[Congressional Record Volume 172, Number 5 (Thursday, January 8, 2026)]
[House]
[Pages H238-H244]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            PROTECTING HEALTHCARE FOR MILLIONS OF AMERICANS

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


                             General Leave

  Ms. RIVAS. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days to revise and extend their remarks and include 
extraneous material into the Record on the subject of my Special Order 
hour.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from California?
  There was no objection.
  Ms. RIVAS. Mr. Speaker, as a Member from California, I yield to my 
colleague from the great State of Utah, Congressman Blake Moore, so 
they can continue honoring Congressman Doug LaMalfa.
  Mr. MOORE of Utah. Mr. Speaker, sincere appreciation to the 
Congresswoman. I thank her very much. That is a great way to honor 
Doug.
  Ms. RIVAS. Mr. Speaker, I yield to the gentleman from Georgia (Mr. 
Austin Scott).
  Mr. AUSTIN SCOTT of Georgia. Mr. Speaker, I just want to say Doug was 
a kind and gentle giant. He was firm and fair. He was wise, and he was 
funny.
  I remember one day in the Agriculture Committee when he spoke for 5 
minutes. He spoke so long that he finally remembered that he forgot to 
leave people any time to answer his questions. It was a pretty funny 
moment for the committee. He laughed about it, and he didn't make that 
mistake again.
  Mr. Speaker, I will say this about him. He was 100 percent American. 
When the local sheriff's department asked for help with people who knew 
how to operate diesel equipment, Doug showed up. Doug is the one. He is 
the Member of Congress that we saw on camera, getting on a bulldozer, 
saying: I love the smell of diesel power in the afternoon. It smells 
like victory.
  Mr. Speaker, Doug LaMalfa and only Doug LaMalfa.
  Ms. RIVAS. Mr. Speaker, I yield to the gentlewoman from North Dakota 
(Mrs. Fedorchak.)
  Mrs. FEDORCHAK. Mr. Speaker, I am happy to be here today as a 
freshman Member. I didn't know Doug long, but I met him on one of our 
first days in the orientation sessions and the planning sessions for 
Congress. He was warm. He was friendly. He was helpful to a new 
freshman who didn't know much.
  From there, I learned how fun he was. He loved to play with my last 
name, ``Fedorchak.'' He used to say: ``How much wood could a Fedorchak 
chuck if a Fedorchak could chuck wood?''
  It always made me laugh. I also learned quickly that not only was he 
fun but he was thoughtful, he was pragmatic, and he was a really, 
really good thinker. I turned to him on issues that I found to be 
difficult. I wanted to get his thoughts on them.
  He was a strong conservative. He was warm, kind, and principled. In 
my mind, he was exactly the kind of leader that Americans want. He is 
going to be dearly missed. I feel robbed that I didn't get to work with 
him more, and I will keep him and his family in my prayers.
  Ms. RIVAS. Mr. Speaker, I yield to the gentleman from Utah (Mr. 
Kennedy).
  Mr. KENNEDY of Utah. Mr. Speaker, I thank the gentlewoman for 
yielding time.
  Mr. Speaker, there is a lot of symbolism that is happening at this 
point. I appreciate the bipartisanship. I thank the gentlewoman for 
yielding time. It is a reflection of what really should happen around 
this place. We should love and help each other and try to find common 
ground. It is a great representation of how Doug LaMalfa served.
  He was a man of the people. He served his people well. He was a man 
of the land. He loved his land. He loved his rice. He would talk about 
it with me and everybody else here regularly. He also loved people 
sufficiently to give them nicknames.
  My nickname had something to do with the villain in ``Ocean's 
Twelve.'' I was the ``Night Fox.'' I don't know if I agree with that 
characterization. He was the guy that did a break dance across a laser 
dance floor to steal things. Maybe some around here would think that is 
the kind of person that I am. I knew it was all in good taste and good 
fun. Doug game nicknames to everybody.
  Mr. Speaker, I will point out the last thing about Doug is that he 
loved his country. He knew that on the top the Capitol rotunda was a 
statue called the Statue of Freedom. Doug served not only his people 
but he served his God. He certainly loved both. In serving his country, 
he understood he was serving freedom.
  Mr. Speaker, I hope that I, as well as all of us, can live up to 
Doug's standard of service, his love for people, and his love for God.
  Ms. RIVAS. Mr. Speaker, I yield to the gentleman from Utah (Mr. 
Moore).
  Mr. MOORE of Utah. Mr. Speaker, to close, I again thank the 
gentlewoman from California (Ms. Rivas) for yielding a few more minutes 
to finish out these thoughts in Doug's memory.
  Mr. Speaker, I will wanted to give a quick closing message to his 
wife, Jill, and his four children: Kyle, Allison, Sophia, and Natalie.
  I get an hour every week to do these floor messages. I am lucky to 
get five Members to come. I try to fill up 20 minutes, 15 of which your 
dad would actually take. He would go on and on. I would try to get him 
to wrap up so I could go to dinner. He was always there for me.
  Tonight, we ran over time with the amount of people who wanted to 
come and take time out of their very busy schedules to come and share a 
brief message. They sat for an hour to spend 60 seconds to reflect on 
your dad and your husband.
  I hope you can take from that some sense of appreciation and 
connection that we all have with your dad and what an amazing man he 
is.

