[Congressional Record Volume 171, Number 214 (Thursday, December 18, 2025)]
[House]
[Pages H6105-H6111]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHANGING HEALTH INSURANCE MARKET
(Under the Speaker's announced policy of January 3, 2025, Mr.
Haridopolos of Florida was recognized for 60 minutes as the designee of
the majority leader.)
Mr. HARIDOPOLOS. Mr. Speaker, it is my honor to be here this
afternoon as we talk about the need to promote accountability,
flexibility, choice, and to allow small businesses to galvanize
together to find the best options for their employees in the changing
health insurance market.
I will start today by ceding some time to my friend from the State of
Montana, Representative Downing, who has great experience in working
with the marketplace in his home State of Montana.
I yield to the gentleman from Montana (Mr. Downing).
Mr. DOWNING. Mr. Speaker, I thank my colleague from Florida, Mr.
Haridopolos, so much.
I rise today to discuss or to comment on what I see is the biggest
fraud this body has ever put upon the American people.
Let's go back to the beginning of the unaffordable care act,
ObamaCare. How was this sold to the American people? You can keep your
doctor if you like them. You can keep your plan. Your insurance
premiums are going to go down.
I will tell you, all of that--I will tell you; this is one time that
both the Republicans and Democrats agree, that it did not deliver on
that.
The Affordable Care Act, ObamaCare, has been one of the biggest
drivers in increasing not just the cost of health insurance but the
cost of healthcare.
To continue this deception, it was clear that this plan would not
work. You don't have to be a Ph.D. in mathematics to understand why. As
you start to add things--the essential health benefits that you added
onto these policies, these required benefits, as you started to add
things that had to be covered--and I am not saying whether those were
good or bad. But if you add expenses, you can't make prices go down. It
would be like saying if you went to a fast food restaurant and ordered
a soda and the price is going to go down but they have to give you a
free cheeseburger as well. It just doesn't make common sense. It
doesn't make mathematical sense. So to further this deception, they
realized that it only worked by subsidizing it. You had to levy a tax
to subsidize it.
The architects on the other side of the aisle who put this together
realized that the American people would rebel against this if they were
given a tax to pay for it. How did they hide that? Well, let's just tax
the payers, let's tax the insurance companies, and then they can pass
those expenses down to the American people through higher premiums.
That is exactly what happened.
Then let's look at another phenomenon. As these prices start going
up, people start to question whether they are getting value for what
they are paying for. For some folks, the answer was no. They didn't
want to pay those higher rates, and so some folks came off.
As we see, the people who come off tend to be the people who least
need services. So the healthy, younger people tend to be the ones that
come off. As they do that, that concentrates the risk. That makes the
prices go higher for the insurance companies, for the payers.
As that happens and you get into the next policy year, they have to
raise the rates again. As they raise the rates again, you lose more
subscribers to those policies. You further concentrate the risk. This
is known as adverse selection.
What happens in adverse selection, every time you see that raise,
those prices rise, you start to see more people come off. They look for
alternatives like healthcare sharing ministries, they look for
something else, or they go uninsured. You start this endless cycle of
these prices going up.
There is another thing I want to point out. This is kind of economics
101. The more money you put into a system, the more expensive things
get. We have seen that in so many different areas. We have seen that in
subprime lending. We have seen that in student loans. You put money
into a system, and it starts to push prices up.
One of the other contributors we have is not just adverse selection,
which is concentrating the risk and making it more expensive for the
insurance companies, but we put so much money in the system that we are
seeing rises in actual healthcare.
It is important to make the distinction between the rising cost of
healthcare and the related rising cost of health insurance. So we just
come to this death spiral of this becoming more and more and more
unaffordable. In my personal opinion, this entire system is going to
collapse under its own weight, and you have got two solutions.
The other side thinks that we should just write a blank check from
the Federal Government, no matter how big that check is going to be, so
that we can hide the fact that this is failing.
Let's face it. This is seen as a landmark piece of legislation that
the Democrats have pushed over the last couple of decades. It is
important to them to protect this landmark legislation. I am sorry, but
the emperor is not wearing clothes. In order to hide that, they are
doing these smoke screens with these increased subsidies.
Now, let's look at the subsidies that have really gotten a lot of
attention, these ObamaCare subsidies that we have been talking about
that the Democrats brought in response to COVID. These are subsidies to
folks who are on the individual market.
It is important to note that the individual market is a small
percentage of the insureds. This is not the entire market. This is not
a small group. This is not a large group. This is a small percentage of
folks who are on the individual marketplace, who get their health
insurance through healthcare.gov or through one of the exchanges. It is
a very small part.
{time} 1650
When the Democrats first put this, it was a reaction to the chaos
during COVID, and it was, by their intent and by their architecture, a
temporary solution for a temporary problem. So it was designed to
expire. It had a sunset.
Then, when it was coming up to a sunset, when the Democrats still had
control and had the ability to make this permanent, they still put an
expiration date on it. These enhanced premium tax credits, or these
ObamaCare credits, were designed to expire at the end of this year.
Essentially, January 1 is when they were designed to expire.
