Floor Statements

Mr. President, this well-meaning CRA is not needed. For decades, Congress has allowed Agencies to fast-track regulations on bureaucratic topics that do not impact the public. The policy that is sought to be overturned merely aligns HHS policy with this longstanding exemption. It does not change the process for major regulations that impact the public.

The courts have weighed in repeatedly on Agency processes for issuing regulations. Fast-track procedures can only be used in a narrow set of circumstances.

If there is a concern about the HHS policy, the goal should be to change the law, not pass this CRA.

There has been an implication that reductions in force would have gone through rulemaking if HHS still had the Richardson waiver in place. That is actually not true. The reductions in force are governed by an Office of Personnel Management regulation implemented by HHS.

I yield the floor.

Vote on Motion

Mr. President, tomorrow, we are going to vote on two different visions of how to cover the cost of health insurance on the ObamaCare exchanges.

Democrats want to cover the cost of health insurance to benefit insurance companies. I will tell you why I am saying that--because I can make that case. Republicans want to cover the cost of health insurance for the actual person who is buying the insurance--the patient, if you will. That is the difference between the Democratic plan and the Republican Health Care Freedom for Patients Act. So let me just kind of build that out.

How do we make healthcare affordable again?

First, the Democrats want people to pay $6,000 out of pocket before the insurance kicks in. The Republicans want to put thousands of dollars in the patient's pocket so she has that to pay before she actually gets into her deductible.

Let me demonstrate with this chart.

The Democratic plan is to give 100 percent of the money to the insurance company of which the insurance company takes 20 percent for profit and overhead. Then it uses the rest of the 80 percent to pay for the insurance that they think--that they agree--the patient needs.

Our plan puts the money in the patient's purse, her pocketbook, her wallet. One hundred percent of the money in there is used for the care she knows she needs. She doesn't have to get permission from the insurance company. She knows she needs it. She can see her doctor, her dentist. She can get her pharmaceuticals. She can get eyeglasses, dental care, and orthodontia. That is a patient-driven account.

This is the plan that Senator Crapo--the Finance chairman--and I propose. So let's compare the two plans. Again, they are two competing visions, two different ways, and I would argue that the Democratic plan principally benefits insurance companies and that the Republican plan is there to benefit the patient.

Let's look at this.

The Democrats just want to extend the enhanced premium tax credits. Who gets the money? Insurance companies. Under our program, where the money goes to the patients, the patients and their families get it.

What can it be used for?

Of the enhanced premium tax credit that the Democrats wish to extend, there are no changes whatsoever--3 years of subsidized premiums. That goes to the insurance company. On our side, the money that the patient gets in that account--the money that we put into her pocket so she can pay the out-of-pocket for the insurance company--goes for real care: the dentist, the physician, the glasses, the prescriptions.

Who makes the decisions? Under the Democratic plan, the insurance companies make the decision. Under our plan, the patient makes the decision. We give power to the patient, not profit to the insurance company.

Does it lower costs? Clearly not. What we have seen since ObamaCare was passed is costs explode. We continue to have the healthcare inflation we are looking at now.

But if we empower the patient and if we give her the money and we say ``The more careful you are spending this money, the more that money is going to stretch,'' I can promise you, she is going to be like every other responsible wife, mother, keeper of the family wallet: She is going shop.

Wait, my x ray is $50 here. No, my x ray is $500 there. I am going where it is $50.

She will make the wise financial decision for her family.

How does it work with low-cost bronze plans? Here, under the Democratic plan, we have just heard Senator Crapo point out how much fraud there has been with this system that we are currently under.

Under the patient-driven account, the money goes into a health savings account--into your wallet, if you will--which is connected with your bronze, and the mechanisms by which we set that up make sure we cut out that fraud.

Our bill goes after that fraud; their bill tolerates it. There is nothing in their legislation to stop the fraudulent stealing of billions of dollars of taxpayers' money. What it does do is it continues payments to insurance companies that take 20 percent of that money for overhead and profit, whereas under our plan, the money we give to the patient--100 percent goes to the care she knows she needs.

That is the plan Republicans are proposing. To put it differently, under the Republican plan, there is power to the patient. Under the Democratic plan, there is profit and power to the insurance company. Under the Republican plan, the patient uses the healthcare money in her wallet to purchase the care she knows she needs. Under the Democratic plan, you go to the insurance company and plead: Please, baby, please can I get permission to get the care I know I need?

The Republican plan meets the American people where they are financially. Studies show that only like a--that most families have less than $1,000 worth of savings. Under our plan, we recognize that, and we put money in their wallet, pocketbook, or purse so that they can pay for the care they need before they go into their deductible.

Like this. This is a new poster for people who have heard my talk before. This is the Democratic plan. You get a $6,000 deductible, and that is what you feel like, that woman right there when she is stressed because she doesn't have the money to pay for the care her family needs.

Here in her health savings account, the money is, if you will, in her purse, and when the doctor says ``You need this prescription for you son's earache,'' she has the money to pay for it right off the bat.

The Democratic plan brings financial stress--profits to the insurance company; stress to the patient. The Republican plan--money in the pocket to pay for the out-of-pocket for the insurance plan.

Now, by the way, this plan in which we put money in the pocket of the patient to pay for the out-of-pocket of her insurance policy the Democratic leader has called a junk plan.

Now, pause for a second. Democrats put that plan into place. Democrats actually put these plans on the ObamaCare exchange. He is calling a junk plan that which they have been preserving for the last 10 years, swearing up and down that it meets the needs of the American people.

All Republicans have done is added to it something called a health savings account, if you will, money in the patient's purse, pocketbook, or wallet to pay for the out-of-pocket associated with this plan.

To call this a junk plan just shows that the Democratic leader does not know what we are talking about or that hypocritically he has been defending an ObamaCare law which created this very plan.

By the way, I was smiling last night when I saw that the New York Times mimicked this talking point like a Democratic Party organ.

What is junk? That for a family of four--two parents in their fifties, children 18 and 19--that they get $5,000 a year? Think about that--$5,000 a year for that family I just described to pay for their initial healthcare expenses.

Think about if one of those children had diabetes--chronic care. Under our plan, they have $5,000 to help pay for that chronic care right off the bat. Under the Democratic plan, with a $6,000 deductible, you are paying for that out of pocket, and that is what your face looks like because you cannot afford it. Our plan relieves the stress.

Now, next, the minority leader says that he wants to reject all these benefits. He wants to continue to send 100 percent of the money to the insurance company, which takes 20 percent for profit and overhead, as opposed to sending the money to the patient for her purse, wallet, or pocketbook so that she has money in the pocketbook to pay the out- of-pocket from the insurance company.

He is defending that with a $6,000 deductible because he says that Republicans want to prevent taxpayer-funded abortions. He wants to have taxpayer-funded abortions apparently, and Republicans, consistent with the American will, as we have for decades, think that we should not do that.

Somehow, he is making out like this is a new development. Well, just for the sake of the American people, the so-called Hyde amendment, which prevents Federal dollars from being spent on abortion, has been agreed to by Democrats on annual appropriations bills since the 1970s. They have been agreeing to this for 50 years, and all of a sudden, that is being used as a rationale to send 100 percent of the money to the insurance companies, which take 20 percent of it for profit and overhead, as opposed to sending thousands of dollars to the patient for her to pay first-dollar coverage, to have it in her pocketbook to pay the out-of-pocket for her insurance plan.

I don't want this to seem partisan. I have been saying ``Republican'' and ``Democrat,'' but let me say that we should not have a Republican plan; we should not have a Democratic plan; we should have an American plan.

This is a cartoon representing an American, but think of the person you know. Think of the person you graduated from high school with--good people. Good people. Several kids. Trying to make ends meet. They don't have a lot of money. But good people. That is who I am talking about.

Let's just separate this from R versus D. What about the people we are supposed to care about who cannot afford a $6,000 deductible but would love to have thousands of dollars in their purse, pocketbook, or wallet to pay for the out-of-pocket costs associated with that insurance plan? Isn't that where we want to be?

Now, just to put a face on this--maybe some numbers, I should say. This is real. This is off healthcare.gov from 2026, this coming year. A family of four, a couple in their fifties with two children, 20 and 21; 500 percent of the Federal poverty level--about $160,000, I think, per year, OK? Under our plan, they would be able to get a bronze plan as opposed to a silver, which saves them roughly $6,000 per year. The amount in their health savings account--if you will, in their pocketbook, purse, or wallet, in their pocketbook to pay the out-of- pocket costs of the insurance plan--would be $5,000.

Under what Democrats are insisting they must buy--will not give them an option--they have zero dollars to pay toward that $6,000 deductible. And the net deductible--because they say: Oh, my gosh, if you get a plan with a lower premium, your deductible is higher. Because of the money that would be going into the health savings account, the net deductible is cheaper with a cheaper policy under the Republican plan. Under the Democratic plan, the net deductible is higher.

Let me add one more thing. Senator Crapo spoke about the incredible amount of fraud associated with the current implementation of ObamaCare, and the Democratic leader wants a straight-up, clean reauthorization for 3 years. He does not want to fight that fraud.

Whatever bill was put up in the past, that is not what he is talking about now. He is talking about right now not only 100 percent of the money going to the insurance company with $6,000 deductibles; he is talking about continuing a system that is rife with fraud.

If you are at home--no. If you are at work and you are working so hard and you are paying taxes to support our country and you hear there is fraud, it should drive you crazy. It drives me crazy.

Why won't our Democratic colleagues join us in doing things to stop that fraud? I have never seen a party so committed to generating profits for insurance companies as what I am seeing right now.

Let's cut that fraud. Let's put the money in the purse, pocketbook, or wallet of the American citizen to give her money to pay for the out- of-pocket costs of the insurance company. Don't stick them with a $6,000 deductible. Let's give power to the patient, not profit to the insurance company.

I yield the floor.

Mr. President, I have nine requests for committees to meet during today's session of the Senate. They have the approval of the Majority and Minority Leaders.

Pursuant to rule XXVI, paragraph 5(a), of the Standing Rules of the Senate, the following committees are authorized to meet during today's session of the Senate:

Mr. President, this is a really interesting debate.

Right now, Democrats are advocating to send $26 billion to insurance companies so that you subsidize plans--silver-level plans--which have a $6,000 deductible.

I have asked people who have asked me about this: Do you have $6,000 in your bank account to spend on healthcare before the insurance actually kicks in?

Not one has yet raised his hand.

I think some of those advocating for this among Democrats just don't realize the financial situation American families are in when we ask them to pay $6,000 before the insurance kicks in--$6,000 beyond the premium that they are paying for their health insurance. So people-- patients--are going to see their doctors, and they can't afford the deductible.