[[Page H239]]

  


                              {time}  1900

  Ms. RIVAS. Mr. Speaker, my condolences to the family of former 
Congressman Doug LaMalfa.
  Mr. Speaker, I am glad to be here on the floor today to lead this 
important discussion with my Congressional Progressive Caucus 
colleagues about protecting healthcare for millions of Americans.
  Earlier today, the House voted to pass Democratic Leader Hakeem 
Jeffries' bill to extend the Affordable Care Act's enhanced premium tax 
credits for 3 more years. I thank Leader Jeffries for his relentless 
leadership to make today's vote a reality.
  House Democrats have been fighting for months to save these critical 
tax credits and for years to protect the Affordable Care Act from 
Republicans' constant attacks.
  The ACA tax credits are the reason that record numbers of Americans 
have health insurance today. The ACA tax credits lower monthly premiums 
and make coverage realistic for working families, small business 
owners, seniors not yet eligible for Medicare, and people who fall 
through the cracks of employer-based insurance.
  Because of these tax credits, people can go to the doctor before a 
problem becomes an emergency. They can manage chronic conditions. They 
can live with dignity instead of fear of bankruptcy.
  Democrats did not give up on the American people, unlike many 
Republicans, who chose to let these tax credits expire 1 week ago. That 
is right. When the ball dropped in Times Square on New Year's Eve, 
millions of Americans saw their healthcare premiums rise. That is a 
direct result of the healthcare crisis that Republicans created through 
their inaction on Americans' most pressing concerns.
  Over the past year, instead of working on meaningful solutions to 
lower the cost of groceries, lower the cost of housing, or protect 
healthcare, Republicans chose to rename the Gulf of Mexico, redefine 
what a showerhead is, rename The Kennedy Center, look into annexing 
Greenland, and regulate fridges and gas stoves.
  Yet, in all seriousness, there are real problems that our country is 
facing. ICE is terrorizing communities across the country, and 
yesterday, masked agents murdered Renee Nicole Good in broad daylight 
in Minnesota. Trump is entertaining entering another war with 
Venezuela. Vaccines are being rolled back, which will make students and 
communities sicker. Americans are struggling to afford basic goods.
  Speaking of affordability, we are in the middle of an affordability 
crisis that Republicans refused to address. Republicans chose to shut 
down the government instead of extending the ACA tax credits to help 
Americans afford healthcare.
  During the longest shutdown in government history, my colleagues and 
I heard from our constituents about how Republicans' inaction to extend 
the ACA tax credits would impact them. I hand-delivered several of 
these stories from my freshman colleagues to Speaker Johnson so that he 
could see how his shutdown was creating hardship for Americans from 
California to New Hampshire, Washington, and everywhere in between.
  In my district, the San Fernando Valley in Los Angeles, nearly 31,000 
people would have seen their healthcare costs rise if the ACA tax 
credits expired, and nearly 11,000 people would have lost access to 
healthcare entirely.
  Additionally, a 60-year-old couple in my district earning nearly 
$83,000 per year would have seen their annual premiums rise by nearly 
$14,000, and a family of four earning nearly $130,000 a year would have 
seen their annual premiums rise by over $6,000. This is just in my 
district.
  Republicans were willing to let this happen to Americans across the 
country, regardless of political affiliation.
  I am proud to have voted with my colleagues to pass Leader Jeffries' 
bill to extend the ACA tax credits and protect healthcare, but our work 
is not done. The Senate needs to take up this bill immediately so that 
Americans don't have to worry about their premiums skyrocketing. In the 
richest country on Earth, no one should have to worry about choosing 
between paying for groceries, making rent, or having healthcare.
  Mr. Speaker, I yield to the gentlewoman from Washington (Ms. 
Randall), my cohost for tonight's Special Order hour and my friend and 
fellow freshman classmate from the beautiful State of Washington.
  Ms. RANDALL. Mr. Speaker, I thank the gentlewoman for yielding.
  Mr. Speaker, I am glad to be here together on the House floor today 
to lead a conversation about how we fix our broken healthcare system.
  Across our country, working families are feeling the pain of rising 
costs from every direction. Donald Trump and congressional Republicans 
have failed the American people. They promised to lower costs. Instead, 
costs keep going up. Housing is more expensive. Electricity bills are 
through the roof. Childcare costs keep rising.
  Now, Republican leadership, who love to extend tax breaks for 
billionaires, are making things worse by, for months, refusing to 
extend the Affordable Care Act's tax credits for regular people. These 
tax credits, which expired on December 31, could have been continued 
had Republicans not skipped every opportunity to prevent it, but they 
chose to walk away from the negotiating table.
  Let's be clear about why these tax credits exist. They were created 
because the U.S. has the most expensive healthcare system in the world, 
and without help, millions of working families are simply unable to 
afford coverage.
  This was never a handout. It was a lifeline. Yet, because Republicans 
refused to act before December 31, millions of Americans have faced 
skyrocketing healthcare costs.
  In my district, I hear from neighbors every day about how devastating 
it has been to lose these tax credits. Right now, families who rely on 
the ACA in Washington's Sixth are facing an average increase of $1,500 
a month in healthcare costs. That is some people's rent, three car 
payments. That strips the ability to put anything away in savings.