It is entirely policy brought by the Democrats. This was not
Republican policy, it was a smokescreen. There are estimates it will
cost between $300 and $400 billion to pay for it over the next
[[Page H6106]]
10 years if they are expanded. Like I said, it is a smokescreen.
Folks are starting to talk about whether prices are going to go up or
go down or what these subsidies will do. Let's talk about that for a
second. These subsidies are a very small part of the increases that we
are seeing in premiums because of what I have already talked about. It
is because of rising costs of healthcare and because of rising costs of
health insurance that are due to those healthcare increases as well as
that adverse selection.
Let me just put this small percentage in perspective. In Montana, we
have a number of payers, a number of insurance companies. The one with
the largest increase on the individual market was about 25 percent. It
is a high number, I agree, but that 25 percent was a single digit
amount. About 9 percent of that, was attributed to the enhanced premium
tax credits, the ObamaCare credits. Even without that, the prices are
going up. Independent of these ObamaCare credits that we are
discussing, it is going up in the small group, the large group, and it
is going up in every other part of insurance.
That part without the enhanced premiums, as I said, that delta
between 25 and 9, let's say that is 16 percent, everybody else is still
seeing that. They are still seeing that increase.
One of the smallest increases we saw from our major payers was about
10, a little bit over 10 percent, and about 3 or 4 percent of that was
attributed to the ObamaCare premiums.
The reason I am bringing this up is that it is a very small
percentage of these overall costs. One thing that I want to point out
is that if these tax credits are allowed to expire on the 31st,
premiums are going up. If we extend them, premiums are going up. It is
happening either way.
Just one thing I want to end on so that people understand how this
process works. If this body decides to extend those premiums, let's say
it is for 2 years or 3 years, an arbitrary amount, then what happens?
The way that insurance rates are filed is they go to the States, the
payers, the insurance companies bring them to the States. They file,
they are approved, they get filed with CMS, with the Centers for
Medicare & Medicaid Services, and then the open enrollment period
starts, which is usually mid-November to mid-December.
Mr. Speaker, during that open enrollment period is when you buy your
policies for the following year. We just closed that open enrollment
period a couple of weeks ago for the 2026 policy years. Those rates are
already baked in. If we were to extend those credits, the rates are
already baked in.
Unless we go to extraordinary measures of allowing the payers to,
once again, refile their rates and then have another open enrollment
period, which I guess would be March or April by the time we got all
that through, then, what do we with that?
Do we make those rates ex post facto? Do we have them go back to the
beginning of the year? Or do you allow it to go through its normal
cycle, in which case those rates affect the 2027 year.
The point I am making is that by extending those ObamaCare subsidies,
we are not affecting the 2026 rates without going to extraordinary
measures to unroll everything that has already happened.
What will happen is those insurance companies that filed higher rates
with the assumption of those premium tax credits staying in will get
the benefit of having a higher rate plus having that tax credit.
Going back to how I started this, this fraud was put on to the
American people to hide the taxes so that the American people weren't
taxed directly. They taxed the insurance companies that are getting
these tax credits to change those rates for the people. This is not
going to affect what is happening right now without extraordinary
measures.
In closing, what we need to do, and I thank the gentleman from
Florida for yielding, we need to start looking at alternatives on what
are the core drivers of the costs of health insurance.
How do we rate health insurance so that younger, healthier people are
still willing to pay for it so we have spread risk there?
What are the things that we can look at for driving costs down to
stopping this endless cycle of adverse selection so that people can
actually, as was promised on this big fraud perpetrated on the American
people, have the doctor they want, the plan they want, and have their
rates going down?
This ObamaCare premium debacle is not the answer, but we do need to
get to work and figure out how we can get to the root causes of these
rising prices. That is because, as I said, this is either going to
collapse under its own weight or we are going to be forced to write an
unlimited check to the Federal Government which many of my colleagues
and I are unwilling to do.
Mr. HARIDOPOLOS. Mr. Speaker, I thank the gentleman for his remarks.
We appreciate his expertise and understanding on these issues as we
take it on toward the future.
I want to read one comment before I call up the Congressman from
Colorado.
This is from The Washington Post, which may be the most liberal major
newspaper in America.
Their comments were simply: ``Many honest people will feel the
squeeze next year, but any serious effort to extend ObamaCare subsidies
would need to include lower income caps, require some out-of-pocket
premiums and impose additional anti-fraud protections.''
The Washington Post said this. They recognize the reality that this
has been a broken system that has been covered up for years at the
expense of other taxpayers and the overall cost of healthcare. That is
why we are having the discussion today.
Mr. Speaker, I yield to the gentleman from Colorado (Mr. Crank). I
thank him for joining this conversation, and we look forward to his
comments.
Mr. CRANK. Mr. Speaker, I thank the gentleman from Florida for
yielding me time.
Mr. Speaker, we heard so much from the gentleman from Montana who
knows a lot about health insurance.
Healthcare is more than these enhanced premium tax credits. The
Democrats have tried to make it about enhanced premium tax credits, but
healthcare is more than that.
As the gentleman from Montana pointed out, enhanced premium tax
credits would cover 7 percent of the American people. That is what we
are talking about with their solution. It would be 7 percent.