When I was practicing, I would say to my patients: What about this procedure? this test? this medicine?

Doctor, I am in my deductible. I cannot afford that.

So, to have a $6,000 deductible is, for many, the same as having no insurance at all.

By the way, it goes without saying, under your traditional medical insurance plan, you don't get eyeglasses, and you don't get your teeth cleaned. Why not, instead of sending 100 percent of the money to the insurance company, of which they take 20 percent for profit and overhead, we send 100 percent to the patient. Then she can spend it on the services that she knows she needs. This is kind of, if you will, the Republican plan, and I will tilt it this way so those in the audience can see because they represent the American people.

Under the Democratic plan, they want to send 100 percent of the money to the insurance company that takes 20 percent for profit and overhead, and only 80 percent goes for patient care, but to get that 80 percent, you have got to ask permission.

We, the Republicans, want to give the money to the patient so that she can pay for her physician, her dentist, her drugs, her eyeglasses. She gets the money, and she can get the healthcare that she knows she needs as opposed to the healthcare that she gets permission from her insurance company to get. To put it simply, we want power to the patient, not profit to the insurance company.

Now, the other side is going to claim: ``Oh, no. Wait. No, no, no, no''; that, in some way, the plan we are proposing does not work out financially for the American people. You are not lowering their premiums. You are not helping them with their first-dollar cost.

So here is a prospective plan for my State for a couple 55 years old, with a 20- and 21-year-old on their insurance policy, at 500 percent of the Federal poverty level. The bronze plan is $2,250 per month. The silver plan is significantly more expensive. It is $6,000 more expensive a year. It is almost $3,000. Under our plan, everybody up to age 49 gets $1,000 into their health savings account. If it is a family account, it goes into the family account, and those over 49 get $1,500. So this family of four, with those ages, gets $5,000 into their health savings account. It is $5,000 so that, when I go to the doctor and I have got an earache and I need medicine, the health savings account pays for the doctor's visit, and the health savings account pays for the medicine.

Contrast that with what Democrats want. They want a plan which is $6,000 more a month. The net deductible is higher, and you don't have $5,000 to begin paying for your medical bill. You have got no money whatsoever, and on that first trip to the doctor, you are paying out of your purse; you are paying out of your pocketbook.

This is the plan that works for the American people? ``Not.''

When I was a physician--but no. As somebody who had three children, this is not the plan that would have worked for my family.

Republicans are trying to meet the American people where we know they are, not some theoretical ``oh, that is where they should be.'' Most Americans don't have $6,000 to pay for healthcare before they get it billed by the insurance.

So let's do just kind of a side-by-side comparison. Here is the difference between the two accounts.

Who gets the money?

Under their plan, the insurance companies. Under our plan, the patients and families.

What can the money be used for?

Well, here it is subsidized premiums, which means that the insurance company gets it and takes 20 percent for the deductible and copay.

Under our plan, you can use it for your doctor visit, your x rays, to see your dentist, your glasses, or your prescriptions. This is real medical care, not something the insurance company permits you to have.

Who makes the decision?

Under their plan, the insurance company. Under our plan, power to the patient.

We want that patient--we want that mama; we want that wife because they are the ones who always make the decisions on healthcare--to be the one who has the power.

Contributes to lower cost?

Under their plan, no, because it goes to the insurance company that continues to pay those higher rates.

To the patient, if you give her this money, you have got $5,000 to spend it wisely. She is going to say: Wait a second. The x ray is $150 here and $500 there. I am going to where it is cheaper, not more expensive.

I can tell you, when that begins to happen, the people who are more expensive will begin to lower their prices. This is a plan that by sending it to the patient for real care, to the patients with the power, you empower the patient to shop, driving competition and lowering healthcare costs.

We just heard from Senator Crapo. Under the plan that my Democratic colleagues support, we have seen widespread fraud and unauthorized enrollment.

Under our plan, if you have got a health savings account, it is pretty easy. I just signed up for a similar type of account on my healthcare. You have got to show who you are. It is not really hard. It took me about 5 minutes,

but the banks that manage this money are going to require that you identify that you are a real person. This is an anti-fraud program. What is not to like? The money goes to the patient, not to the insurance company. It is used for real care. It gives the patient the power to shop and find a better price, which lowers healthcare costs, and along the way, we have mechanisms which cut out the fraud. This should be the basis of a bipartisan deal.

So I have called some of my Democratic colleagues. Let me start over. I have been asked by the press: Why wouldn't Democrats want this? I mean, why would they not want 100 percent of the money going to the patient instead of 100 percent of it going to the insurance company, and the insurance company takes 20 percent for profit and for overhead? Why wouldn't Democrats want to give power to the patient so that she can shop for a better deal, instilling competition, which ultimately lowers costs? Why would Democrats not want a system which begins to squeeze out the fraud that Senator Crapo pointed out is so rampant in this program?

I just shrugged my shoulders. I am not sure. As I say in my Spanish language class, ``digame.'' I am not quite sure I follow.

Then I heard Minority Leader Schumer explain that this is all about Hyde. They are afraid that our plan will not allow abortions, so they are going to continue to send the money to the insurance companies, subsidizing premiums, profit for the insurance companies, contributing to healthcare inflation and with unchecked fraud--all because of what is called the Hyde amendment.

By the way, what is the Hyde amendment?

For those watching, the Federal Government, consistent with the will of the American people, has made a decision not to spend Federal dollars to pay for abortion. That is what the Hyde amendment is. For most Republicans, that is an important part of our position, and Democrats have decided that they are willing to forgo all of these advantages in order to protect insurance companies paying for abortion.

Let me tell you the ultimate irony in that. When ObamaCare passed, President Obama made a deal in which these plans were not supposed to pay for abortion. Section 1303 of the ObamaCare law, if I remember correctly, said that these dollars are not supposed to pay for abortion.

Democrats are defending dollars paying for abortion. Either they are going to acknowledge that insurance companies are ignoring the law, in which case--wait--we are going to enable insurance companies to break the law or they are attempting to introduce a source of funding for abortion that President Obama himself did not include.

Now, if your rationale is to send 100 percent to the insurance companies instead of 100 percent to the patient to subsidize premiums instead of paying for real doctor care--they let the insurance companies make the decision instead of the patient--and to not contribute to lowering costs versus empowering patients to shop for a better deal and, with competition, lowering healthcare costs--and, by the way, did I point out they can get a lower premium with $5,000 in a health savings account for that family that otherwise could not afford care because you are trying to introduce a new right to abortion in a Federal insurance policy? Be honest with the American people. Either the original ObamaCare law is being ignored or you are trying to establish a new right.

I have said before that we need to find a way that the American people can afford their insurance. Absolutely, we need to find that way. I have said repeatedly I don't want a Republican plan; I don't want a Democratic plan. I want an American plan, a plan that works for our fellow Americans so that they can afford the insurance that this Republican absolutely wants them to have, but we have got to do it in a way in which they have real insurance, not a policy with a $6,000 deductible, with lots of fraud associated with it, and which does nothing to achieve the goals that we know we need.

I don't see why Republicans merely pointing out that under the ObamaCare law this was not to pay for abortion in the first place should be the reason that we cannot protect Americans from these $6,000 deductibles.

With that, I yield the floor.

Mr. President, we just had a shutdown over something that the American people I am not quite sure understand, but what they do understand is that they cannot afford their health insurance. They cannot, if you will, afford the cost of being insured. Prices of health insurance and of healthcare are up for everybody. It is not sustainable, and they are looking to us--they are looking to Congress-- for solutions.

As a physician, as a doctor, I have seen it firsthand. I have seen patients come to see me with insurance, but they could not afford their deductibles. I have seen people who could not afford their insurance and who therefore take the risk that they will not get sick. We should not have that in our country.

In July, the Health, Education, Labor, and Pensions Committee--the HELP Committee, which I chair--discussed affordability across the entire commercial insurance market, trying to find out why costs are going up so high when you are buying your insurance through your employer or, as the employer, buying the insurance for the employee. But it doesn't matter. If you are on the individual market or if you are on the small business market, you are paying more, and because of increasing healthcare costs, insurance premiums are climbing as well.

Now let's go to the ObamaCare exchanges because the shutdown we just had for over 40 days was related to the fact that subsidies are ending on the ObamaCare exchanges.

A little bit of history: During the COVID pandemic, health insurance premiums were going up so much that Democrats passed extended, temporary, enhanced premium tax credits--if you will, EPTCs--which helped give more money on top of the original ObamaCare subsidies to help people afford their premiums.

The way it works is they didn't give the money to the patient, to the individual, to our fellow American; they gave the money to highly consolidated insurance companies, which take 20 percent of that for profit and overhead.

Now, I am not knocking insurance companies. We all have insurance for our cars, for flood insurance, for property and casualty, et cetera. I am just pointing out that they do take 20 percent of what we give them for profit and overhead.

By giving the money to the insurance companies, we are not actually lowering the cost of the premium; we are just papering over it with subsidies. Somebody is paying for that. It is the taxpayer who is paying for that. The premium is going up. Yes, the person getting the insurance pays less, but we the taxpayers are paying for it. There is no free lunch when it comes to this.

The enhanced premium tax credits don't lower the cost of healthcare, but they are a bandaid on a broken bone.

By the way, we can prove this.

In 2014, taxpayers covered 68 percent of an ObamaCare exchange enrollee's premiums. By 2020, 60 percent had become 80 percent, meaning that is how much the taxpayer was subsidizing. From 2021 to 2025--the era of the enhanced premium tax credits--the taxpayers' share of subsidizing the premiums on the exchanges grew to 93 percent. What started off as 68 percent has become 93 percent this year. Yet, despite all this money--let me repeat--the actual premium never decreased; it is just that the taxpayers were paying more of it for our fellow Americans.

Now, somebody is paying. You and I are paying it. By the way, if you are not getting extra money, if you are paying for it on your own, you are still paying those higher and higher rates. If I were that person individually insured who was not getting the subsidy when everyone else was but my tax dollars were going to subsidize other people, I would feel totally taken advantage of. You are paying for others to get cheaper insurance, but you are paying more because nobody is addressing the higher costs of healthcare.

We should be fair to our fellow Americans who can't afford their premiums. We should be fair to our fellow Americans who are not getting subsidies. So what do we have to do? Well, let's go after the root cause of what is causing the healthcare costs to rise. Let's find out why that is, and let's attempt to decrease the cost of healthcare. It is hard, but I think there are practical solutions that are implementable that could actually do that.