  Even if you are on private insurance, monthly costs are estimated to 
rise across the board by 21 percent in Washington because of the 
overall strain on our system. When healthy people are priced out of 
insurance, costs go up for everyone else. That is just math.
  This Republican-created crisis will price out an estimated 80,000 
Washingtonians from coverage, and that doesn't even include the 
millions more in Washington and across the country who are losing care 
because of the cuts to Medicaid and Medicare.
  Mr. Speaker, who is being hit hardest when these tax credits 
disappear? Women who are already struggling with restrictions to 
reproductive care, who make less money than men do, and who are on the 
front lines of growing childcare crises.
  Who else will be impacted? LGBTQ Americans, who are more likely to 
rely on the ACA because of lower incomes and employment discrimination, 
on top of this administration rapidly stripping away access to their 
lifesaving care and protections.
  Families really struggling to get by, living paycheck to paycheck, 
are more likely to work jobs without employer-provided benefits, making 
the ACA their only real option for coverage.
  I want to make this clear: Republican leadership let tax credits 
expire in order to pay for tax breaks for billionaires. They didn't 
make an abstract budget decision. They decided that their wealthy and 
well-connected donors deserved the very best that this country has to 
offer while condemning everyday Americans to lose health insurance and 
to have to wait until they are sick enough to end up in the emergency 
room.
  I will say what we all know: We don't have a genuine healthcare 
system in this country. We have a sick care system, a system where 
people are forced to delay care until a problem becomes a crisis, a 
system where chronic conditions go unmanaged or managed with 
unprescribed medication, a system where cancers are caught later when 
treatment is more expensive and outcomes are worse, and a system where 
more people die.
  One thing drove me to public service and has continued to drive me: 
Everyone deserves access to healthcare. That is why, in the State 
legislature, I worked every day to protect and expand access to care, 
passing laws to expand postpartum Medicaid so that new

[[Page H240]]

parents received the care that they needed after childbirth, 
establishing a universal healthcare commission, removing barriers to 
behavioral health and dental care, and lowering prescription drug 
prices.
  I have seen the way families thrive when access to care is expanded 
and the devastation that follows when it is taken away. While families 
are worried about whether they can afford insulin, inhalers, or mental 
health care, Republican leadership chose inaction. They found time to 
give tax breaks to corporations but not to protect healthcare for 
working people before tax credits expired.
  That tells you everything you need to know about Republican 
leadership priorities.
  President Trump says that he has concepts of a plan and has been 
making empty promises for a decade, but the American people don't need 
concepts. We need affordable healthcare now.
  I am very glad that 17 of my Republican colleagues joined Democrats 
today in doing the right thing by voting to extend the ACA tax credits 
for 3 more years to protect access to affordable healthcare. I hope 
that my colleagues in the Senate follow suit by passing this bill 
immediately, but I also know that it is not enough.
  We need a universal healthcare system, a system where you can go to 
the doctor, receive the care you need, and walk out without worrying 
about what other bills you will have to skip to afford it.
  We need a system where losing a job doesn't mean losing your 
healthcare and where starting a business doesn't mean risking your life 
in addition to your livelihood.
  We need a system where no one lies awake at night wondering if they 
will be able to afford insulin, whether they will be able to afford it 
if their kid breaks their arm, or whether they will be able to afford 
it if their spouse has a pregnancy complication or a cancer diagnosis.
  It is not radical. It is not unrealistic. It is humanity.
  The United States, arguably the wealthiest country in the world, 
doesn't have a universal healthcare system like every advanced nation 
in the world does. It is time for our Nation's leaders to stop making 
excuses. It is time for us to find real solutions that put the American 
people first.

