[Congressional Record Volume 171, Number 208 (Wednesday, December 10, 2025)]
[Senate]
[Pages S8632-S8633]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               HEALTHCARE

  Ms. CANTWELL. Now, Mr. President, I rise today to urge my colleagues 
to continue to work on the affordable care issues that are facing our 
Nation. We know that we have to work together to address the Affordable 
Care Act and that the system needs to continue to have updates.
  We know that in this time period since 2010, the uninsured rate in 
the United States was a staggering 18.2 percent. After the enactment of 
the ACA, which significantly expanded coverage, around 45 million 
Americans had access to either Medicaid or the ACA plans--and that is 
that we actually cut by more than half the uninsured rate to an alltime 
low in 2023 of 7 percent.
  Now, in my home State, we took advantage of the Affordable Care Act 
and further drove the uninsured rate down to 4 percent, significantly 
reducing hospitals' and providers' financial burden from providing 
uncompensated care. So there has much been said about these individual 
provisions in the Affordable Care Act on the exchange, but the bottom 
line is--that ability for the Affordable Care Act to drive the 
uninsured rate in half to an alltime low of 7 percent and 4 percent in 
my State is a great example of what it did to help lower costs across 
the whole system.
  There are still some challenges on the exchange, and there are more 
affordable ways to deal with that population on the exchange. I 
authored one of them called the Basic Health Program. It is now working 
in three States and soon to be the District of Columbia, and that is 
definitely thousands of dollars cheaper per year than what you can buy 
on the exchange. And I would encourage all of us to look at that as a 
solution for the future.
  But according to a report from the Commonwealth Fund, States that 
expanded Medicaid through the Affordable Care Act saw an average 40-
percent decrease in uncompensated care. Another, the Center for Budget 
and Policy, basically, as this chart shows, found that the Affordable 
Care Act reduced uncompensated care costs by more than $6 billion in 
expansion states.
  Just imagine--reduce the cost by $6 billion by just covering people 
and not having this tragedy of uncompensated care. Literally, I have 
had hospitals tell me that one person can cost millions of dollars by 
just constantly coming to the hospital. If they would have just had 
healthcare, had insurance, their costs would have been covered, instead 
of the constant uncompensated care costs.
  So the real challenge here is that since the passage of the ACA, our 
colleagues on the other side of the aisle, the Republicans, have been 
trying to repeal this bill that cut the uninsured rate in half, 
provided care that was affordable in the Medicaid expansion and covered 
other things, as in the basic plan, they tried to repeal all that 70 
times--70 times. OK. So I am not surprised that we are days away from a 
vote, and yet they are still not coming together to show us how they 
are going to reduce healthcare costs.
  We need to keep covering people because covering people is a way to 
help reduce costs. As I mentioned, the expansion of the Basic Health 
Program is one way to lower those costs. But I know that in this last 
big bill passed by my colleagues, they basically cut $1 trillion from 
the healthcare system, taking away health insurance from 15 million 
Americans, raising the healthcare costs and basically creating 
challenges. I know in one Seattle Times headline, basically, 
``Washington health care insurers fret as the ACA subsidies remain in 
limbo.'' That is because people are following what we are doing--or I 
should say not doing--and they are trying to understand where they are 
going to get affordable insurance.
  I heard from a woman in Spokane, she has a chronic lung disease and 
recently fractured her knee. Her premium has gone from $723 per month 
to $2,180 per month. Her only option, a plan with less coverage, has a 
lower premium, but makes her liable for 30 percent of all hospital and 
ER payments, making the plan incredibly risky. She is just a year and a 
half away from qualifying for Medicare, but these massive costs mean 
she and her husband will have to cut back on groceries and other 
expenses.
  I heard from another constituent in Clark County. She works three 
jobs, but none of them--none of them provide healthcare. Because of the 
expiring subsidies, the cost of her basic bronze plan has doubled to 
$1,050 per month with a deductible of $9,000. She is going to an 
occupational therapy provider for arthritis. But when she got the 
$1,000 cost estimate, she canceled.
  Another constituent from Long Beach, WA, told me her son has mental 
health issues, and she helps pay for his housing. But if her premiums 
go up, she will have to make the difficult decision about getting care 
for her son or a roof over their head or this issue of premiums.
  We know the costs are rising for other things, like groceries, 
prescription drugs, and other necessities. So health insurance is going 
to push people off of a financial stability. If Congress doesn't extend 
the expiring ACA credits, an estimated 5 million Americans--80,000 
Washingtonians--will drop insurance altogether, creating more 
uncompensated care.
  And as I said in the beginning, passing the Affordable Care Act, 
cutting the uninsured rate in half, was a huge milestone, beyond saving 
$6 billion, but making the system healthier and less expensive. So why 
do my colleagues on the other side of the aisle not understand that we 
can't just cut, in the Big Beautiful Bill, these important healthcare 
programs. We can't try to repeal the ACA 70 times and then, all of a 
sudden, believe that you can just cut people off of the ACA program 
without trying to provide a more cost-effective solution?
  I know my colleagues Senator Crapo and Cassidy are trying. My guess 
is they would like to get a solution here. I thought we should have 
done it before we opened the government back up because we had the 
optimal period of time where people were listening to real solutions. 
Now, we have kind of divided into our corners.
  I am very worried that we are not going to get this done when, in 
reality, we could. We could. We are making things more expensive when 
we don't need to. Without the extension, millions of Americans will 
simply choose not to purchase the coverage, and the premiums will, on 
average, double for the remaining people on the exchange. So that 
meager $1,000 to $1,500 provided by my colleagues, Senators Cassidy and 
Crapo, in health savings accounts is nowhere--nowhere--close to 
covering the out-of-pocket deductible of a $7,000 typical associated 
plan with the health savings accounts.
  So I talked to them before, I wanted to work with them in earnest. I 
thought it was some novelty in certain places like Indiana that was 
worth exploring. But we cannot take millions of people off of the 
Affordable Care plan and then say that you are going to give them 
$1,000 when we know that their out-of-pocket expenses are going to be 
$7,000.
  So, as we have all suggested, fix this program, particularly for the 
very small 5 percent or 6 percent that are at the very high income 
level, figure out a plan that is more cost effective than what we are 
providing today, and I am sure--I am sure--we can provide a solution 
for the American people.
  We know now that the cost of hospitalization by people like my 
constituent in Spokane with chronic conditions like lung cancer or 
other issues are really worrying the American people. We know that even 
as we try to get a solution, that people are focusing on abortion 
restrictions, as if those people in the Affordable Care Act part of the 
exchange we are talking about are people that were part of this issue. 
So literally, our colleagues on the other side,