But that is only one part of the conversation. The second part of the conversation is, what do we do about January 1, 2026, when the tax credits that the Democrats passed are set to expire at the end of this year? What do we do for those Americans who are in some cases facing $33,000-a-year premiums who have a salary of $90,000? What do we do for them?

Some people just want to continue the subsidies as they are--the status quo: Let's continue the subsidies for 3 more years. And, yes, the premiums will continue to rise. Yes, it will require taxpayers to subsidize more and more. By the way, the policies we are buying have $6,000 deductibles. They want to continue that status quo.

Well, I can tell you that I am not interested in the status quo. As a physician, I can tell you that putting a bandaid over a broken bone doesn't work. And the Republicans are absolutely interested in finding a solution that can make healthcare and health insurance more affordable beginning on January 1, 2026, but going on beyond that.

So what can we do for January 1, 2026? This is where I think we are headed: If Congress does what it always does, Democrats are going to put up a bill, and it is going to fail. They are going to put up a bill, and they are going to know it is going to fail. The Republicans will put up a bill, and it will fail, and everyone will know that that bill will fail too.

Then premiums will rise on January 1, 2026. The American people who are looking to Congress for a solution will find two bills side by side, neither of which passes and both of which we know will fail, and their premiums will go up. That should not be an option.

I suggest that we find a solution--not a Republican solution, not a Democratic solution, but an American solution. Put differently, not an R, not a D, but an A solution. There are ideas out there on the right and the left that are big ideas, good ideas, or bad ideas, but they are going to take a long time to discuss, debate, figure out, and implement. We have to be focused on January 1, 2026, and that means we have to build on what we already have. Now, folks may not like what we already have, but we have to focus on getting something done in 3 weeks.

So we have two choices: Do nothing and accept the premise that no deal is possible, that the enhanced premium tax credits go away, that there are no reforms to a failing system, that a Democratic bill and a Republican bill both fail like so much fails in Congress, and that the American people are not served--that is one option--or we can roll up our sleeves and figure out something we can all live with.

I think that there is, if you will, such a sweet spot, one in which Congress appropriates funds equivalent--roughly equivalent--to what we would spend on the enhanced premium tax credits, but instead of 100 percent of this money going to insurance companies, which take 20 percent of it for their deductibles and copays, we give 100 percent almost to the patient, to our fellow American, in an account that she controls and can use as she wishes.

So I am proposing not to continue--I will put it up there for our guests in the audience.

Good to see you all.

If we just keep doing what we have been doing for the last 4 years, we send $26 billion to the insurance companies, which take 20 percent of it for profit and for overhead--that is under the ObamaCare law that they can take that 20 percent--or we can send 100 percent to an account that the patient controls. She makes the decision on her doctor, her dentist, and on some things that insurance doesn't pay for: eye care, dental care, orthodonture. She makes the decision. She gets the healthcare she knows she needs as opposed to the healthcare the insurance company gives her permission to have. Put differently, giving her the money gives power to the patient. That is where we should be.

What Democrat wants to give 100 percent of the money to the insurance companies for them to take 20 percent for profit and overhead? What Republican does not want to give power to the patient by putting money in her account for her to use--I am chuckling, and I will tell you why in a second--as she sees fit?

Sometimes people say--and there are a lot of men up in the audience who are chuckling with me. Some people say: Well, why do you use the feminine when you speak about this? Because women make 85 percent of the decisions in healthcare, and we can trust her to make a decision which is good for her family's health and which is good for her purse, which is good for her pocketbook.

Let's have faith in her to make the wise decision for her family as opposed to having to go to the insurance company, which returns roughly 80 percent of it back but takes 20 percent for profit and overhead. Give power to the patient.

Now, you can do this because under ObamaCare, you can take a credit which goes to a more expensive healthcare policy or you can apply it to a less expensive policy. That gives you savings, and those savings you can split up between all of the eligible people on the exchanges into their health savings accounts. It would be to the patient's financial advantage to take a cheaper plan but to have the health savings account to help pay for her expenses.

By the way, the health savings account, it has been shown, empowers, encourages somebody to make wise decisions. If she knows that ``I can get the x ray here for $500 or down the street for $2,500,'' she is going to go where she gets it for $500. That begins to lower costs because the people who are more expensive will lower their costs. She, the woman in charge of this, is going to drive lower costs across the healthcare economy.

Some folks say: Wait a second. Health savings accounts--aren't those just for rich people?

No. One, I don't think they are in general, but in this case, we are prefunding them. It doesn't matter what your income is. You get more money. The Federal Government, instead of sending it to the insurance company, puts it into the account for you. You get more money.

By the way, if you do it the way I would like to set it up, if you are less well-off, you get more money. If you are a little bit older, you get more money because--I hate to say it--when you get a little bit older, your healthcare costs go up. If you have a bunch of kids, you get a little bit more money, too, because taking a child to the emergency room can be expensive.

We can make this work for the American family as opposed to the American family working to get the insurance company to approve the care they know they need. My plan does not take away coverage. It doesn't touch the original ObamaCare tax credits. The patients need a solution that reduces their costs of being insured, not just the cost of the premium.

There are a lot of other issues to address. I am pro-life. There are some pro-life issues. But I have found that if we come together in a well-meaning way and work out a way that we can keep the American people from getting stuck with a high healthcare cost, treat their tax dollars with respect, and ideally lower the cost of the program, we can work out other issues.

President Trump endorses this approach. President Trump has said he would rather not give money to the insurance companies. He would rather give it to the people. Actually, he said: Don't give the money to the money-sucking insurance companies; give it to the patient--or something like that. President Trump has a way with words. So, however you say it, let's give the patient the power.

Because President Trump endorses it, though, I do think that Republicans will by and large support it, that there will be a vote in the House of Representatives, and that there is enough in here that Democrats want that Democrats can find some way to embrace it.

The American people want something to pass. Let's work to find something that can pass. Let's give power to the patient, not profit to the insurance company. Let's make healthcare affordable again.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I ask unanimous consent that the Senate action with respect to H.R. 3174 be vitiated.

Mr. President, I have been coming to the floor to speak about how we can go forward in a way that actually lowers the cost of having health insurance for those who are on the exchanges and begin to build a future where we lower the cost of health insurance and healthcare for everybody whether you are on an ObamaCare exchange or have employer-sponsored insurance or you name it. We know there is going to be a vote--as part of this agreement to open the government-- on what to do about the exchanges; so we need to be thinking and talking about the solutions that are out there that benefit the American people.

Of course, the issue underlying it is that people cannot afford their health insurance. They cannot afford their healthcare. Those are two different things, by the way. The cost of healthcare is what dictates, theoretically, at least, the price of health insurance. If you lower the cost of healthcare, then you lower the price of health insurance. I saw this as a physician when I was practicing in a hospital for the uninsured for 20 years--I should say the uninsured and the poorly insured. There were middle-income people who could not afford their insurance and/or could not afford their healthcare.

So how do we get out of it? Well, first, it is complicated. We have got to be creative, and we have got to abandon set positions. Sometimes we are in this Chamber, and all we do is stick to our guns, and if the other party suggests something, we automatically reject it. We have got to move beyond that, not as, ``Oh, my gosh. If the other side proposes it, I reject it,'' but rather as, ``Wait a second. Let's listen. Is there a solution here that can benefit the American people?''

ObamaCare tried to make and has tried to make healthcare insurance affordable by just throwing billions at it. The problem with that is that it doesn't make healthcare affordable. It just makes the health insurance premium less expensive for those who are on the exchanges. This actually drives up the cost of insurance for some and does nothing about the underlying healthcare costs driving up the premiums for others.

So what is my proposal? I propose, instead of paying insurance companies to manage more of our billions, why don't we trust the American people to manage their own resources or to manage their own care with something which I call a prefunded Federal flexible spending account?

Let's first talk about the enhanced premium tax credit, which is at the center of this discussion. It is just a primer. Let's get the basics.

There are two types of premium tax credits used to fund insurance for those who are on the ObamaCare exchanges. One is the baseline tax credit, in the original ObamaCare law, which helps pay for the premiums for those who earn less than 400 percent of the Federal poverty level, but that didn't control costs. So, during the COVID epidemic, the Biden administration put in something called the enhanced premium tax credit that provides some additional benefits for those less than 400 percent of Federal poverty, but it gave additional benefits for those above 400

percent of Federal poverty, if you will, acknowledging that ObamaCare had not controlled healthcare costs, and premiums on the exchanges for those above 400 percent had become unaffordable.

Let's be clear: The discussion we are having now is not about the baseline premium tax credits; it is about the enhanced premium tax credits, which started under the Biden administration.

So it begs the question: Why were enhanced premium tax credits necessary? Well, as we have said, the cost of healthcare has continued to rise. You can argue, if you are going to an insurance company and you are saying, ``We are going to give you more money if healthcare costs more,'' that they do not have the incentive to help control those healthcare costs.

Now, I am not here to bash insurance companies. They are essential to our society. So I will just put that out there. But if you have the choice of giving the money to the patient for her to manage it or giving it to the insurance company, I think we should give it to the patient.

So the question is: Can we put in programs that lower the cost of healthcare? How long will it be before it takes effect, and what do we do in the interim?

Well, it is too soon this coming year to put in programs to lower the costs of healthcare, but it is not too soon to put in programs that empower patients to manage their costs and give them the money, as opposed to giving it to the health insurance companies, but to do that, we have got to think differently.

So how do we lower costs for the coming year for the individual who is on the exchanges? It is important to realize that the total cost of having health insurance is not just the premium but that it includes the deductible and the copay. So if you can help with the deductible and the copay, that is as effective, or even more effective, than helping with the premiums.

So what I am proposing is something which actually helps the patient become a wise consumer of healthcare, helping her with the premiums and the copays, working with the health insurance policy but in a way which lowers their cost.

Let me be clear: This is not the official Republican position. President Trump has endorsed the concept, but it is not, say, for Leader Thune. But I am the chairman of the Health, Education, Labor, and Pensions Committee, which has jurisdiction over this, and we will be having hearings in the near future to address this. And my motivation is as a Senator and as a doctor who wants to make healthcare more affordable for all Americans.

Let's discuss what I am calling a prefunded flexible spending account. First, here is what we currently have: an enhanced premium tax credit, which is going to take $26 billion next year and give it to insurance companies that tell the patient what she can buy and what she cannot buy.

I have a typo here. I fixed it yesterday, but I have got to fix it once more.

Twenty percent of the money--20 percent of the $26 billion going out the door to help pay for insurance premiums--actually will go for profits and overhead of the insurance company. So let me just change it right here. Again, I had a typo yesterday, and I have a typo today.