                              {time}  1910

  Ms. RIVAS. Mr. Speaker, I yield to the gentleman from New York (Mr. 
Tonko).
  Mr. TONKO. Mr. Speaker, I appreciate the gentlewoman yielding and 
thank both Congresswoman Luz Rivas of California and Congresswoman 
Emily Randall of Washington State for hosting us with this Special 
Order hour. I know with them being two freshmen Congresswomen, and I 
know at least one other freshman Congresswoman that will be joining in 
the discussion, that it just reflects the tremendous amount of talent 
and passion to make a difference in this freshman class. We are so 
blessed to have them in the Caucus. It is so important to witness the 
efforts that the two congresswomen hosting us have made in regard to 
accessibility and affordability. It is most appreciated.
  After months of pushing, Democrats succeeded in forcing a vote to 
extend ACA subsidies that offer lifesaving healthcare benefits to 
millions of families. That extension passed the House just hours ago, 
but the fight isn't over to secure these benefits and meaningfully 
lower costs for Americans. The Senate must act at once to restore these 
benefits and ease the burden of rising costs for people like Mekhiya, 
one of my constituents from New York's 20th Congressional District.
  Mekhiya was born and raised in Schenectady, New York. She recently 
turned 26 and was bumped off of her parents' health insurance plan. She 
made the smart and responsible choice to switch to an ACA plan. Because 
Republicans let vital ACA subsidies lapse last year, she no longer 
knows how she will afford coverage. This is at a time when she and her 
wife are thinking about starting a family together.
  So often I hear the reaction from those on the right saying: Just get 
a job. Well, Mekhiya already works at a job, in fact two jobs; one for 
her local school district and one as a manager at McDonald's. All told, 
between both jobs, she works some 16 hours a day. Neither position 
offers affordable or comprehensive enough healthcare, so an ACA plan is 
her only real option.
  In this, the richest country in the world, the richest country in the 
history of the world, this is simply unacceptable. No one should be 
spending nearly all of their waking hours working multiple jobs and 
still unable to afford basic healthcare coverage for themselves and 
their family members. Yet this is the painful reality for millions of 
Americans.
  Faced with this impossible scenario, Mekhiya said that she may try to 
work even more hours to make ends meet, but there are simply not enough 
hours in the day to work much more than she already does.
  We have the chance here in Congress to ease the immense burden being 
carried by Mekhiya and the tens of millions more seeing a spike in 
healthcare premiums. I urge my colleagues in the Senate to do right by 
families and act without delay to lower healthcare and help working 
family people breathe a little easier.
  Make no mistake, the fight to lower costs is far from over. We have 
got to put our foot on the gas when it comes to driving down those 
healthcare costs and making life much more affordable for the American 
people.
  Ms. RIVAS. Mr. Speaker, I yield to the gentleman from the great State 
of California (Mr. Garamendi).
  Mr. GARAMENDI. Mr. Speaker, indeed, it is a great State because we 
have great freshmen Representatives. I thank them for this Special 
Order hour and the opportunity to really talk about a critical issue 
for our constituents in California and really all across America.
  If we go back to the beginning of the Trump administration and we 
think about the various issues that he has put forth and the burdens 
that he has placed on America, one of the most important is in the big, 
ugly bill. If you take a look at the big, ugly bill and you get into 
the details, well, there are the enhanced tax credits for the 
Affordable Care Act, and we will talk about that in a few moments; but 
also in the big, ugly bill is the big problem coming up at the end of 
this 2026 year.
  They have put in place a dismantling of the Medicaid program. They 
pushed it off until after the election, but the facts of the matter are 
those impacts are already being recognized across the healthcare 
system. It is going to affect every American and particularly those 
that are relying on Medicare.
  Now, if we talk about what the issue is today--and thank goodness, 
the Democratic leadership in this House put forth an opportunity to 
solve one of the most critical problems that face Americans right now, 
and that is the expiration of the Affordable Care Act tax credits. That 
has happened. Today, on this floor, there was a vote. Fortunately, the 
House of Representatives, led by the Democrats and a handful of 
Republicans, pushed forward an extension, a 3-year extension of the 
Affordable Care Act subsidies which will be exceedingly important.
  The Affordable Care Act enhanced premium credits expired. They 
expired last year at the end of the year, and 4 million Americans 
immediately faced a problem. The expiration of these tax credits not 
only raised the cost for individuals in the marketplace, but it also 
raised the healthcare costs all across America because it rippled down 
into all aspects of the healthcare system, the insurance, and the 
operations at hospitals and clinics. These harmful impacts won't stop 
at the Affordable Care Act insurance premiums. Those costs are now 
across the system.
  Let me level with the American people. The Republican healthcare 
crisis will make the American people wait longer for healthcare. It 
will make Americans pay more for worse healthcare systems. And for 
people who live in rural, as well as urban areas, your clinics and your 
hospitals are shut down. Why? Because the Republicans have been after a 
challenge dating back to the 1960s when the Medicare program was put in 
place to eliminate the government's operations there.
  There is still time to avoid this crisis, and today, this House, led 
by the Democrats, took action to solve at least one of the major pieces 
of that, the Affordable Care Act enhanced premium tax credits. It is up 
to the Senate Republicans now.

[[Page H241]]

  Hello, where are you, Senate Republicans? Are you paying attention? 
It is in your House. You have the opportunity to save this system, 
Senate Republicans. I know that Senate Democrats are already on board. 
They want to do this. Let's get this done.
  So let's challenge the Senate Republicans, see where they stand. We 
know where a whole lot of our Republican colleagues in the House of 
Representatives stand. They did not stand with Americans. They didn't 
stand with those people in your districts, in my district, that are 
going to lose their Affordable Care Act insurance premiums.
  We have got work to do. This isn't the end of this healthcare crisis. 
This is just one more step along the way to try to find some way to 
overcome the terrible burden that the Trump administration and the 
Republicans have placed on Americans as they go about trying to provide 
healthcare coverage for themselves, for their families, and for their 
communities.
  We met that challenge today. The Democrats here in the House of 
Representatives met that challenge today, and we forced through a 3-
year extension of the Affordable Care Act insurance premium subsidies. 
We are thankful that many, and a handful of Republicans, stood with us 
in this.
  Ms. RIVAS. Mr. Speaker, I yield to the gentleman from California (Mr. 
Takano), my colleague and friend and the ranking member of the 
Committee on Veterans' Affairs.
  Mr. TAKANO. Mr. Speaker, I thank my California colleague for yielding 
to me and thank Congresswoman Rivas for co-hosting, and I thank 
Congresswoman Emily Randall from Washington for also co-hosting this 
important Congressional Progressive Caucus Special Order hour.
  Now, we are here because this heretofore do-nothing Republican 
Congress has let 22 million Americans get priced out of their 
healthcare.
  I learned of a coffeehouse owner in Riverside, a good friend of mine, 
whose health insurance went from $600 a month to $1,100 a month. We are 
here because my Republican colleagues think our national budget is too 
tight to ensure that our seniors and families can afford healthcare, 
but it is flush enough with enough cash to fund escapades in Venezuela 
and billions of new spending on ICE and giving billionaires permanent 
tax cuts.
  We are here because Democrats are the ones that are keeping 
healthcare front and center for this body. Republicans wish we would 
stop talking about this, that we would stop bringing it up, but we will 
not stop because healthcare is vital. It is essential to every 
American.

