to stay alive. These subsidies allow people to 
stay insured. These subsidies allow people to afford their healthcare 
so they can pay their rent or their mortgage or buy their groceries.
  The question in front of us is not some big abstraction about public 
policy. We are not at some Axios event about what we should do about 
the American healthcare system. The vote in front of us next week is, 
do you want people to pay double and triple, or do you not want people 
to pay double and triple?
  So let's stop messing around. Let's stop pretending there is some 
magical solution that will emerge over the weekend. We have got 47 
votes. We have got 47 votes. I take some pride in being able to count. 
It is a weird business I am in that being able to count is such a 
unique skill, but I can tell you we have got 47 votes. So what does 
that mean? We need 13 votes over there. I can't even find 13 people who 
will verbalize that they would like to avoid this spike in premiums.
  We have run out of time, and if Republicans want to solve this, there 
is a very straightforward path.