Even if we were to fix that 7 percent, what would the fix mean?
Let's talk about who these people are.
These are folks in the enhanced premium tax credit who make, for a
family of four, over $128,000 a year. That is what we are talking
about. We are not talking about people who are making 40 or 30 or
$50,000. Those tax credits continue under this broken, failed
Affordable Care Act system. Those continue.
What my friends over here want to do is pull money out of our pockets
and give it to people who are making for a family of four over $128,000
a year.
Is that their solution for 7 percent of the people?
That doesn't make sense. That is what it would do.
What effect would it have?
It would reduce premiums by 5 percent for 7 percent of the population
all making over $128,000 for a family of four. That doesn't sound like
much of a solution to me because it is not a solution.
The solution is free market reforms.
The fact of the matter is that the enhanced premium tax credit is a
Band-aid on the gaping wound of ObamaCare. It is a Band-aid on the
gaping wound of the Affordable Care Act.
{time} 1700
The left loves to mislabel things. We know that they called the
spending package that they passed 4\1/2\, 4 years ago the Inflation
Reduction Act. What did it lead to? It led to 22 percent inflation. In
1 year, 9 percent inflation. We are still dealing with the effects of
their misnamed Inflation Reduction Act.
They called this the Affordable Care Act, and it has been nothing of
the sort. It is anything but the Affordable Care Act.
My friends on the other side of this aisle created this mess. No one
over on this side, not one person who is here serving in this body on
this side of the aisle, voted for our current healthcare system--not
one voted for the Affordable Care Act.
[[Page H6107]]
Those on the other side of the aisle who did vote for it promised a
few things. What did they promise? Lower premiums. Where are the lower
premiums? This is the ObamaCare system that we are living under right
now. They promised lower premiums. We are not getting those.
They promised better healthcare. Are we getting better healthcare? I
don't think most Americans believe that we are.
They promised that if you like your doctor, you can keep your doctor.
Sure, if your doctor takes the insurance that they force you into.
We are currently living under ObamaCare, under the Affordable Care
Act, so if you don't like our healthcare system, news flash, you don't
like ObamaCare, you don't like the Affordable Care Act.
The fact of the matter is that this law was written behind closed
doors in a backroom deal here in this building and down at the Obama
White House with and by insurance companies. There you go, with and by
insurance companies. That is a fact.
The scam is this: The scam is that the money is taken from average
Americans and sent as a subsidy not to other Americans, but to big
insurance companies. That is the scam. That is the scam. The profits of
these big insurance companies are at an all-time high. UnitedHealthcare
profits are up 1,200 percent under their plan. I get lectured all the
time that we are the ones for big business, the ones cutting the deals.
They are the ones that cut the deal with the insurance companies, and
they put it to the American people when they did.
Those same insurance companies are denying the claims of the very
same taxpayers who pay taxes to subsidize their profits. What a scam, a
government-sponsored scam.
Under the ACA, the government colluded with insurance companies to
ensure customers for themselves, for the insurance companies, and to
profit from subsidies provided by the government.
Government intervention does not work in healthcare. In Medicare and
Medicaid, the government sets reimbursement rates that underpay doctors
and cause access issues.
Very quickly, what are the solutions?
We are $36, $37 trillion in debt. We have to fix this system. We
can't throw money at the problem. We can't just continue to throw more
money. We have to fix a broken system.
How do we fix that? We need long-term solutions for healthcare. What
are the real solutions? There are lots of them. I don't have time to go
through every one individually today, but the bottom line is that we
need to get the government out of dictating healthcare to the American
people. We need to return to a patient-centered, market-driven solution
in healthcare that doesn't pick big insurance companies over the
American people. The American people should have a choice about who
they see and who they pay for their insurance.
That is the solution. It isn't this scam. It isn't this election-year
gimmick that some are trying to make it out to be. It isn't the
solution that fixes a 5 percent fix for 7 percent of the population. It
is real, honest healthcare reform for all the American people.
Mr. HARIDOPOLOS. Mr. Speaker, I thank Congressman Crank for his
remarks.
I yield to the gentleman from the 13th Congressional District of
North Carolina (Mr. Knott).
Mr. KNOTT. Mr. Speaker, I thank Congressman Haridopolos for hosting
this Special Order hour on one of the critical issues that we face as a
nation and have faced for the better part of 20 years now.
I am referring, of course, to ObamaCare, a deceptively named bill,
the Affordable Care Act, which has, of course, been a disaster for
Americans all over the country.
Before it was passed, Democrats essentially allowed big insurance
companies and Federal bureaucrats to craft an extremely regulated
patchwork of rules and cloudy regulations to enrich themselves at the
expense of the American patient and American physician.
They then jammed it through Congress without a single Republican
vote, ushering in a new era of high costs, restricted access, and lower
quality healthcare.
As is the case far too often, this law is now harming precisely the
groups of people it was designed to assist.
At its core, ObamaCare is a redistributionist program that empowers a
public and private bureaucracy rather than patients and physicians.
In various medical fields that are not part of the ObamaCare web, the
harmful effects of its policy have not been seen since the law's
passage. For example, over the past decade, the cost of outpatient
services rose between 80 and 100 percent on average. Prescription drugs
are up, at times, 200 percent.