                              {time}  1920

  It was the Democrats that forced this do-nothing Congress to actually 
act. Neither Speaker Johnson nor President Trump wanted to make 
healthcare more affordable, so we took it upon ourselves to pass a 3-
year extension of these vital tax credits, 3 years that match with the 
remaining 3 years of this Presidency.
  Mr. Speaker, 17 Republicans joined us to actually lower costs and to 
make health insurance affordable. Now, I am sure the President will 
have in his mind that he should target for retribution these 17 
Republicans for defying him, for defying the orthodoxy of the 
Republican leadership. He can choose to lead with fear, to be more 
concerned about Venezuelan oil or how many more people he can deport or 
how much more he can enrich himself, or he can use his considerable 
influence and power over Republicans, over Senate Republicans.
  We saw the reach of his power today as Republicans unanimously voted 
for water projects for poor people in Colorado and for a Native 
American Tribe in Florida, reversed themselves and sustained his veto. 
They voted for these two measures before. That is how immense his 
influence is. The question is: Will he get seven Republicans to do 
something right for the American people and lower healthcare costs, and 
will he use his influence to help Americans lower healthcare costs for 
all Americans or will he act in retribution? He can lower healthcare 
costs for all by expanding the pool of insureds.
  The fight is not over. We still have to get through the Senate, but 
the key to all this is President Trump. Will he demand that the Senate 
pass a 3-year extension of this bill, 3-year extension of healthcare 
tax credits? That is the big question.
  Ms. RIVAS. Mr. Speaker, I yield to the gentlewoman from the great 
State of Arizona (Mrs. Grijalva).
  Mrs. GRIJALVA. Mr. Speaker, I thank Representatives Rivas and Randall 
for leading on this very urgent healthcare issue.
  Millions of Americans who depend on the Affordable Care Act are 
selecting their plans right now, and what they are seeing are 
healthcare options that they cannot afford due to Republicans' refusal 
to extend premium assistance.
  I am here today speaking on behalf of my constituents in southern 
Arizona and those throughout the Nation. I am here for the parents that 
are going through their monthly budget trying to figure out what they 
can give up just to be able to pay for these premiums. I am speaking 
for those who have the horrible feeling in the pit of their stomachs 
because they know the risk of being uninsured, being one hospital visit 
away from bankruptcy.
  My Republican colleagues and, certainly, Donald Trump might not 
understand this, but health insurance is not a luxury. It is a 
necessity.
  The facts are clear. Republicans paid for their trillion-dollar tax 
giveaway for the wealthy by cutting healthcare, plain and simple.
  Over 10 million people will lose their Medicaid, and now millions 
more could lose their health coverage because they can't afford their 
premiums.
  Mr. Speaker, 22 million people, including 400,000 Arizonans with 
marketplace coverage, are already seeing their healthcare premiums 
skyrocket. These cuts mean the closure of rural hospitals in Arizona, 
job losses in our healthcare sector, higher healthcare costs for those 
with private insurance, and the overall stress to an already stretched 
thin healthcare system.
  The State of Arizona has estimated the impact of Medicaid cuts alone 
to be $34 billion over the next 10 years.
  For every $1 billion tax cut there is an estimated loss of 36,000 
jobs across multiple industries. While the economic impacts will be 
devastating throughout the State, the most immediate impact will be on 
those going without needed healthcare.
  Already a community health center in my district is feeling the 
impact of the healthcare cuts. In 2025, they saw significant cuts in 
their Ryan White part B funding.
  Due to these cuts, some positions had to be eliminated and workflows 
realigned, including the loss of medical case management and treatment 
adherence support.
  The impacts are real. For instance, a 29-year-old woman was diagnosed 
with HIV during her pregnancy. She is a mom of two young kids, 7 and 1 
years old. She has struggled with mental illness, depression, and 
cognitive delay. Because she lacks daily adherence support for her 
lifesaving Valley fever medication, she has been hospitalized three 
times due to sepsis related to the condition.
  Another 18-year-old with HIV who works as a landscaper has not been 
able to get back on his medication due to the loss of insurance. His 
employer does not provide insurance, and he makes too much money to 
qualify for Medicaid. Now the health center team is trying to get 
support from pharmaceutical companies for this individual.
  These are the types of stories of real people that simply want to 
live their lives. Illness and disease do not discriminate, neither 
should Congress. Americans have had enough of cutting programs that 
Americans need for basic survival, enough of the attempts to repeal the 
Affordable Care Act, enough Republicans' skyrocketing costs.
  It is up to Donald Trump and the Republican Party to decide if they 
will join Democrats to restore these tax credits or whether they will 
keep making life unaffordable for hardworking Americans. I urge the 
Senate to act immediately and take up the premium extension bill passed 
by the House.
  Ms. RIVAS. Mr. Speaker, I yield to the gentlewoman from the great 
State of Oregon (Ms. Hoyle).
  Ms. HOYLE of Oregon. Mr. Speaker, I thank the gentlewoman for 
yielding. This has been a week. We invaded Venezuela; threatened to 
invade Greenland; put Cuba, Mexico, and Colombia on notice that they 
could be next; had the administration and many of my