Twenty percent of the money we are giving to the insurance companies under the enhanced premium tax credits goes for profit and it goes for administrative overhead. Only 80 percent goes to pay for the insurance premium to pay for healthcare costs for the person who is a recipient.

Let's speak of what I am describing, the prefunded flexible spending account--prefunded because you take the enhanced premium tax credit, instead of giving it to the insurance company, you give it to the individual and her family through a flexible spending account--a flexible spending account which millions of Americans already have.

She can use this money to pay for prescription drugs, for dental work, for medical care, eyeglasses, orthodontia--much more flexibility than through a traditional insurance company.

The key thing is, whereas, if we give this money to the insurance company, 20 percent goes for profit and overhead. If we give it to the patient, 100 percent goes to healthcare that she needs. One hundred percent goes to her family's healthcare needs--100 percent, not 80 percent. This is better value for their healthcare dollar.

Now, who would get it? Every eligible American citizen on the exchange would receive a prefunded flexible spending account equal in value to the enhanced premium tax credit they would have received had the money gone to their insurance company. It doesn't pay for insurance premiums, but it pays for the actual healthcare that they actually need.

I am pleased to say President Trump has tweeted in support of the concept. Of course, I am pleased to be aligned with the President on this. He says he recommends that instead of giving hundreds of billions of dollars--and this is President Trump's rhetoric--to money-sucking insurance companies, the money should ``BE SENT DIRECTLY TO THE PEOPLE

Mr. President, there are reports that the government will be reopened tonight or tomorrow morning, and all I can say is, it is about time. It has been 40 days too long.

But we also know there is going to be some vote in the not-so-distant future on what do we do about high health insurance costs and, hopefully, another vote as to what can we do about the high healthcare costs that are driving the high health insurance costs.

And we need to talk now. We can't just like come up on the vote and suddenly have a solution. Rather, people need to be thinking about it between now and then, about the solutions that benefit the American people.

Clearly, we have a problem with the affordability of healthcare and of health insurance, and, of course, that is related. And this is something that, in my professional life as a physician, I addressed over 20-some years, before entering political life.

I practiced in a public hospital for the uninsured for over two decades, seeing middle-income and lower income Americans--fellow Americans--who, for whatever reason, couldn't afford their insurance or couldn't afford their healthcare, and they came to the hospital for the uninsured.

So health insurance, healthcare costs--very complicated--and we have got to be a little more creative than just the Federal Government throwing money at them. ObamaCare tried to do that, and it has not worked.

The enhanced premium tax credit, or the EPTC, is the latest example. It was a COVID program unrelated to the original ObamaCare program, and the enhanced premium tax credits sent billions of tax dollars straight to the insurers, hoping that families would see smaller bills.

But you know, it might paper money over the high health insurance costs, but it did nothing for healthcare costs, and, by the way, it also made health insurance more expensive for many. So I think we can do better than just hiding the costs of high healthcare and high health insurance costs by the Federal Government spending billions more.

So an idea that I am asking my colleagues and the American people to consider is a prefunded Federal flexible spending account.

Now, let me make a couple of things clear. First, I am not speaking for John Thune, the majority leader. I am not speaking for Donald Trump.

In fact, although I was the chairman of the Health, Education, Labor, and Pensions Committee, I am more speaking as Bill Cassidy, a doctor that worked with the uninsured for 20 years and is now representing the great State

of Louisiana. And I am speaking to my colleagues and to fellow Americans, asking all of us to put aside our prejudice, to put aside our kind of: Oh, no, gosh, the Republicans are proposing it or the Democrats are proposing it; so, therefore, I must oppose.

No, to actually come together in good faith to try and find a solution--so let me first describe what I am speaking of. First, there are two types of tax credits on the Affordable Care Act exchange--the ObamaCare exchanges. And I am going into this for a reason. One is the baseline tax credit that was enacted into law in 2010 that lowers premium costs for those less than 400 percent of Federal poverty.

So the first one started, in 2010, under ObamaCare, the original legislation. It goes to people making less than 400 percent of Federal poverty. During COVID, there was another sum added called the enhanced premium tax credit, and that gives some extra benefits to those less than 400 percent of Federal poverty level but began to cover people over 400 percent of Federal poverty level--so two pots of money. One pot dates from 2010, part of the original Affordable Care Act law, and the other passed by the Biden administration during the COVID pandemic, benefitting those above 400 percent of Federal poverty.

What I am proposing does not touch that baseline. What I am about to propose does not touch the moneys that were set aside in 2010 under the Affordable Care Act. Why do I say that?

President Trump endorsed the concept I will be speaking of, and one of my Democratic colleagues said: Wait. Are you going to give all the insurance money for these accounts?

No. Time out. Absolutely not. We are going to leave that portion which was part of the baseline alone, not touching it at all, but trying to do something with the enhanced premium tax credits, which only began most recently by President Biden under the COVID pandemic.

That begs the question: Why were enhanced premium tax credits necessary?

Premiums had gone up so much. The Affordable Care Act was supposed to lower the cost of healthcare. The cost of healthcare has exploded. The cost of health insurance has exploded. And, unfortunately, under the enhanced premium tax credit, it doesn't matter what the premium is; the Federal taxpayer throws billions more at it. And the insurance companies lost the incentive to negotiate down prices because, whatever the price was, the taxpayer would help pay for it. And we misaligned the incentives to where the insurance companies actually do better if healthcare costs are high.

Now, by the way, I am not here to bash insurance companies. We need them. They are essential. But everybody is going to respond to incentives, and the incentive here is not the right incentive.

So how can we do something different?

Well, I would like to empower the patient instead of sending billions to the insurance company. And if we can put in programs that lower healthcare costs, we may still have premiums that are too high this year, because, by gosh, we only have 2 months until the next plan year starts; but we are going to be able to substitute out these enhanced premiums with something that doesn't go to the insurance company but goes to you the patient. And we are going to begin the process of aligning incentives for giving the patient the incentive to find the better deal, and that begins to lower costs. By the way, that means that we have to think differently.

Now, let's try a new approach, as opposed to just sending paper money to paper over the high healthcare costs and the resultant high premiums.

This is kind of my idea. Right now, we have the enhanced premium tax credit, which I have been speaking of. It goes to the insurance company.

That should say 20 right there. It says 80. I am just going to mark that out right now. Right now--give me just a second. I am going to take this down. I am going to go just like this, and I am going to go 20.

And I don't know if you can see this, but that 20 is the administrative cost and the profit that the insurance companies take out of every dollar you take them.

My assistant is getting me a marker.

I had a misprint last night, and I don't want to be misprinted right now. This should be 20. Of that $26 billion, we are going to send them next year, 20 percent of the $26 billion goes to profit, and it goes to administrative costs.

Can we do it better? By golly, we can.

Here we go. I am going to get this out of here. I am just bugged the heck out of this. This should say 20. Twenty percent of the $26 billion that we send them next year would go to profit and administrative overhead.

What if we give the patient the power? What if we say it goes to an account that she controls, that she can spend on her physician, her dental care, her prescriptions, on her eyeglasses? She can spend it on orthodontia. She can spend it on more things than this, and, by the way, 100 percent of the $26 billion would go to the real care that that woman and her family needs.

So we need to empower her, not give 20 percent of $26 billion to insurance companies. Nothing against insurance companies. God bless them. We need them. But if I have a choice of empowering you or empowering them--100 percent to you or 20 percent to them--my vote is with you. And I think we as a Congress, no matter what your political party, should all vote the same way.

I want to emphasize something here, by the way: This is prefunded.

People think about flexible spending accounts, and they think: Well, my gosh, this poor person--120 percent of Federal poverty, 150 percent of Federal poverty--has to put their own money into this.

No. We take the dollars that are in the enhanced premium tax credit, and we put them there instead, and it is prefunded. So it is a little different than we normally think of flexible spending accounts, but, it still works.

Now, on a couple of things I have heard from my Democratic colleagues, by the way, my Democratic colleagues are concerned that whatever we pass over here will not get a vote in the House of Representatives. I am pleased to say that, yesterday, President Trump tweeted in favor of this proposal. I am sure he would ask Mike Johnson to take it up. If Democrats want to vote on something that benefits the American people--and, by the way, here is the tweet. You can't read this. It is classic President Trump. He is talking about money-sucking insurance companies. And then in all caps he goes:

I think Senator Moreno and, frankly, Senator Schumer are reflecting the frustration the American people have.

I want to give a speech which is substantially the same as what I gave last night, and I will give it again later today. It is like TV advertising. I need people to actually listen to what I am saying as opposed to immediately presuming they know what I am going to say, and we end up in the same daggum situation we have been in for 39 days.

We need to open the government, so if we need to talk about healthcare to open the government, let's talk about healthcare.

Again, I worked for 20 years in a public hospital for the uninsured and the poorly insured. I know the consequences of this inflation that we have been having when it comes to health insurance. I know the impact it is having upon people as to whether or not--``My gosh, can I even afford to keep it?''

So Congress, Senate, let's find a solution, but to find a solution, we have to put down the way we have always thought, the way that--``Oh my gosh, we are going to oppose it if the other side proposes it just because the other side proposes.'' We have to actually move beyond the entrenched way of thinking and be creative.

May I point out an irony here? Senator Moreno talked about irony. Right now--right now--Republicans are trying to return to the original ACA model in which money went straight to the patient but not to the insurance company. At some point, it wasn't funded, so the first Trump administration allowed a workaround, and that workaround has led to these high premiums.

Democrats are going to the mattress to defend a workaround from the first Trump administration that was trying to make up for a portion of the Affordable Care Act that could not be implemented. They should be saying: Let's go back to the model of how the Affordable Care Act was supposed to be implemented.

Instead, they are defending Trump 1 policies. I don't even know if they

know that. But it is their ``My gosh, I have to oppose just to oppose'' that is going to defeat us getting out of this lockdown.

Let's just talk about the enhanced premium tax credit, again, a program that sends billions--this coming year, $26 billion will go to insurers if all we do is a straight-out reauthorization. But that actually doesn't make healthcare less affordable; in fact, even for health insurance, it can make the policies more expensive for many of those who are in the individual market.

Let me make it clear now. Let me show this chart as to the impact this is having upon health insurers.

This is major health insurance company stock performance after the passage of ObamaCare, from March 2010 to November 2025. For UnitedHealth Group, they are up almost 1,200 percent; for Cigna, 800 percent. And you can go down the line.

I am not bashing insurance companies. We need them. But do we really need to send $26 billion more this year when we can send it straight to the patient?