Meanwhile, as a counter example, the cost of LASIK surgery, which is
not covered under the ObamaCare policy or subjected to its onerous
regulatory framework, has decreased by 30 percent over the same time.
Free from bureaucratic suppression, more providers have entered the
LASIK market, and innovations like bladeless lasers have made
operations safer, more efficient, and more available.
Another example: Cash-pay diagnostic imaging is often 75 percent
cheaper than the ObamaCare-approved MRIs. Direct primary care providers
offering wholesale labs can be, at times, 15 times cheaper than doctors
who are required to fill out government-mandated paperwork.
The examples could continue on and on. Sadly, ObamaCare has succeeded
in blocking free market innovations from reaching the broader American
healthcare system. Rather than reform the broken system that they
designed, the Democrats are committed to throwing more money at the
problem, literally subsidizing a framework that has elevated costs so
much that they are even willing to subsidize households earning
$600,000 per year.
It is time to reintroduce competition into healthcare by removing
handouts to corporate titans. We must cut the layers of red tape that
hurt patients and providers. We must build a commonsense system that
enables the patient to have choices, which will, of course, bring about
more quality care and increased access. In a very basic sense, we
should not make healthcare a DMV-type experience.
I thank Congressman Haridopolos again for holding this Special Order.
Mr. HARIDOPOLOS. Mr. Speaker, I thank Congressman Knott for his
comments.
I yield to the gentlewoman from North Dakota (Mrs. Fedorchak).
Mrs. FEDORCHAK. Mr. Speaker, I appreciate Mr. Haridopolos' leadership
on this issue and organizing this Special Order, inviting all of us
freshmen and a few other nonfreshmen here to talk about an issue that
is so important to our country and to all of our constituents.
Mr. Speaker, our healthcare system is broken, and my constituents in
North Dakota know it.
The law that was supposed to make things better, the Affordable Care
Act, has definitely not lived up to its name. If you like your plan,
you can keep it, they promised. A typical family will save $2,500 a
year, they assured. The ACA will help bring down healthcare costs and
even reduce the deficit, they claimed. Well, none of that is true.
Here we are, fixing the ObamaCare mess Democrats created 15 years
ago. Families today are paying higher premiums, facing fewer choices,
and watching Washington throw money at a problem that needs to be fixed
immediately.
Yet, somehow, my colleagues on the other side of the aisle continue
to paint this as a problem that Republicans created.
{time} 1710
The reality is, Democrats passed ObamaCare without a single
Republican vote, not one. They also set the enhanced premium tax
credits to expire this month. Ask them why. They had the votes. They
could have extended this. They could have made it permanent, but they
didn't. They set the expiration date for this month. This was
completely their doing.
The COVID-era enhanced premium tax credits expanded eligibility far
beyond the ACA's original design, including households earning well
into six figures. In North Dakota, that means a family of four earning
over $125,000 a year. Making those temporary subsidies permanent would
cost taxpayers $350 billion over 10 years. For all that money, it still
won't fix the problem.
[[Page H6108]]
Since the enhanced subsidies were enacted, premiums have increased 31
percent. These subsidies don't show up in people's wallets. They go
straight to the insurance companies with no incentive to lower prices
or improve care. Even worse, massive fraud plagues the marketplace.
A recent Joint Economic Committee study found roughly 35 percent of
marketplace enrollees are now considered phantom enrollees. These are
people who exist on paper but generate zero medical claims. The chart
on my right shows a massive growth of these types of claims, all the
way up to almost 11 million of those types in existence today.
Regardless of whether they have a single claim in a year, insurance
companies still get paid anyway, while working families pay more and
more for their premiums.
Democrats call that affordable. North Dakotans sure don't. That is
why Republicans offered a different path last night, one that focuses
on patients, affordability, and real competition, not endless
subsidies.
The Lower Health Care Premiums for All Americans Act takes practical
steps to lower costs and expand options. It creates cost-sharing
reductions that will actually stabilize the market. These will reduce
marketplace premiums by 11 percent after the first year of
implementation. That is nearly twice as much as the impact of extending
the Democrats' credits.
Our plan also cracks down on pharmacy benefit managers, the middlemen
who drive up drug prices. Our plan requires transparency so employers
and workers can finally see where their prescription dollars are going.
It also expands association health plans, allowing small businesses
and self-employed workers to band together and increase competition.
This could lower premiums by as much as 30 percent. Our plan also
protects employer-sponsored insurance and strengthens flexible tax-
advantaged options like CHOICE arrangements.
These reforms give workers control over their coverage dollars and
lets employers offer benefits for the first time.
Most importantly, this is just the beginning. We have many more
policy reforms coming. Republicans' vision for healthcare is putting
patients, not insurance companies, in control, with greater access,
more choices, lower costs, and good quality care.
These are commonsense reforms. It is past time we move beyond
temporary patches and tackle the problem head-on and fix what is
broken.
Mr. HARIDOPOLOS. Mr. Speaker, I thank Representative Fedorchak for
adding her voice to this very important debate.
Mr. Speaker, I yield to the gentleman from Missouri (Mr. Onder), the
doctor, for his ideas on how we reform our system.