[[Page H242]]

colleagues, who know better because they were here, try and rewrite the 
history of what happened on January 6; and an ICE agent shot and killed 
a woman in Minnesota, and DHS immediately blamed the victim with no 
pretense of wanting to find out what the facts were. An hour ago we 
just had two more people shot by an ICE agent in Portland, Oregon.

  These are dark times, and it is really easy to get bogged down in the 
negative, but today, something really good happened. Mr. Speaker, 
today, 17 Republicans joined Democrats to override the Speaker's 
attempt to stifle the will of this body to vote to extend subsidies for 
the Affordable Care Act for 3 years.
  My district is just over 17,000 square miles. It is mostly rural with 
rural hospitals hanging on by a thread. Some of them have just 15 
percent commercial payer mix. Without the Affordable Care Act 
subsidies, we will have more uninsured people, and these hospitals 
could go under.
  Prior to being in Congress, I worked at the United Way before the 
Affordable Care Act working on healthcare access, and my county had a 
21 percent uninsured rate. We have a lot of farmers, small business 
people. We have people that couldn't afford insurance. Now our 
uninsured rate is just under 8 percent. That is because of the 
subsidies.
  I have had people call me. One woman called and said she was paying 
$87 a month. She now will have to pay over $1,000 a month, and she 
can't afford her medication or the treatment that keeps her alive. I 
have people, small business people in my district, that are calling to 
say this is the first time they have ever had to go without insurance.
  The fact of the matter is this is the right policy.
  Now, if people want to talk about how to deliver quality, affordable, 
appropriate healthcare with less money going to hedge fund-owned 
medical practices or to insurance companies, I would love to work with 
my colleagues on that. We have a Medicare for All bill that anybody can 
get on. That is what we should be moving toward.
  The bottom line is this: I remember when my mother, who was working 
as a contractor because her job got shipped offshore, didn't have 
insurance and she badly broke her leg, lost her home, went bankrupt, 
lost everything, and had to start over.