By the way, we are not talking about doing away with every part of the health insurance program--just that portion currently being funded by the enhanced premium tax credits.

When Senator Moreno talks about these dollars going to insurance companies, we can see the impact of that on their stock price. They are doing great.

Let's maybe do something different. Instead of worrying about the pocketbook of the insurance company, let's worry about the pocketbook of our fellow American who is paying these higher costs. Instead of paying an insurance company to manage the care, my proposal is to have a prefunded Federal flexible spending account.

Before I go into that detail, let's talk about the problems with the enhanced premium tax credits.

By the way, this is Bill Cassidy talking. This is not the chairman of the HELP Committee. This is not the Trump administration. This is not the leader of the Senate. This is my proposal, and I don't attribute it to anybody--although I will note the President apparently is in support of it.

Right now, I am speaking to my colleagues, and I am speaking to Americans who might be watching.

The problems under the enhanced premium tax credit--if your insurance premium goes up, Washington just pays more. There is absolutely no incentive for the insurers to hold down costs because the more it costs, the more they get. Think about that. The higher the healthcare costs, the more the insurance company gets. They are not evil, but I will say there is a clear motivation here. If you are a profit-making company and you can be insensitive to how much that cost is increasing, you are going to be insensitive.

We need to have an incentive to bring the cost down, we need to have transparency as to what things actually cost, and we need to reward families who actually try to save.

I liken this to, if you have a broken bone and you put a bandage on it, it doesn't heal the fracture; it just hides the broken bone. Let's fix the broken bone.

We actually need to help the patient, the family, be incentivized to shop for that lower cost and incentivize the companies to lower the cost.

The enhanced premium tax credit doesn't empower patients; it enriches insurance companies.

I will note that since this ObamaCare passed, insurance companies have done very well, but the patient's healthcare has become more expensive, and it is now out of reach for many families.

I got a tweet last night from one of my Democratic colleagues. ``No, we have to defend status quo.'' I am thinking--and this person is a vociferous critic of insurance companies--I am thinking: Will you just listen? As opposed to just reject, listen.

We don't want this $26 billion going to insurance companies, where 20 percent of it is taken for administrative overhead and profit; we want it to go to the families, where 100 percent is paid for healthcare--and not in some way which puts them at a disadvantage but in a way that puts them at an advantage.

As opposed to discussing this over Twitter, let's actually meet face to face and see if you can be persuaded that this is a better way to go.

So what can we do to break the model and do something different? Imagine a different type of health--not an insurance subsidy but a health account that you, our fellow Americans, control.

Right now, where does the healthcare dollar go? In the enhanced premium tax credit, it goes to the insurance company. Twenty percent is going to administrative overhead--that should read 80 percent--and 80 percent is going to pay for payment of care. So 20 percent for administrative overhead--you lose that--80 percent to take care of payments.

Here, we take that portion of the current payment the Federal Government is making that goes to enhanced premium tax credits, and we put it in a prefunded, flexible savings account, and the patient has an account. My wife and I have one of these. It works pretty well. One hundred percent of the money goes to pay for healthcare. It can pay for the physician, the medicine. It can pay for dentistry and orthodontia-- all of that. So in all of this, you have a 20-percent plus-up in the amount available to actually pay for healthcare.

Every eligible American citizen on the exchange would get this federally prefunded--I keep stressing the prefunded. In the health savings account my wife and I have--we are on an ObamaCare exchange--we actually take a portion of our income and we designate it to go into the flexible spending account. But here, we would take a value equal to the amount the person would have otherwise received from the enhanced premium tax credit, and we put it in the flexible spending account, and it pays for the real-world expenses I just mentioned. It pays for dental care. It pays for eyeglasses. Keep in mind, many insurance companies on the exchanges don't pay for dental care, and they don't pay for eyeglasses. It is something extra that you have to purchase. In this case, the flexible spending account would allow that to be done for prescription drugs, your routine medical services, and preventive care. It does not go for premiums, though. It goes to the patient. The patient then uses it as she understands it helps her family's budget the most.

By the way, let me just give a shout-out to the President. He recognizes we have a problem. He knows the insurance market is broken. He put out a tweet last night favoring this approach. You can't read this because it is too much language, but you will see it is from Donald J. Trump, and the bottom line is he wants the money to go to the patients and not to insurance companies.

The response to that from one of my Democratic colleagues was: Oh, oh, oh. We are taking money from insurance companies.

No, we are taking that portion that would be part of the enhanced premium tax credit, and we are putting it in a prefunded flexible spending account.

If people would just listen as opposed to automatically rejecting and if people would realize that Democrats are defending a Republican workaround to something that ObamaCare tried to do, but they wrote the language poorly so it couldn't be implemented, maybe they would stop and reconsider: Why am I part of this totally ironic situation, where Democrats are fighting to the death keeping the government closed for almost 40 days because we want to defend Trump 1 administration policies?

The irony here is incredible.

So the President is posting that we need to redirect these enhanced premium tax credit subsidy amounts to Americans so that they can get their own healthcare. I agree with the President. We need to give the money to the patients and bypass the insurance companies for this portion of what they would otherwise receive.

I have also been told ``it sounds great, Bill, but it sounds complicated.'' There are 72 percent of Americans who are working for a government entity--the Federal Government, the State, and local--who have access to a flexible spending account, and 47 percent of those are in the commercial market. Hundreds of millions of Americans have access to these accounts.

My wife and I have had an account for several years. This is not complicated. My wife and I are on the

Small Business ObamaCare exchange. It is not offered on the individual exchange, but it is offered on the Small Business exchange. It is the one Congress is on.

The point is that we are already doing this. You say it is complicated. Yet we are already doing it. So I am not quite sure where the complication comes in. It is like saying it is complicated to play a football game, but we have been playing football games every Friday, Saturday, and Sunday. No, it is not complicated. We know the rules of the game. The players know who they are. They go out and play, and we have a score.

By the way, if there were going to be some bureaucratic obstacle to getting some rule changed in order to make sure we can take it from one exchange to the other, even the people who hate President Donald J. Trump will admit that guy can get the bureaucracy to do things. If there is anybody in Washington, DC, who can get something done when a bureaucrat says it can't be, it is Donald J. Trump. So you may not like the guy, but at this point, his strength is our strength, so let's use his strength to solve this problem if we can just get beyond an outright rejection because the President might like it too. I have one example, and I will hold that example just for the sake of time.

Let me make clear the differences between the enhanced premium tax credits and a federally funded, prefunded flexible spending account. Again, this is only the portion benefiting the patient that currently goes to the enhanced premium tax credit, which will be $26 billion this coming year.

Who gets the money from the enhanced premium tax credit? Insurance companies.

Under a prefunded flexible savings account? Patients and families.

What can it be used for? Insurance premiums.

For patients? Real care--doctors' visits, dentists' visits, glasses, prescriptions--boom--real care.

Who makes the decision, the insurance company? No. In the prefunded FSA, it is the patient making the decision.

Does it lower costs? No. Demonstrably, this enhanced premium tax credit has contributed to higher premium costs.

Here, the patient is empowered to shop. ``If I can get my medical service--my mammogram, my MRI--cheaper here than there, I am motivated to do that because it leaves more money in my pocket.'' That is called patient empowerment. Give the patient the power, dadgummit.

By the way, if it turns out you can save money by paying cash instead of the negotiated rate from the insurance company, pay cash, as that begins to lower it. You would at least get the negotiated price, but now you also have the option of paying cash. Believe it or not, it is oftentimes cheaper to pay cash than to pay the negotiated price from the insurance company. So you save money, and the taxpayers prefunding your account also save money. That is the essence of giving a patient the power. She picks the best deal just like she would for groceries, for a car, or for a house.

Now, how does this empower consumers?

The prefunded flexible spending account doesn't treat someone as a dependent of the Federal Government like the enhanced premium tax credit does. It treats them like a capable consumer who knows what is best for their family: where to go for the dental work, where to go for their pharmacy, and how much to pay in a negotiated rate from the insurance company or, if you can find it, in a cheaper cash price. Instead of Washington paying the insurance company to manage your day- to-day care, you manage it; the patient manages it; the mama manages it with fairness, transparency, and flexibility.

By the way, some say: Well, won't this cost more? It will cost about the same as the enhanced premium tax credit, which should be--and is-- something to appeal to my Democratic colleagues. By and large, we would take the same money going for the enhanced premium tax credit, and we would put it into these prefunded flexible savings accounts. That would cut out the fraud; you would save some money there and some little bit and little bit. In the second year, I think we would save money. I would like to do this for 2 years--but this is up for talking--because people are going to start purchasing more wisely, and other reforms will kick in.

The point being, my Democratic colleagues, it will cost about the same as far as I am concerned. The difference is, instead of 20 percent going to an insurance company's profit and administrative overhead, 100 percent is going for real care. So this isn't just fiscally responsible; it is common sense.

Now, as I conclude, let me once more point out the irony. The irony is, with the enhanced premium tax credits, you can draw a straight line back to the higher premium cost associated with the Trump 1 administration trying to find a workaround for a poorly drafted Affordable Care Act, and since then, premiums have gone up. What my Democratic colleagues are fighting for to the death is to continue a direct result of that Trump 1 policy. We could say there is some irony that Republicans are saying: Let's go back to an original structure because it gave more money to the patient. I would like to say that is something that, as a Republican, I was always for. But I would say that, currently, the Democratic position is entrenched--not all--but entrenched. If a Republican proposes it, if Donald Trump tweets in favor of it, we have to reject it.

All I am asking is to stop being a Democrat for just a second and be an American. Be an American who hasn't been paid for 40 days. Be an American who is paying too much for her health insurance and too much for her healthcare. Stop being a partisan, and start being an American.

I am ready to talk. Again, it is Bill Cassidy. It is not Trump. It is not Thune. It is not anybody else. But only when we begin to communicate are we going to find a solution that works for us all. Let's stop writing blank checks to insurance companies. Let's invest in the patients.

I will finish by saying this: We have got to open the government. We have got to open the government. Now, once we do that, we will have the people back who can finish drafting this, but we have to be willing to take a risk. We have to get out of our entrenched positions. By the way, I am going to get criticized for this, but we have got to take a risk. If we take that risk--if we are brave enough to do something different--then we are going to solve this problem. I am a doctor, but most importantly, I am a doctor who is an American, who wants our country to be served by a Congress which is less concerned about partisan bickering than about the people back home.

With that, I yield the floor.

I will. Yes, sir.

Unfortunately, none.

Absolutely not.

Absolutely not.