Mr. ONDER. Mr. Speaker, recent polls show that the top issue on the
minds of Americans today is that of affordability. Whether food,
education, childcare, energy, or healthcare, rising prices are
resulting in more and more Americans feeling less secure about their
economic well-being.
Indeed, prices have been going up. Under President Biden, inflation
hit 9 percent in June 2022. Cumulatively over the Biden Presidency,
inflation is up 21.2 percent.
Things have improved since President Trump and Republicans assumed
office in January. Energy prices are down by 6.3 percent. Inflation is
moderated, but with the exception of energy, we have not had deflation.
Prices are higher than we would like them to be.
Nowhere is the issue of affordability more acute than in healthcare.
We must address America's healthcare affordability crisis. As a
physician, I will tell you, though, the first step in solving any
medical problem is getting the correct diagnosis. If you do not know
what the problem is, you will not formulate the right treatment. You
may make the patient worse.
That is what has been going on.
What is the problem, then? Our problem is that Big Government's anti-
free market, anticompetitive, and anti-consumer policies have made our
healthcare system more and more expensive by the year.
This has been a problem for a long time, but it was made much worse
after the passage of ObamaCare in 2010.
How did ObamaCare, the unaffordable care act, make healthcare more
expensive? Quite simply, by removing what market forces there were in
our system and expanding the role of government. The unaffordable care
act literally outlawed the private insurance market.
Remember Barack Obama saying that if you like your plan, you can keep
it. They lied. They outlawed your plan. What were the results?
The ostensible rationale for the unaffordable care act was to get
more people insured, but we know that, in many cases, workers lost
their private insurance and have been, if you will, dumped by their
employers onto Medicaid.
The Foundation for Government Accountability has estimated that if
non-Medicaid expansion States all expanded and added able-bodied,
working-age adults to their Medicaid programs, an additional 3.6
million Americans would lose their private health insurance.
Similarly, enhanced COVID-era ObamaCare credits--remember, that is
what we are talking about today--crowded out employer-based insurance.
According to the Paragon Institute and the Congressional Budget
Office, extending the COVID credits would reduce employer-based
coverage by roughly 4 million people.
In addition to crowding out employer plans, The Wall Street Journal's
Allysia Finley recently highlighted that the ACA and its subsidies even
led many Democrat-run cities, including Chicago and Detroit, to offload
public-sector retiree healthcare costs onto ObamaCare. These cities
moved their retirees onto ACA exchanges, eliminating their unfunded
healthcare liability. Finley correctly argues that COVID credits make
this dumping of public-sector retirees' healthcare obligations onto the
exchanges even more likely, as few governments have set aside,
especially in blue States and cities, the money to pay their retirees'
future healthcare costs. Through ObamaCare, you are paying for the
financial irresponsibility of some of our biggest city governments,
blue cities especially.
The unaffordable care act has resulted in skyrocketing health
insurance premiums. In 2014, the first year that subsidized ACA
marketplaces were in effect, premiums increased 47 percent. That is
right. They increased by 47 percent in 1 year. Over the next decade,
premiums increased another 96 percent.
The only reason that this is not more obvious to Americans today is
that the healthcare consumer is not only paying the premiums, but the
taxpayer is paying extensive subsidies, accounting for 90.3 percent of
the increased premiums.
Healthcare affordability is critical. Therefore, we need to look at
the issue that has received a lot of attention these days, the
expiration of the COVID-era enhanced ObamaCare credits. The expiration
date was passed by congressional Democrats as part of the misnamed
Inflation Reduction Act without a single Republican vote.
{time} 1720
Mr. Speaker, as mentioned, this scheme known as ObamaCare exchanges
resulted in skyrocketing insurance costs. At the same time, we need to
address some false assertions about what the expiration of these
enhanced super subsidies would mean.
First, the vast majority of ObamaCare subsidies are not expiring at
all. What is at issue are these temporary COVID-era subsidies. Even if
these enhanced COVID super subsidies were to expire, the Federal
Government and the taxpayers will still cover 78 percent of the
premiums, compared to roughly 88 percent right now. That is a
relatively small change, nowhere near doubling.
In fact, if the COVID subsidies are allowed to expire, only 4.3
percent of the projected premium increase would be attributable to that
change. Again, that is less than 5 percent of the increase. Here is the
key point the other side does not want to talk about. ObamaCare
premiums are going up regardless, even if the COVID credits are
extended.
ObamaCare premiums are expected to rise about 18 percent in 2026,
driven by higher medical costs, labor shortages, economic uncertainty,
inflation, and other conditions. These increases are structural. They
have nothing to do with the expiring subsidies.
[[Page H6109]]
What Democrats are doing is conflating premiums with out-of-pocket
costs. Premiums are not doubling, and out-of-pocket costs are rising
only because the expiration of these enhanced subsidies is exposing a
deeper truth that the unaffordable care act is, for many families,
anything but affordable.
According to CMS, the projected average premium after tax credits for
the lowest-cost plan, should the COVID subsidies expire, is $50 per
month. That is about $20 less than they were in 2020.