                              {time}  1930

  Many people in this country will lose everything. This is the right 
thing to do for right now, and then we should work together and be 
responsible as Congress to lower the cost of healthcare, take out the 
middleman, decrease the price of pharmaceuticals, and make sure that 
people have access to healthcare wherever they are in this country.
  Mr. Speaker, I look forward to working with my colleagues on both 
sides of the aisle to do that, and I encourage the Senate to take up 
this bill and get it done so that we can actually do what we got sent 
here to do, which is the work of the people.
  Ms. RIVAS. Mr. Speaker, I yield to the gentlewoman from the great 
State of Arizona (Ms. Ansari).
  Ms. ANSARI. Mr. Speaker, I thank Representatives Rivas and Randall 
for hosting this Special Order hour.
  Mr. Speaker, I represent Phoenix, Glendale, and Guadalupe, 
communities where families are working hard every single day to stay 
afloat. Across this country, including throughout Arizona, millions of 
families are struggling to afford basic healthcare. With costs rising 
on everything that they need to live, housing, food, and childcare, 
they have been through enough.
  The ACA enhanced premium tax credits were a lifeline for these 
families, but Republican inaction allowed these tax credits to expire 
on December 31 because they don't care about regular people.
  The consequences were immediate. For many families in Arizona, ACA 
marketplace premiums have already more than doubled as a result of 
Republican negligence. That means parents are skipping doctors' 
appointments for their babies, seniors are reconsidering prescriptions, 
and families are facing the very real possibility of going uninsured.
  Take Cricket, for example, a constituent in my district. At 63, 
Cricket is self-employed and not yet eligible for Medicare. She has 
relied on ACA coverage for 8 years, paying $350 a month.
  Last year, she suffered a head injury that required emergency care, 
and ACA kept her bill around $1,000 instead of $10,000, saving her from 
potential bankruptcy. She fears rising premiums. The ACA is her 
lifeline, and without it, she could lose her home and everything else 
that she has built.
  Today, the House of Representatives finally voted to extend these 
enhanced premium tax credits for 3 years. Despite 17 Republicans 
standing up to Donald Trump and to their own leadership, I want to 
point out that not a single Republican from Arizona's delegation chose 
to put their constituents first and extend the lifesaving subsidies. 
That is egregious, and that is unacceptable.
  There is still so much more work to do, even after today's passage in 
this House. We must apply pressure to the United States Senate to pass 
a clean 3-year extension of these ACA tax credits.
  Arizonans cannot afford any more delays. Let's be clear: Extending 
these tax credits is necessary, but it is certainly not enough. We need 
to pass Medicare for All. We are the richest country in the world, and 
we pay more for healthcare per person than any other developed nation.
  On average, we spend at least double per person as countries like the 
United Kingdom, Canada, Australia, and Japan spend on healthcare, so we 
should be the healthiest. We are not. We are 48th in the world for life 
expectancy.
  Do you know, Mr. Speaker, what most of the countries doing better and 
paying less than us have in common? They have universal healthcare. 
Americans' physical and financial health depend on us doing the same.
  It is time to take real action to bring down healthcare costs for 
Arizonans and for people all across the United States. That means 
Medicare for All before more Americans lose their healthcare or go into 
medical debt.
  Ms. RIVAS. Mr. Speaker, I yield to the gentleman from the great State 
of New York (Mr. Goldman).
  Mr. GOLDMAN of New York. Mr. Speaker, I thank the gentlewoman from 
California and Representative Randall for hosting this Special Order.
  Seven days ago, the Affordable Care Act's enhanced premium tax 
credits expired. For years, these credits allowed millions of Americans 
to afford health insurance that they would otherwise not be able to 
get. For tens of millions of others, these tax credits drastically 
lowered premiums--for some families, by as much as thousands of 
dollars. They gave working families essential relief amidst an ongoing 
cost-of-living crisis that Donald Trump has only made worse.
  Without these tax credits, an estimated 5 million Americans will lose 
their insurance as a result of higher premium costs.
  Today, House Democrats successfully forced this body to vote to 
extend those tax credits so that those 5 million Americans can hold on 
to their health insurance with a 3-year extension of these premium tax 
credits, and it passed this body.
  Now, this bill goes to the Senate, which must pass it in order to 
save health insurance for millions of Americans.
  In my State of New York alone, more than 140,000 people relied on the 
tax credits. These credits also supported an additional 1.7 million New 
Yorkers who would probably otherwise not be able to afford health 
insurance.
  One constituent of mine who lives in public housing and holds a good 
job told me that without these tax credits, her monthly premiums have 
gone from $450 to more than $1,000, which she simply cannot afford. She 
is in her sixties and will be left with no health insurance.
  It is not just those eligible for the tax credits who will suffer. 
That is because when people lose coverage, they don't stop getting 
sick. They delay preventative care. They skip prescriptions. They end 
up in emergency rooms. Emergency rooms become overrun, and care gets 
worse and more delayed. Costs rise for everyone, and all outcomes 
suffer.

[[Page H243]]

  Because of months of inaction by Donald Trump and congressional 
Republicans, those tax credits have expired and will be gone without 
this legislation that we passed today. This is nothing short of a 
crisis, and it is a crisis created entirely by the President of the 
United States and his Republican Party.

  Let me say this clearly to the American people. If you cannot afford 
health insurance anymore, you have one person and one party to blame: 
Donald Trump and the Republican Party. It is the same party that cut 
taxes for billionaires and cut Medicaid for working-class Americans.
  Mr. Speaker, you can count on one thing at all times with this 
Republican Party: They will always choose billionaires over babies.
  Ms. RIVAS. Mr. Speaker, may I ask how much time I have remaining.
  The SPEAKER pro tempore (Mr. Wied). The gentlewoman from California 
has 16 minutes remaining.
  Ms. RIVAS. Mr. Speaker, I thank my colleagues who participated in 
this Special Order hour on the ACA tax credits. The Affordable Care Act 
tax credits are why our country has a record-high number of insured 
people.
  Like many of my colleagues who today shared stories of their 
constituents and how this will impact them and their daily lives, I 
also have heard many stories from my own constituents. This includes 
Angel from San Fernando. Angel's husband is self-employed, and she 
works part time. Because of the ACA, they can have reliable healthcare 
that covers her husband's preexisting conditions. Angel is dreading the 
update that will make healthcare more costly. They will have to make it 
work, but it will come at an extreme hardship. Angel and her husband 
are two of the over 31,000 people in my district who will see their 
healthcare costs rise if the ACA tax credits are not extended.
  Another constituent from North Hollywood said that their costs will 
more than double. They write: ``My husband and I are already scraping 
by, living paycheck to paycheck each month. Rent and groceries are both 
harder to pay for. I also have two kids who are on Medi-Cal.'' Families 
of four like this woman's will be forced to pay over $6,000 more this 
year if the ACA tax credits are not extended.
  Mr. Speaker, I am sure Congresswoman Randall has heard hundreds of 
stories from her constituents, too, and would like to share some with 
us.
  Mr. Speaker, I yield to the gentlewoman from Washington for the 
purpose of a colloquy.
  Ms. RANDALL. The gentlewoman is right. I think all of us have been 
receiving stories, texts, emails, and phone calls from neighbors, 
friends, families, and constituents around the country who are impacted 
by rising healthcare costs because of the decisions that Republican 
leadership has made.