It does nothing to benefit those people you are describing.

No.

You are absolutely accurate.

Well, insurance companies most directly, and there will be lower premiums.

Correct.

Correct.

Correct.

Bernie Sanders.

In the last Congress, a year ago.

Yes, for 2 years.

Correct. I think that is right.

To expire in 2025.

None of the Republicans. Rather, Democrats.

Correct.

There was none.

They did not.

Yes.

Unfortunately, shutting down the government.

Correct.

Correct.

I cannot imagine feeling good about that.

Insurance companies would do pretty well, no matter what.

It would take $26 billion that would go to an insurance company, and, instead, it gives it to a family for the--I always use the feminine. Women make all of the decisions in healthcare. It would give her the ability to make the best decision for real care for her family, finding the best care for her dollar. A hundred percent of it would go to her, to all of those, and they would make a better decision.

Absolutely.

Wait. Wait. Just to understand, the EV subsidies did not expire until 2032, but this subsidy for people's health insurance expires this year?

I yield.

Madam President, I have given this speech two times in the last, probably, 16 hours, but it is going to be like a TV commercial, wherein I want to say it over and over again, hoping that someone actually hears it because the soul of education is repetition, and I want to have a very different tone than some of the speeches that have been heard. I want this to be nonpartisan. I want this to be, if you will, a plea for moving beyond our kind of camps we have been in and into something that can end the shutdown and actually benefit patients. So, to open the government, if we need to

talk about healthcare, then, by golly, let's talk about healthcare.

We have an affordability crisis. Families are being pounded by the cost of everything, including insurance. So how can we make it more affordable?

By the way, I am a doctor. I have practiced in a public hospital for the uninsured for 20 years. Many of my patients were middle income, but they could not afford either the insurance or the healthcare they were receiving. I know the impact this has on a family's budget, but if we are going to solve this, we have to put down the ways that we have kind of become entrenched. It is just like trench warfare. We are going to win. We are going to make them do the white flag. We are going to continue to take our same tired arguments and fight each other until we wear the other one down. Well, the people who are casualties--the collateral damage, if you will--are the American people. We need to have creative thinking but in a way in which people are willing to move beyond the way they have ordinarily thought.

The Affordable Care Act attempted to make healthcare affordable by throwing more money at insurance companies. The enhanced premium tax credit is the latest example. Next year, if it is restarted, it will send $26 billion to insurers to not lower the cost of healthcare but to paper over the premium increases that are part of the increased cost of healthcare. That doesn't make healthcare cheaper. In fact, if you don't have one of these policies, it could contribute to inflation, and if you are not getting the subsidy and you are buying individual insurance, your policies are definitely higher. This is actually working against the financial interests of many American families. Oh, yes, if you are getting it, it papers over the increase. I would argue, though, there is a better way to do it.

Instead of paying insurance companies to manage our money, why don't we trust the American family with a prefunded Federal flexible spending account?

First, let me make clear: This is Bill Cassidy speaking. I am not advocating for the President, although I will note that he now supports this, nor am I advocating for John Thune. I am the chairman of the HELP Committee, and we will be having a hearing soon on these issues. I will make that announcement right now. I am not speaking for anyone but myself, in a nonpartisan way, trying to convey to colleagues on the other side of the aisle, there is another way to get to a solution that gets us out of this shutdown and actually lowers costs as opposed to just papering them over.

Here is the problem: Under the enhanced premium tax credit, it doesn't matter how much healthcare costs because, if it costs more, the insurance company just increases the premium and passes that increased premium bill to the Federal taxpayer. It actually is almost inflationary. There is no incentive for the provider to keep the cost lower because the cost is just passed on to the subsidy, which is increased to meet the higher cost. It is like putting a bandaid on a broken bone. You are not fixing the fracture. You are just covering it up so no one can see that fracture. So we are not dealing with healthcare costs. We are just covering it with higher subsidies. Let's actually fix the fracture. Let's fix the broken bone.

Of course, the way to do that is to support the patient, not the insurance company. By the way, insurance companies are important--I am not going to join the bashing--but I do think it is better if we give the money to the family as opposed to the insurance company. I will say, though, many of my colleagues want the status quo. They are so entrenched on their side that they refuse to discuss alternative ideas that will actually lower costs, and we get all the same ObamaCare debates. People in America, right now, don't care about those debates. What they want is to make their family's healthcare more affordable. So the way to do that is to be creative. Let's think differently.

Imagine a different kind of health. There is a misprint on here, but I will get to it. Under the enhanced premium tax credit, the money goes to the insurance company, and 20 percent of that money goes for administrative overhead and profit for the insurance company. That should read ``80 percent.'' That 80 percent goes to healthcare. What if we do something different? Let's just imagine that we have the creativity and the guts to do something that isn't really different but is different for this program.

Let's establish a prefunded flexible spending account, taking the money that would go to the insurance company and giving it, instead, to the family in a prefunded flexible spending account. One hundred percent of the healthcare dollars would go toward their care, and we would trust the mother, the wife--occasionally, a guy, but women make most of these decisions--to pick her doctor, her dentist, and the best value for prescription drugs and services. So this would be 100 percent going to real healthcare as opposed to only 80 percent going to real healthcare.

You might say this is a radical idea. No. We already do this. I would not be surprised if some of the people up here--my family does--already have a flexible spending account. Now, the flexible spending account takes money that I could have put toward a premium, but, instead, puts it into this account, and I pay for my services. I already do this. I pay for my services. The difference between what I do and what this does is that this would be prefunded with money that would otherwise be spent on the enhanced premium tax credit.

I am pleased to say that, this morning, the President posted on Truth Social that he is calling on Congress to redirect subsidies from insurance companies directly to Americans so that they can purchase their own healthcare. Now, there are a lot of words there, but just start at the top: Donald J. Trump is recommending to Senate Republicans that the hundreds of billions of dollars being sent to insurance companies go directly to the people.

Why is that important beyond the President's support?

A lot of my Democratic colleagues have been saying they don't know that Mike Johnson would bring this up for a vote in the House of Representatives. They want a guarantee that, if we pass something on the floor, Mike Johnson will put it on the floor in the House. I am from Louisiana. I have a great deal of respect and regard for Mike Johnson, and we are good friends. But I do know, if the President supports this concept, that Mike is more likely to put it on the floor of the House. If what you want is a guarantee to get a vote on the floor of the House, the President's support for this concept makes it more likely that that happens.

I thank the President for his support.

By the way, I will also say, after the President spoke to this and after I spoke to this last night, we got immediate criticism from people saying: Oh, you want to give everything that we are giving to the insurance companies to the American people. Not a bad idea. But let's just say, this is not the total premium going to the insurance company. The insurance companies still provide the basis for things like a car wreck or if you have got kidney failure or heart failure. This is that portion that would go to an enhanced premium tax credit and instead would go to the family to make their choices as opposed to the insurance company to make their choice for them.

If this still seems too complicated, I am going to tell you why you can trust it. Seventy-two percent of Americans who work for a Federal entity or a State government or a local government have this as one of their choices of a healthcare plan. Forty-seven percent of people who work for a commercial employer--47 percent of those folks have access to a flexible spending plan. If it was so complicated--if it was so complicated--why do 72 percent of government employees and 47 percent of people in the private sector have access to this plan? It works. We know how to do it. There are established mechanisms.

In fact, I have my plan through what is called the small business exchange--about an ObamaCare exchange--through the Federal Government. I get my FSA through this small business exchange. It is just a little bit ported over from the small business exchange to the individual exchange to allow an individual to get the same thing.

This is so incredibly workable. This is not so complicated that I just kind

of scratch my head when people say that it is too complicated.

Now, it may take the Federal Government some time to--it may take them some effort to make sure it can go from one exchange to the other, but we have a President that can make things happen--just his track record. Operation Warp Speed--some people said it would take 10 years to develop a vaccine for COVID; others, at least 18 months. President Trump got it done in 10 to 11 months.

President Trump can make the bureaucracy work. If he did it for Operation Warp Speed, we could do it for this. We can have this ready for the beginning of next year, and that would be President Trump's effort. There is not a stronger force to get the bureaucracy to do what it should do than President Trump.

Let's talk about some key differences between enhanced premium tax credits and what I am calling federally prefunded flexible savings accounts.

Who gets the money? With enhanced premium tax credits, the insurance company gets the money. But in the prefunded flexible spending account, the patient--the family--gets the money.

What can it be used for? Under the enhanced premium tax credit, insurance premiums; under the prefunded flexible spending account, real care. It can be your doctor, your physician, your dentist, your glasses, your prescriptions.

By the way, oftentimes, these policies don't cover dental work. They don't cover orthodontia. Under this, you can use your flexible spending account to get your teeth cleaned. You can use it to have your child's orthodontic work done.

Who makes the decision? Here, you go through a preauthorization process with the insurance company. There, the patient makes the decision for herself and for her family.

Does it lower costs? No. There is evidence that the way this works, it actually drives up premium costs.

Here, under the prefunded flexible spending account, it empowers a patient to shop--driving competition, driving down costs.

By the way, if the patient finds that it is cheaper to pay cash with their flexible spending account than to pay the deductible--and that sometimes happens--then she could pay less by paying cash.

The point is, if you give the patient the power, good things happen.

The prefunded flexible spending account does not treat the individual as a ward of the State. It treats them like a capable consumer who can decide where to go in a way which is best for them and their family.

Some ask: Won't this cost money?

Yes, about the same as the enhanced premium tax credits for the first year. My Democratic colleagues should like that. An individual, though, would be getting a better value.

But instead of only 80 percent of the money going for healthcare, under the prefunded flexible spending account, 100 percent of the money that we are putting up is going to pay for real healthcare: your dentist, your physician, your prescription drugs, et cetera--100 percent. And over here, only 80 percent. And she makes the choice; the choice is not made for her.

As I conclude, let me point out a real irony. I have not wanted this to be partisan at all. I am asking for Democrats and Republicans to come together and find a solution to reopen the government, to pay the people who have been working, and to make sure that those people traveling over Thanksgiving actually have an airport that is open that they can go to.

Let's just move beyond our trench line, and let's actually think creatively. And can we give just a little bit to find something which benefits the patient but may also get us out of this situation?

I think the American people are mad as hell, and they are not going to put up with it anymore. We have to be responsive to that. It is the right thing to do.

Let me conclude by pointing out the irony. These enhanced premium tax credits are a direct result of a workaround to a portion of ObamaCare that was not fully implemented. Democrats are fighting to keep something which is a workaround for something that Republicans formerly objected to. And, frankly, Republicans are kind of supporting something that is in line with what ObamaCare tried to do. The roles have been flipped.