In the year 2026, most enrollees on HealthCare.gov will have access
to plans priced at or below $50 per month. To put that into
perspective, compared to the years prior to the COVID pandemic,
marketplace enrollees this year will have access on average to lower-
plan premiums and more choices.
This debate isn't just about premiums. It is also about expanded
eligibility and widespread abuse. The COVID expansion dramatically
broadened eligibility far beyond the middle-class and lower middle-
class families and significantly increased the subsidies.
Under this system, households earning $500,000 a year or more can
qualify for subsidies. In 2024, nearly 42 percent of the enrollees, on
the other hand, paid nothing at all. These subsidies don't go to
individuals. They go directly to insurance companies.
That is why many Americans see these enhanced COVID subsidies for
what they really are: Welfare checks to large healthcare corporations.
Worse still, the system incentivizes fraud. People are encouraged to
misreport their income in order to qualify for larger subsidies and
zero-dollar plans. As a result, insurance companies collect an
estimated $35 billion in taxpayer subsidies for phantom enrollees.
An estimated 6.4 million individuals were improperly enrolled in
ObamaCare in 2025, often fraudulently taken off their private insurance
plans to do so, costing taxpayers $27 billion. Among households
claiming incomes between 100 and 150 percent of the Federal poverty
level, roughly 62 percent were not actually eligible. It gets worse.
In 2024, insurance companies received at least $35 billion in
subsidies for about 12 million marketplace enrollees who made not a
single medical claim--not a single checkup, not a single prescription.
About 40 percent of the people fully subsidized under the COVID
credits never used their coverage at all, often because they didn't
know that they were enrolled or they didn't even exist. One Social
Security number, according to the Government Accountability Office, was
used to purchase health insurance 125 times. That is massive fraud.
When fraud estimates from the exchange subsidies alone range into the
tens of billions of dollars, it is not unreasonable--no, it is
responsible--to ask people to contribute something. Even a small copay
insurance payment per month, $10 or $20 per month, promotes personal
responsibility, discourages fraud, and helps ensure that the system
serves the people who really need it, not those gaming it and not the
corporations cashing the check.
That is what this debate is about. It is about facts, accountability,
sustainability, and making coverage more affordable for all Americans.
It is not the fear-mongering of my Democrat colleagues.
Mr. HARIDOPOLOS. Mr. Speaker, I yield to the gentleman from North
Carolina (Mr. Moore), the Representative of the 14th District. He is
the former speaker of the house of North Carolina and my current
colleague on the Financial Services Committee.
Mr. MOORE of North Carolina. Mr. Speaker, before giving my remarks
about the Affordable Care Act, I want to mention a couple of things.
Mr. Speaker, it is with a heavy heart that I mention on the House
floor the tragic passing of Greg Biffle, his wife, and two children in
an airplane crash that happened just a few hours ago in North Carolina.
On behalf of this body and all North Carolinians, I want to express my
condolences to this wonderful family on this terrible tragedy. They
will be in the thoughts and prayers of so many around the Nation.
Mr. Speaker, I want to let this body know about the passing of a
great leader in our State, former Governor Jim Hunt, who passed away
today. The news came out a little bit ago from his daughter who
currently is our State's Lieutenant Governor.
He was a great man and a great leader in North Carolina. He loved and
cared a lot about public education in our great State. He was a man I
came to know during my time as speaker of the statehouse and he was
someone who loved his State.
Our thoughts and prayers and condolences are with his widow and with
his family, particularly as we go into this Christmas season.
Mr. Speaker, I appreciate the gentleman from Florida (Mr.
Haridopolos) affording some time to not only myself but to a number of
our colleagues today to talk about the legacy of ObamaCare that we find
ourselves inheriting here in this Congress.
It is a program that passed some 15 years ago before I believe any of
the Members who have spoken so far today were even serving in this
body. Here we are in a situation where we have to try to clean up this
mess. Why would I say it is a mess?
Mr. Speaker, I can think back to a time before ObamaCare, back before
this passed. Healthcare was less expensive. Healthcare was more
accessible. A person could go out and afford to buy health insurance.
Prescription medications were more affordable. In fact, when I talked
to colleagues, when I talked to businessowners, and when I talked to
folks, it was easier to be able to get good health insurance.
ObamaCare passes. What happens? We see healthcare costs spike. We see
prescription drug costs go out of control. We see total inefficiencies
in the system. We see a lot of wasted money. We see these phantom
insured folks. These people aren't really insured, but insurance
companies are receiving billions of dollars every year for coverage
that simply does not exist.
Look at the premiums. Look at a lot of the sticker shock that a lot
of Americans are getting right now during this time of year, as we are
in the Christmas season, where they are told, they will have to pay
more. They need to understand ObamaCare is what has caused all of this
mess.
When we move away from a free-market system where we are allowed to
have greater efficiency, when we have a system that strives for cost
containment but, at the same time, great health outcomes, it works
better.
Today, we hear stories of denials and delays, everything on
insurance, and it costs more. That, my friends, is unfortunately the
legacy of ObamaCare. It is why this body is not going to continue to
throw good money after bad. It is an investment that is not paying off
economically, and it is an investment that is not paying off for the
health of Americans around this country.
