[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.
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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.
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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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