But because one side proposes it, the other side reflexively objects. Let's just stop that. Why don't we just say right now that we are actually going to listen as opposed to automatically objecting because the other side puts it up?

So the choice is before us: We can keep on paying insurance companies to hide the cost of the healthcare by confusing bills and rising premiums in a system which actually raises the cost of premiums for some, or we can trust Americans with the tools to pay for the care directly at fair prices with total transparency. If we can, it puts patients first, not insurers. It encourages competition, smart choices, and it begins to make healthcare truly affordable, not by inflating subsidies but by unleashing the power of an informed consumer.

I will finish by saying we have got to open the government. I can't even write this legislation unless we have the government open. But you have got this chairman's commitment that we are going to have a hearing in the HELP Committee in November on how we address the issue that is before us right now.

I will finish by saying, as a physician who used to work in the hospital for the working uninsured, who saw middle-income families who could not afford their insurance and could not afford their healthcare, I am personally--I am personally--deeply invested in not just reopening the government but making healthcare affordable again.

I just ask that my Democratic colleagues not oppose this idea just because it is a Republican proposal. And I will say that, as a Republican, I will do my best to listen to them.

I yield the floor.

Madam President, I am going to try and envision a way forward for Democrats, Republicans, and Americans out of our current situation, with a different proposal than people have already thought of.

Now, the government has been shut down for 38 days, and tomorrow we are going to vote again, and tomorrow the vote will again fail. But Americans and Congress are frustrated.

We need to open the government. So if to open the government we need to talk about healthcare, let's talk about healthcare. Let's have a conversation in the family.

We have an affordability crisis, and health insurance is part of it. Now, this is personal to me. I am a doctor. I practiced in a hospital for the uninsured and the poorly insured for 20 years, and many of those people that came to see me were middle-income Americans who could not afford their medical bills and could not afford insurance. I want to see this solved.

But if we are going to solve it now, in this present circumstance, we need to move beyond entrenched ways of thinking that have settled us in our camps and refused to allow us to listen to the other person.

And I thank some of my Democratic colleagues for being here. We have got to be creative.

Now, the Affordable Care Act, ObamaCare--whatever you want to call it--tried to make healthcare affordable by giving insurance companies more money. The enhanced premium tax credit, EPTC, is the latest example. Next year, it would send $26 billion to insurers hoping families would see smaller bills.

But that doesn't actually make healthcare less expensive, and for some, it actually makes the health insurance more expensive if you are not getting subsidized care on the exchange.

So we can do better than just papering over the costs for subsidies. Instead of paying insurance companies to manage your money, let's trust Americans with a prefunded flexible savings account worth as much as the enhanced premium tax credit that they would receive.

Let me repeat that: a prefunded--not out of their salary but prefunded for the Federal taxpayer--equivalent in value to the enhanced premium tax credit that they would receive.

Now, let me make it clear. I am not speaking for the Republican caucus. I am not speaking for President Trump. I am not even speaking as the HELP Committee chairman. I am speaking as a Senator and as an American that sees us at an impasse and is trying to think differently about how we can move forward.

So I am going to present to my fellow Americans an idea that, hopefully, will move us out of this stalemate and go forward. And I want to try and speak as if I am speaking to the Americans back home.

Here is the problem. Under the enhanced premium tax credit, if your insurance premium goes up, if the insurance company decides to pay more, they just get more subsidy from the taxpayer.

Now, insurance companies get paid no matter what, and it doesn't matter how expensive the tab is. There is absolutely no incentive to bring the cost down. There is no transparency as to what the care really costs, and there is absolutely no reward for the family that goes to a place which is less expensive.

It is like putting a bandaid on a broken bone. You are hiding the fracture, but you are not fixing the broken bone. Let's fix the broken bone, which is high healthcare costs.

So put simply, the enhanced premium tax credit does not empower patients. It enriches insurance companies. By the way, they are important. We need them. But if I have a choice of empowering you, the American, or enriching an insurance company, I and we should pick our fellow American.

Now, imagine a different type of help, not paying the insurance company another subsidy but putting money, prefunded, not out of your salary, but roughly equal to the enhanced premium tax credit--put that into an account that you control. Every eligible American citizen on the exchange would receive this federally prefunded flexible spending account, and it would work like the prepaid health account you use for real world health expenses.

It would actually have more flexibility than your current insurance proposal. You go to the dentist; it can pay for dental care. You go to the orthodontist; it can pay for your orthodontal care. It can pay for eyeglasses, which typically insurance does not pay for. Prescriptions, drugs, medical supplies, your deductible, your copays--it can pay for it all.

Now, it wouldn't pay for insurance premiums. This is about you spending directly for your healthcare costs, not about enriching insurance companies.

It would pay for the care that families actually use. That is what a prefunded flexible spending account actually does.

I keep emphasizing ``pre'' because I mentioned this to people, and they say: Wait a second. This has to come out of my salary.

No, this would be the money that would go to an enhanced premium tax credit, and instead, it goes into this account that you control.

Now, it seems complicated for some. I go and I mention it to them, and they say: Oh, boy, this is something different, Bill. This is a great idea, but it is kind of like, it is just too different.

Seventy-two percent of Americans getting their healthcare through some government entity are offered flexible savings accounts. Forty- seven percent of people getting insurance through their employer are offered FSAs. This is something that is used by millions of Americans already.

So what I am proposing is just to give this option to people on the exchanges. And, by the way, the Federal Government already offers flexible savings accounts to people on the small business exchanges.

Members of Congress, we are on the ObamaCare small business exchange. We have the option of choosing an FSA. My family has one. And the Department of Treasury already has an office through which they funnel money to pay for these flexible spending accounts that I, as an individual, choose to get.

So what we are speaking of is just offering to people on the exchanges--on the individual exchange--that which is already offered to people on the small business exchange and paying for it by the same mechanism in which it is already done through that exchange.

Now, still, there is going to be some bureaucracy involved, but if there is any President that can overcome the inertia of the bureaucracy to make it happen by January 1, 2026, it is Donald J. Trump. Donald Trump is the man who, when it was told to him it would take 18 years, 10 years, 18 months to come up with a vaccine and a program to prevent COVID transmission, he did it in 10 to 11 months. This President can overcome the inertia, and we have a running start because the Federal Government is already doing this.

Now, let me make clear the key differences between enhanced premium tax credits and federally funded flexible spending accounts.

First, who gets the money? Under the enhanced premium tax credit, insurance companies; under this, it is patients and families.

What can it be used for? Here, the premium tax credit goes for insurance premiums--period, stop, full stop. The money goes to the insurance company. Here, real care, your doctor visit, your deductible, your copay, your dentist, your glasses, your prescriptions, that sort of thing.

Who makes the decision? The insurance company. Just wait and fight with them about a preauthorization. Under the flexible spending account, you make the decision. You have the power.

And, lastly, does it lower costs? No. It is pretty clear. If we continue to fund insurance companies no matter what they pay, it drives up the costs. In contrast, if you empower the patient, that mother is going to find the most affordable option. It has been studied.

If you give people something that they perceive as their own money, they hunt for that bargain. By the way, if they go and they find out that the cash price is cheaper than what the insurance company would charge them, they will have the option of using this for the cash price.

So we have reforms in here that give the patient even more power. The good thing about that, as the patient saves money, so does the taxpayer, and that is a good thing.

So the prefunded--prefunded, prefunded--flexible spending account doesn't treat people like dependents of the government, as do the enhanced premium tax credits. It treats you like a capable consumer who knows what is best for your family.

You decide where to go for dental work. You decide your pharmacy. You decide whether to pay the cash price or the negotiated price that the insurance company offers you, and instead of Washington paying insurance companies to manage your day-to-day care, you manage it with fairness, transparency, and flexibility.

Now, some will ask: Won't this cost money? Of course. In the first year, it will be about the same amount as the enhanced premium tax credit, and my Democratic colleagues should like that. But the individual would be getting better value through the federally prefunded FSA because she is spending it on that which she actually needs, as opposed to up to 20 percent of it going for overhead profit and administrative costs.

It isn't just fiscally responsible. It is common sense. Who wouldn't rather have their money in their own pocket than for the insurance company to dictate how they spend it?

So here is the choice before us: In conclusion, we can keep paying insurance companies to pay for over the higher costs, behind confusing bills, in a system which actually raises the cost for some, or we can give Americans the tools--we can trust our fellow Americans to pay for their care directly, at fair prices, with transparency.

If you will, it puts patients first, not insurers. It encourages competition. It rewards smart choices, and it begins to make healthcare truly affordable, not by inflating subsidies but by unleashing the power of the consumer.

Let's stop writing blank checks to insurance companies. Let's invest in our fellow Americans.

I say this: We have to first open the government. This takes writing some legislation. We have to open the government.

But we have to be willing to take a risk to solve a problem and not be

afraid to do something different. I have seen in our Chamber right now a hunkering down. We have not been able to solve it. So we are not going to try anything different. We are just going to wear the other side down until they wave the white flag.

Now is the time to be creative. I am a rock-ribbed Republican, but I will just say what I just offered is not a Republican solution; it is not a Democratic solution. It is an American solution.

Let's open the government. Let's work together. Let's fix healthcare and give the American more power than the insurance company.

Absolutely.

That is the goal, to have this ready for next year.

One other question first, this is a flexible savings account, not a health savings account. There is a legal distinction, and I want to make that.

When the enhanced premium tax credits are not renewed--we know the insurance companies have already set up their rates--and so the consumer, our fellow American, will be choosing from the offerings that have been made by the insurance company for them to choose from.

The difference would be--and they will see, by the way, that the policy for someone at 400 percent of Federal poverty levels costs about $2,500 more a year than it otherwise would have with the enhanced premium tax credit.

This would be supplemental. We would say to that individual: You are at 400 percent of Federal poverty level. Your policy is $2,500 more a year. You will get a flexible spending account prefunded to offset the cost of this.

Now, if it is my family, I would say: Hmm, I have got $2,500. Maybe, instead of going for a silver plan, I will go for a bronze plan, because now I can offset the higher deductible with my flexible savings account. And because I am going for a bronze plan, my premium will be lower.

But that is trust in the American people. We are plugging into the current insurance market. We are actually not changing at all how it functions.

That is a wonderful question. No.

The Federal Government knows--or put it this way. Many States have calculated what the insurance rate would be with an enhanced premium tax credit and what will the insurance rate be without the enhanced premium tax credit. It has been calculated for our fellow Americans what the value of enhanced premium tax credits would be if they signed up for a certain policy in their State, given their age and their health condition. They know that. The question is whether they get the credit or not.