On the planned premiums, the actual cost, the premium cost, ObamaCare
premiums have risen two times faster than employer plans.
We have a chart. We probably can't see it on TV. There is a chart
where we can see this thing spiking up right there out of control.
Those are the resulting ObamaCare premium increases that are happening.
{time} 1730
This is not acceptable, and it is not appropriate to keep throwing
money after it.
These surging premiums are also driving a higher Federal subsidy
cost. So what do we mean? The ACA subsidy grew from $18 billion in 2014
to $92 billion in 2023. Now, how many people out there think that they
have actually gotten better healthcare in that period of time? I don't
think many are going to speak up and say that they are.
Get this. I have talked about it going from $18 billion to $92
billion. This year alone, in 2025, costs are projected to reach $138
billion. Again, it just keeps going up.
The only thing my friends on the other side of the aisle know to do
is to keep throwing money at it--keep throwing money at it; nothing to
try to improve efficiency, nothing to try to improve coverage, nothing
to try to improve the system, nothing but wasting more and more money
in a system that is not working.
The COVID extension is what a lot of talk has been about. There was a
temporary COVID extension that, when Democrats were in charge, they
solely passed, right? They passed to put that in place. The Biden
administration put that in with an expiration date.
[[Page H6110]]
Well, they knew it could not continue. They knew it wouldn't sustain.
I think, frankly, they knew it wasn't going to work.
Get this. Let's say we went along with extending that. It would cost
right now $335 billion over 10 years, which is going to, again, only
put the budget more out of balance, is going to affect our national
debt, and it is simply not sustainable.
The other thing that we looked at earlier was what is called the
zero-claim enrollment. That is where folks really aren't even assured.
I think they are called phantom insured. It is not real, but it is
money being paid to insurance companies. These zero-claim enrollments
have more than tripled--more than tripled--rising from 3 to 4 million
in 2021 to nearly 12 million in 2024.
Get this. In 2024, about 35 percent of the marketplace enrollees had
zero claims, up from 20 percent before the subsidy expansions. At the
same time, these insurers received billions in taxpayer subsidies for
enrollees who received no care, including--this is real numbers--$21
billion in 2023 alone.
To those folks watching, those folks who are genuinely concerned
about improving access to healthcare and affordability, know that
Republicans are serious about this. We passed legislation this week to
deal with that--to look at some marketplace reforms, to look at
association health plans, to look at PBM reform and transparency, and
to do things to drive those costs down and to make healthcare more
accessible.
Also, look at the bill we put in a few weeks ago to put $50 billion
into rural healthcare that will help all of America. It will help my
State in North Carolina, but it will help all 50 States because there
are areas of our country where simply they do not have access to
healthcare because of the rural location, distance to hospital,
distance to provider, you name it. Republicans are putting those funds
in there to make this more available.
Don't believe a lot of the hype on the other side out there of just
spend money and spend money on a system that isn't working. Republicans
are serious about improving healthcare for all Americans. The bills we
have passed this week and the statements we have made are clear to
that.
I appreciate Congressman Haridopolos, my good friend from Florida,
for doing this.
I have to say, Congressman, you helped them bring attention to this.
You did a great job in Florida when you were in the State legislature,
the work that you all did, the work to help there and bringing this
issue to the forefront here in Congress. Sir, as a colleague, I
appreciate what you are doing, and I appreciate the time to speak
today.
Mr. HARIDOPOLOS. Mr. Speaker, I thank the Congressman for those
generous comments.
Mr. Speaker, I yield to the gentleman from North Carolina (Mr.
Knott), the 13th Congressional District, for comments.
All Things Work Together For Good
Mr. KNOTT. Mr. Speaker, I rise today in order to commemorate the
extraordinary story and mission of one of my neighbors and her family
in North Carolina, someone by the name of Olivia Wooten.
Olivia is currently suffering mightily in a battle with ALS. I have
watched in admiration as she has remained a constant source of robust
encouragement and joy despite her debilitating illness.
Her circumstances have only brightened because of the eternal hope
that she has in the Lord, her Savior, Jesus Christ. I spoke to Olivia
earlier today, who fearlessly and joyfully awaits entry into eternal
life, where `` . . . there shall be no more death, neither sorrow, nor
crying, nor shall there be any more pain. . . . `' as stated in
Revelation 21:4. She helped me draft these remarks knowing that they
would be heard by all today.
Olivia Wooten's parents, Robin and Elizabeth, met while attending
college in Raleigh, North Carolina. Robin attended NC State, and
Elizabeth enrolled at Saint Mary's School. They were married shortly
after graduating in 1989 and returned to Robin's hometown in Kinston,
North Carolina.
Robin and Elizabeth passed the years enjoying all that makes east
North Carolina so special. They, with their loved ones, enjoyed
hunting, fishing, time at the Crystal Coast, and a community that is
more of a family than a neighborhood.
In the greatest blessings of all, Robin and Elizabeth became parents
to two girls, Olivia in 1992 and Carrington in 1995.
In 2016, Robin was tragically diagnosed with ALS. Up to that point,
Robin's faith in the Lord had been more ceremonial. While his wife,
Elizabeth, regularly attended neighborhood Bible studies and prayer
groups for years, Robin had not.
