Mr. Speaker, recent polls show that the top issue on the minds of Americans today is that of affordability. Whether food, education, childcare, energy, or healthcare, rising prices are resulting in more and more Americans feeling less…
Mr. Speaker, recent polls show that the top issue on the minds of Americans today is that of affordability. Whether food, education, childcare, energy, or healthcare, rising prices are resulting in more and more Americans feeling less secure about their economic well-being.
Indeed, prices have been going up. Under President Biden, inflation hit 9 percent in June 2022. Cumulatively over the Biden Presidency, inflation is up 21.2 percent.
Things have improved since President Trump and Republicans assumed office in January. Energy prices are down by 6.3 percent. Inflation is moderated, but with the exception of energy, we have not had deflation. Prices are higher than we would like them to be.
Nowhere is the issue of affordability more acute than in healthcare. We must address America's healthcare affordability crisis. As a physician, I will tell you, though, the first step in solving any medical problem is getting the correct diagnosis. If you do not know what the problem is, you will not formulate the right treatment. You may make the patient worse.
That is what has been going on.
What is the problem, then? Our problem is that Big Government's anti- free market, anticompetitive, and anti-consumer policies have made our healthcare system more and more expensive by the year.
This has been a problem for a long time, but it was made much worse after the passage of ObamaCare in 2010.
How did ObamaCare, the unaffordable care act, make healthcare more expensive? Quite simply, by removing what market forces there were in our system and expanding the role of government. The unaffordable care act literally outlawed the private insurance market.
Remember Barack Obama saying that if you like your plan, you can keep it. They lied. They outlawed your plan. What were the results?
The ostensible rationale for the unaffordable care act was to get more people insured, but we know that, in many cases, workers lost their private insurance and have been, if you will, dumped by their employers onto Medicaid.
The Foundation for Government Accountability has estimated that if non-Medicaid expansion States all expanded and added able-bodied, working-age adults to their Medicaid programs, an additional 3.6 million Americans would lose their private health insurance.
Similarly, enhanced COVID-era ObamaCare credits--remember, that is what we are talking about today--crowded out employer-based insurance.
According to the Paragon Institute and the Congressional Budget Office, extending the COVID credits would reduce employer-based coverage by roughly 4 million people.
In addition to crowding out employer plans, The Wall Street Journal's Allysia Finley recently highlighted that the ACA and its subsidies even led many Democrat-run cities, including Chicago and Detroit, to offload public-sector retiree healthcare costs onto ObamaCare. These cities moved their retirees onto ACA exchanges, eliminating their unfunded healthcare liability. Finley correctly argues that COVID credits make this dumping of public-sector retirees' healthcare obligations onto the exchanges even more likely, as few governments have set aside, especially in blue States and cities, the money to pay their retirees' future healthcare costs. Through ObamaCare, you are paying for the financial irresponsibility of some of our biggest city governments, blue cities especially.
The unaffordable care act has resulted in skyrocketing health insurance premiums. In 2014, the first year that subsidized ACA marketplaces were in effect, premiums increased 47 percent. That is right. They increased by 47 percent in 1 year. Over the next decade, premiums increased another 96 percent.
The only reason that this is not more obvious to Americans today is that the healthcare consumer is not only paying the premiums, but the taxpayer is paying extensive subsidies, accounting for 90.3 percent of the increased premiums.
Healthcare affordability is critical. Therefore, we need to look at the issue that has received a lot of attention these days, the expiration of the COVID-era enhanced ObamaCare credits. The expiration date was passed by congressional Democrats as part of the misnamed Inflation Reduction Act without a single Republican vote.
Mr. Speaker, as mentioned, this scheme known as ObamaCare exchanges resulted in skyrocketing insurance costs. At the same time, we need to address some false assertions about what the expiration of these enhanced super subsidies would mean.
First, the vast majority of ObamaCare subsidies are not expiring at all. What is at issue are these temporary COVID-era subsidies. Even if these enhanced COVID super subsidies were to expire, the Federal Government and the taxpayers will still cover 78 percent of the premiums, compared to roughly 88 percent right now. That is a relatively small change, nowhere near doubling.
In fact, if the COVID subsidies are allowed to expire, only 4.3 percent of the projected premium increase would be attributable to that change. Again, that is less than 5 percent of the increase. Here is the key point the other side does not want to talk about. ObamaCare premiums are going up regardless, even if the COVID credits are extended.
ObamaCare premiums are expected to rise about 18 percent in 2026, driven by higher medical costs, labor shortages, economic uncertainty, inflation, and other conditions. These increases are structural. They have nothing to do with the expiring subsidies.
What Democrats are doing is conflating premiums with out-of-pocket costs. Premiums are not doubling, and out-of-pocket costs are rising only because the expiration of these enhanced subsidies is exposing a deeper truth that the unaffordable care act is, for many families, anything but affordable.
According to CMS, the projected average premium after tax credits for the lowest-cost plan, should the COVID subsidies expire, is $50 per month. That is about $20 less than they were in 2020.
In the year 2026, most enrollees on HealthCare.gov will have access to plans priced at or below $50 per month. To put that into perspective, compared to the years prior to the COVID pandemic, marketplace enrollees this year will have access on average to lower- plan premiums and more choices.
This debate isn't just about premiums. It is also about expanded eligibility and widespread abuse. The COVID expansion dramatically broadened eligibility far beyond the middle-class and lower middle- class families and significantly increased the subsidies.
Under this system, households earning $500,000 a year or more can qualify for subsidies. In 2024, nearly 42 percent of the enrollees, on the other hand, paid nothing at all. These subsidies don't go to individuals. They go directly to insurance companies.
That is why many Americans see these enhanced COVID subsidies for what they really are: Welfare checks to large healthcare corporations. Worse still, the system incentivizes fraud. People are encouraged to misreport their income in order to qualify for larger subsidies and zero-dollar plans. As a result, insurance companies collect an estimated $35 billion in taxpayer subsidies for phantom enrollees.
An estimated 6.4 million individuals were improperly enrolled in ObamaCare in 2025, often fraudulently taken off their private insurance plans to do so, costing taxpayers $27 billion. Among households claiming incomes between 100 and 150 percent of the Federal poverty level, roughly 62 percent were not actually eligible. It gets worse.
In 2024, insurance companies received at least $35 billion in subsidies for about 12 million marketplace enrollees who made not a single medical claim--not a single checkup, not a single prescription.
About 40 percent of the people fully subsidized under the COVID credits never used their coverage at all, often because they didn't know that they were enrolled or they didn't even exist. One Social Security number, according to the Government Accountability Office, was used to purchase health insurance 125 times. That is massive fraud.
When fraud estimates from the exchange subsidies alone range into the tens of billions of dollars, it is not unreasonable--no, it is responsible--to ask people to contribute something. Even a small copay insurance payment per month, $10 or $20 per month, promotes personal responsibility, discourages fraud, and helps ensure that the system serves the people who really need it, not those gaming it and not the corporations cashing the check.
That is what this debate is about. It is about facts, accountability, sustainability, and making coverage more affordable for all Americans. It is not the fear-mongering of my Democrat colleagues.