Well, they are not going to get it, so their policy is going to be higher. And this, under the plan--if we could agree to it--they would then get the FSA in an amount equivalent to that which they did not receive as a payment to the insurance company. Instead, it would be a payment to the flexible savings account they would have and that they would then use it for these services.

That is correct.

Thank you for the questions, and let me just respond very quickly.

I think the beauty of what I am proposing is it fits in very nicely with the insurance markets as they currently are. It doesn't require anything to change between now and January 1. It is too late to change those plans and those rates. It is just too late.

This does not require those rates to change. This would be something which could benefit our fellow Americans next year and could be implemented by then.

Yes, the bureaucracy is going to have to work hard. President Trump can get them to work hard.

You mentioned several other reforms. I am in total agreement. We should be working together--Democrats and Republicans, that is what we need do to get something done--in order to come together for a set of proposals that will lower healthcare costs.

And both as a member of the Committee on Finance as well as the chairman of the HELP Committee, it is my intent do that. We have got to do that.

But this can work this year for Americans who are going to be on the exchanges, and that is my hope.

I yield the floor.

Mr. President, I rise today to recognize Donna Jeanne Gunckel Villere, who is celebrating her birthday on December 1, 2025. She has dedicated her life to family and community service.

Donna was raised in Harahan, LA, and now resides in Metairie. She has been married to Roger Villere for 56 years and is the proud mother of three sons, four granddaughters, two great-grandsons, and two great- granddaughters. Donna and Roger have two more great-grandchildren on the way, one expected in November and another in February. Few things bring her more joy than babysitting her great-grandchildren.

Besides caring for her family, Donna has spent decades mentoring young people. She coached volleyball for nearly 30 years at Lakeshore Playground in Metairie, sharing her love for the game and teaching lessons in teamwork, perseverance, and leadership. She also served as a den leader in the Cub Scouts, where she helped instill the values of integrity and service.

Donna's commitment to her family and community is inspiring. On behalf of the people of Louisiana and all Americans, I wish Donna Villere a happy birthday. May her birthday celebration be filled with love, joy, and appreciation.

Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I rise to pay tribute to retired 9th Armored Division soldier Prigeon Fontenot, who is celebrating his 100th birthday on November 23, 2025.

Born on November 23, 1925, in Rayne, LA, he grew up on his family's farm, speaking Cajun French. He attended Indian Bayou High School until his enlistment into the U.S. Army during his senior year. Upon completion of basic training at Fort Hood, he was inducted into the Army on July 27, 1944, in New Orleans, LA. He was then assigned to Fort Meade, where he boarded a ship to Europe. Following his voyage across the Atlantic, he landed in France in January 1945. He remained in France for 2 weeks and was then attached to the 9th Armored Division. A proud Cajun who was later nicknamed Frenchie, PFC Fontenot used his fluency in Cajun French to communicate with local French-speaking allies. He and his fellow Frenchies, or French-speaking soldiers, served as interpreters for U.S. troops stationed in Europe. The 9th Armored Division was the first Allied unit to cross the Rhine River into Germany on March 7, 1945.

PFC Fontenot was later discharged on April 28, 1946. Due to his brave service, he was awarded the Combat Infantry Badge, the European African-Middle Eastern Campaign Medal, the Good Conduct Medal, and the World War II Victory Medal.

Upon completion of his service, he returned to Louisiana and worked on his family farm until 1950. He then opened his own farm and began working at Rayne Wholesale. He married Betty Ann Trahan in 1956, and they celebrated 60 years of marriage before her passing in 2017. Mr. Fontenot has 5 children, 8 grandchildren, as well as multiple great- grandchildren.

He currently resides at Southwind Assisted Living Facility in Crowley, LA. He is the longest living Frenchie and an active member of the Veterans of Foreign Wars, Post 9822, and the American Legion, Post 77. His story highlights how the war revived pride in Cajun heritage and identity in so many Americans. I invite all Americans to join me in thanking Prigeon Fontenot for his work to defend freedom and to build and bring pride to his community.

Mr. President, the government has been shut down for nearly a month--the longest full government shutdown in American history. It all began with the Democratic leader's desire to play politics with people's lives and paychecks.

Americans, including those in Louisiana, are paying the price. Nationwide, 1.4 million Federal employees--many of whom, of course, are living paycheck to paycheck--are furloughed or working without pay, and 13,000 air traffic controllers have already missed 1 paycheck and will miss another soon.

SNAP, the Supplemental Nutrition Assistance Program, and food stamps--these benefits run out November 1 in many States, like mine, and that is just 2 days away. In Louisiana alone, that is 804,000 individuals, including 312,000 children, who rely on SNAP.

Now, this is not an abstract ideological issue; we are literally talking about food on the table. SNAP can be the difference between a child having a full belly, going to sleep, waking up the next morning, and going to school happy and that same child asking their mom when is the next time they will eat a meal, going to bed hungry, and doing poorly the next day.

Republicans are working to extend the program. I want a bill to fund SNAP, but it looks like we will not have Democratic support to pass.

There are a lot of empty dinner tables and a lot of children going to bed hungry. Democrats have voted against reopening our government 13 times. Thirteen times they have voted to deny children food, sending families to food banks instead.

I am told that food banks will not be able to keep up. Federal workers, single parents with young children, walking into empty food banks. That is coming from a party that regularly claims that they are the party of children, families, and vulnerable communities.

Republicans and the Trump administration are working hard to mitigate the worst parts of the shutdown. President Trump found the money to pay our troops through the generosity of a patriotic American. Senate Republicans voted for a bill to pay all Federal employees, including air traffic controllers who are working without pay now. Democrats blocked it.

They are the party of ``no.'' And the bizarre part is no one is quite sure why, until one of their leaders said the quiet part out loud. The House Democratic whip acknowledged that Democrats are allowing people to suffer because of the shutdown but said:

There will be families that are going to suffer . . . but

it is one of the few leverage times that we have.

This is the second highest ranking House Democrat openly confirming that working families are being used as political leverage.

This is all about politics, not what is best for the people of our country. Now, they will tell you it is about healthcare, but their position crumbles under scrutiny. If it were about healthcare costs, why would they make people suffer more in order to change healthcare policy rather than reopen the government and negotiate with Republicans on solutions which actually lower healthcare costs?

Republicans have repeatedly said we will negotiate to lower healthcare costs, just not while Americans suffer. Our position is clear: End the shutdown, and then let's talk about healthcare. It seems reasonable.

You might ask why they are still voting against reopening the government. It is because they know that their proposals on healthcare won't actually lower healthcare costs.

Under Democrats' current plan, premiums still go up next year, not to mention their proposed solution is just aimed at papering over the mess that ObamaCare created because the facts are clear: The Affordable Care Act did not make care affordable.

All of this seems like one elaborate attempt to save face. Well, it is not working, and, more importantly, Americans are suffering. I repeat: Reopen the government, then let's have a conversation about the areas in healthcare we can address to actually lower premium costs and out-of-pocket costs for middle-income Americans.

By the way, the Democrats' current plan will only affect 7 percent of the people on ObamaCare. Their plan ignores 93 percent of Americans who will also see costs go up. We need to help all Americans by fixing our healthcare system, not just paper over the failures of ObamaCare to help a few.

I will add, for as much as they talk about healthcare, the Democrat shutdown is defunding important healthcare programs.

As chairman of the Health, Education, Labor, and Pensions Committee, I led a bipartisan effort to protect Americans' access to affordable over-the-counter drugs. The members of my committees worked together to remodify the Over-the-counter Monograph Drug User Fee Program, sometimes referred to as OMUFA. This funds the review process to bring over-the-counter drugs to market.

Because of the shutdown, because of my Democratic colleagues refusing to vote to open the government, for the first time in history, a user fee program has expired, meaning patient access to new over-the-counter treatments for common ailments is in jeopardy.

I am a doctor. I want to tackle the numerous issues facing our healthcare system. I spent my whole career fighting for patients. Let's have a conversation about lowering costs for all Americans like those on Medicare, those with employer-sponsored insurance, and small business owners who provide insurance to their workers.

If Democrats are interested in lowering healthcare costs, as they say they are, reopen the government, pay our troops, and stop taking food from children. I am tired of hearing people say there is no off-ramp or way out of the shutdown. Here it is, the way forward: Open the government.

National Flood Insurance Program

Mr. President, I spoke on this floor a month ago about the consequences of a government shutdown on our country and upon Louisiana, particularly the half million Louisianans enrolled in the National Flood Insurance Program or the NFIP.

I called on Senate Democrats to join me and Republican colleagues in keeping the government open and Congress working. Unfortunately, the Senate minority leader shut the government down nearly a month ago to appease a radical base. That is nearly a month that many people in Louisiana on the NFIP that have gone without the trust, certainty, and stability that the program is designed to provide.

Families are unable to close on a new house because they can't purchase a new flood insurance policy. Homeowners are vulnerable during hurricane season because they cannot renew existing policies, and that raises a question the American people are asking every day: How can they trust a government that isn't even open?

Now, by the way, NFIP is not perfect. It faces financial challenges. Some reforms are needed. But shutting it down makes the problem worse, not better.

The Democratic leader said that every day the shutdown gets better for them. Well, I can tell you every day the government is shut down, it gets worse for the Americans in my State who are worried about flooding and losing everything.

The American people want solutions. They want a government that works. They want flood insurance that protects their homes, families, and livelihoods. That is why I am working on legislation that would automatically reauthorize the NFIP if there is any lapse in government funding; in other words, prevent any future shutdown from interrupting the NFIP.

It fixes the damage caused by the Schumer shutdown and ensures stability going forward. My colleague John Kennedy from Louisiana and I have introduced two bills, one to extend NFIP in the short term, another to provide a full year of coverage.

We are also working toward broader reforms that keep premiums affordable and the program sustainable for generations to come.

We must reopen the government immediately. Democrats have voted against doing so 13 times. Thirteen opportunities they have been given to end their shutdown, and they have thrown it back in the face of all Americans.

Government services might be on pause, but hurricane season is not. Reopen the government, restore certainty to the American people, protect homes, protect families, protect livelihoods. Republicans are working to prevent the worst effects of the Schumer shutdown from taking place, but Democrats keep blocking our efforts.

We want to pay the troops. We want to fund SNAP. We want to extend NFIP. The American people deserve better. They deserve more than the Democratic Party is willing to give.

I yield the floor.

Mr. President, I ask unanimous consent that the Senate be in a period of morning business, with Senators permitted to speak therein for up to 10 minutes each.