However, that fully changed as Robin came to grips with his
diagnosis. Rather than indulging in fear or resentment of assured
physical suffering here on Earth, Robin encouraged anyone he met to
look up and to consider Christ. He pushed others to focus on eternity
and to rely on the Lord rather than the fleeting things of this Earth.
Robin helped others grow in their faith until entering his Heavenly
home 1 year after his diagnosis.
Tragically, in July of 2023, Robin's daughter, Olivia, would herself
be diagnosed with ALS. Since that time, Olivia has surpassed every
expectation in how long and how well she has fought this vicious
disease. Yes, while she has weakened, she remains buoyant and
inexplicably joyful in a manner that can only be called inspirational
and miraculous.
It was my honor and my privilege to speak with Olivia today. In spite
of her physical limitations and her suffering, which are unbelievably
real, she will likely not walk unassisted again. She cannot go out with
friends today. Absent a miracle, she will no longer be able to travel
far from home. Absent a miracle, she will likely never meet her nephew,
who will likely be born in the next few weeks.
Despite this very real suffering and the limitations that she is
currently experiencing, her joy and her hope remain palpable. Olivia
knows that her earthly departure is not the end but, rather, her new
beginning in Heaven is with her Savior, Jesus Christ.
When I asked her what she wanted me to share with all of us, she
simply requested the following for our consideration. She did not bring
up policy. She did not bring up new types of ideas for Washington, D.C.
She simply said the following: ``This Earth is fallen, and it offers
afflictions for which there is no remedy other than the Almighty. My
faith in Jesus has become more vibrant and real than anything I could
have ever imagined. To anyone who hears this message, if you do not
know Christ, I urge you to consider Him. Where this Earth offers
temporary solutions, it cannot and it will not offer durable and
lasting ones. Only Christ can offer real peace, real healing, real
rest, and an eternal home.''
Olivia closed our conversation with a verse, which she aptly
described as her life verse. It is Romans 8:28, and it simply states:
``And we know that for those who love God all things work together for
good, for those who are called according to his purpose.''
In Olivia's testimony, I can see firsthand and I have seen firsthand
the truth of this passage. As we enter the week of Christmas, when we
celebrate the birth of Christ, I stand in awe and in gratitude for
Olivia and her family's witness and example, and I urge each person who
hears this to consider her Savior, the Savior of the world, Jesus
Christ.
Mr. HARIDOPOLOS. Mr. Speaker, I thank Congressman Knott, and she will
not be forgotten.
{time} 1740
Broken ObamaCare System
Mr. HARIDOPOLOS. Mr. Speaker, I thank Congressman Knott, Congressman
Crank, Congressman Downing, Congressman Onder, Congresswoman Fedorchak,
and also Congressman Moore for their comments today about the broken
ObamaCare system.
It is simply that; it is broken. It is the reason why they have been
subsidizing a broken system for a long time, at the expense of so many
Americans and so many potential innovations, as well.
As this issue has been talked about very well today, I just want to
remind people of where we were versus where we are. The Democrats had
the opportunity to make this a permanent plan. They did not have the
votes or the will
[[Page H6111]]
to get it done. They also had the opportunity to reduce taxes on tips.
They had the opportunity to reduce the taxes on overtime. They had the
opportunity to reduce taxes on Social Security, all of which are
earned. Those are not welfare programs. Those are programs that are
earned. When they had the power, they chose to do nothing.
This year, when we were passing the big, beautiful bill back in July,
we had the opportunity again to reduce costs for this broken system.
The Republicans put forth in this body a CSR. What happened here? They
used the Byrd rule in the United States Senate to fight what would have
reduced rates by 11 percent.
Let's break away from this discussion about affordability. Let's talk
about reality. This is purely politics. Their votes have been shown
throughout the year. They care nothing about results. They care
everything about politics.
Candidly, maybe Republicans aren't as good at politics as the
Democrats, but we are pushing policies that work and are based in
reality. That is what this push has been about today, laying out the
facts for the American public to say this system is untenable, and it
only undercuts what could be the best system in the world.
There has been so much discussion about the 22 to 24 million people
on ObamaCare. We all found out today that half of them might be phantom
enrollees. We found out that the future is not bright when you look at
the contrast of what it is doing to the remainder of the people who are
paying for their own healthcare system.
There are 165 million people who have employer-based systems that
they most likely contribute to or pay out of their own pocket. They are
paying $1,500 to $2,000 a month, and they have to subsidize a broken
system on top of it and crowd out a medical system in the process.
All we are asking from the other side is to say let's start doing
some commonsense things. The number one thing I would like to see us do
is simply do income verification so that those people who pay full
freight and subsidize the system know that the people who are being
helped are actually people truly in need who qualify for a program,
instead of giving it away.
It is simple identification checks, just like we have asked the
Democrats to do on things like voting, just like we have asked the
Democrats to do on simple ideas to make things work again, so that when
you pay your taxes, which are quite exorbitant, in my opinion, people
know they are actually going to help people.
Mr. Speaker, I appreciate your indulgence this afternoon as we get
ready to celebrate the holiday season.
____________________