[[Page S8633]]

who tried to say, let's cut the Affordable Care Act 70 times, put in 
decimating language in the Big Beautiful Bill are also saying, The only 
way I am going to solve this problem for you is if you change the law 
and try to put more restrictive reproductive rights into statute.
  So we can do better than this. We can focus on finding bipartisan 
solutions. We can focus on working together as members of the Finance 
Committee and actually get something done, but time is running out. I 
know that we want to get something done, but this Finance Committee--
has the full committee met in open mark-up for 7 days of debating and 
amending legislation, and that is what it takes to get our colleagues 
in order.
  I want us to understand what legislating really looks like. We know 
that when we had the Covid pandemic, we all came together and created a 
solution to help the economy keep going, to help the airline industry 
keep going, to help small businesses. We could have done more. We 
obviously had differences of opinion about how much to do, but we 
worked in a bipartisan fashion.
  So now, as we face this crisis where Americans are losing their 
health insurance, people have retreated to partisan corners again on 
things like choice and things like cutting people off of health 
insurance, instead of working on solutions that really lower costs.
  I ask my colleagues, let's work on solutions so that we will have 
something for Americans. Otherwise, beginning January 1, which is not 
that far from now, Americans are going to have less insurance, they are 
going to have more costs, and many of them are going to be facing a 
healthcare crisis without the aid and help of insurance to get them 
through it.
  I hope we can do better than that. I hope that we can learn from the 
fact that expanding affordable health insurance to Americans is a 
winning concept. It is worth achieving. I hope our colleagues will try 
to achieve it in the next day.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Justice). The Senator from Massachusetts.

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