                              {time}  1940

  It is certainly not just my district. We know that in central 
Washington and Washington's Fourth District, a family of four earning 
$66,000 a year is seeing annual premium increases of $2,651.
  In Louisiana's Fourth District, we are seeing a family of four that 
is earning $66,000 have the same increase.
  In Texas, a 60-year-old couple earning $85,600 a year would see their 
premiums increase 333 percent, $20,466.
  The numbers can sometimes feel abstract, right? What are those 
numbers? They are people.
  Amanda in Bremerton told us that for her family, the ACA credits were 
the only way that she could afford healthcare. If they lose the 
discount with the ACA, they wouldn't be able to have healthcare, 
period. Her family members won't be able to afford the medications that 
they need to help keep them alive.
  Healthcare should be affordable for all citizens in the United 
States. Amanda is worried that they will possibly lose their home if 
they get sick and have to go to a doctor.
  Andrea from Tacoma works for a California-based company. The 
insurance that they offer would cost her $1,000 a month, which is out 
of her budget, but obtaining insurance through the Washington 
marketplace, with ACA tax credits, allowed her to purchase it for just 
$300 a month, less than a third of what her employer-sponsored coverage 
would be. She still struggles to make this payment.
  If she can no longer afford healthcare, Andrea is going to feel the 
impact significantly. She makes just too much money to receive Apple 
Health, our version of Medicaid. She is pregnant. She will be swimming 
in medical debt. She says she is the only one who provides for her and 
her children.
  Our neighbors deserve better, and they deserve us to keep fighting, 
not just for this ACA tax credit extension, which we will continue to 
put pressure on the Senate to pass, but also for a system that meets 
our needs nationwide.
  Ms. RIVAS. Mr. Speaker, I thank Congresswoman Randall for sharing 
those stories. We are hearing these stories from all over the country, 
not just blue States, but also red States, everywhere.
  The Affordable Care Act tax credits keep healthcare affordable for 
all Americans. If the Senate does not act immediately, constituents 
like Stephen from Van Nuys will bear that burden. Stephen and his wife 
are both independent contractors who pay for their own health 
insurance. In 2026, they are facing a monthly increase of over $1,000 a 
month each. This is absolutely unacceptable in the United States.
  Before I close, I thank Congresswoman Randall for joining me for 
tonight's discussion and would like to yield to her for any closing 
remarks she may have.
  Ms. RANDALL. Mr. Speaker, I thank Congresswoman Rivas.
  Mr. Speaker, at the end of the day, this comes down to a simple 
question: Who is Congress fighting for? Right now, Republican 
leadership is offering Americans higher healthcare costs, less 
coverage, and more uncertainty.
  By refusing to extend the Affordable Care Act tax credits before they 
expired last month, they made healthcare costs more expensive for 
working families when people are already stretched thin.
  I have heard from families across my district who are forgoing 
coverage this year because of the absurd premium increases.
  A small business owner in Bremerton said that her new monthly premium 
for her family of three would be more than her mortgage, costing 
$35,000 a year. She is now being forced to look for a new job that 
includes health benefits and told us it is very likely she will have to 
sell her home in order to pay for insurance.
  If the Senate doesn't pass the 3-year ACA extension immediately, 
families will be locked into these higher prices for 2026, and they 
will lose coverage. People will delay care, skip prescriptions, or 
avoid seeing a doctor, not because they don't need it, but because they 
can't afford it. That is not a healthcare system that works.
  Healthcare is a human right, and your ability to get it shouldn't 
depend on how much you earn, where you live, or whether your employer 
offers coverage. No one should have to choose between paying rent and 
seeing a doctor or between putting food on the table and buying a 
prescription.
  The ACA tax credits exist because Congress recognized a simple truth. 
Without them, millions of Americans would be priced out of care. These 
credits make coverage possible for seniors who are not yet eligible for 
Medicare, for small business owners, and gig workers, for families who 
earn too much to qualify for Medicaid but not enough to absorb soaring 
premiums. Allowing these tax credits to expire was a choice, and it was 
the wrong one.
  Americans are being screwed by this administration. Tariffs are 
screwing our farmers and raising prices. Trump is killing energy 
projects that raise our utility bills, and Republicans screwed around 
with our health insurance by refusing to extend the ACA tax credits.
  Congress has a real opportunity right now to take action: to lower 
costs, to protect coverage, and to improve the health of people across 
the country. Extending the ACA tax credits will keep families insured, 
reduce financial strain, and prevent avoidable deaths.
  This is a moment for leadership, a moment to put people over 
politics. Republicans in the Senate must act to extend these tax 
credits. We must make it clear that in this country access to 
healthcare is not a privilege; it is a right worth protecting.

[[Page H244]]

  I am glad to be a partner in this fight with Representative Rivas and 
all of my other Democratic colleagues who spoke on the floor tonight.
  Ms. RIVAS. Mr. Speaker, I thank Congresswoman Randall and thanks 
again to my other colleagues who spoke tonight.
  Today's vote will help keep healthcare affordable for millions of 
Americans, but our work isn't done. The Senate needs to pass this bill 
immediately, and then we need to get back to work on progressive and 
equitable solutions that leave no family behind.
  Families are still facing high costs for housing, childcare, 
groceries, and other everyday necessities. House Democrats and the 
Congressional Progressive Caucus will continue to stand with the 
American people to protect their healthcare against Republicans' 
attacks and keep the American Dream attainable for all.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. Members are reminded to refrain from 
engaging in personalities toward the President.

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