Healthcare
Floor Speech
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Mr. THUNE. Mr. President, the Democrat leader was just talking about healthcare, and obviously there has been a lot of conversation around that here in these past few weeks and months. In fact, the Democrats shut down the government for 43 days, the longest shutdown in history, allegedly, for healthcare; although, I think we all know that it was Trump derangement syndrome more than anything else that led to the government shutdown.
But I would just say because there is a--you know, sometimes you have to take a walk down memory lane to remind people that facts are stubborn things, and facts are stubborn things.
The Democrat leader implied Republicans are not interested in lowering healthcare costs and that somehow they are. The contrary is actually the truth.
If you look at what has happened since the ObamaCare exchanges went live over 10 years ago, healthcare premiums on the exchange have gone up, on average, 221 percent--a 221-percent increase in healthcare premiums in the individual marketplace on the ObamaCare exchanges.
Now, you might ask, why is that? There are a lot of reasons behind it. When they put the law in place in the first place, it was flawed structurally. But then he referred to these so-called Biden COVID bonuses, which were the enhancements that the Democrats now want to lock into place.
Now, remember, this was done in 2021 with a Democrat majority, Democrat in the White House, under reconciliation. So there wasn't a single Republican who voted for these enhancements in the first place. But, remember, they were enhancements designed to be responsive to the pandemic.
They were COVID bonuses, only supposed to be temporary. And then, in 2022, they extended them again and set them up to expire at the end of this year. This is a problem of Democrats' making, pure and simple.
So to suggest for a moment that Republicans somehow aren't interested in lowering healthcare costs when, in fact, it is Democrat policies that have led to the runup, the rampant increase--221 percent increase in premiums since the exchanges went live over 10 years ago. You find me anything else in our economy that has seen that kind of an increase over that same time period, Mr. President. That is a staggering increase.
The Biden COVID bonuses that were enacted with all Democrat votes in 2021 and then extended again in 2022 and are set to expire at the end of this year were, again, designed to be a response to a COVID emergency which no longer exists.
So what has happened? They locked in the Biden COVID bonuses that are set to expire at the end of this year, and they expect Republicans now to bail them out. Well, frankly, Republicans are interested in things that will drive down and lower healthcare costs.
The other thing they did in 2022, which is sort of interesting, is that the base ObamaCare policies covered people up to 400 percent of the poverty level. Well, today, that is about, for a family of four, $128,000. So in the exchanges, you could get coverage, and if your healthcare insurance premiums hit a certain percentage of your income, anything above and beyond that was covered by a government subsidy. That is, in fact, the way it worked prior to 2021. The Biden COVID bonuses took that cap off. There is no cap--no cap. So now you have people making $500,000, $600,000 a year who are getting subsidies from the Federal Government to buy insurance.
The other thing they did is they did away with--there are what are called zero-dollar policies or zero-dollar premiums. In other words, there are people out there who pay nothing for coverage. Their coverage is entirely covered by the Federal Government through the subsidy.
Well, what that has done and because of the way the program is structured--they structured it--is to provide the subsidies directly to insurance companies. This is called, falsely, a premium tax credit. It is not a tax credit. A tax credit would be something that would lower tax liability dollar for dollar when you file your income taxes. This is a subsidy, a direct subsidy.
So you have literally millions of people--millions of people--who have no idea they are covered because they aren't paying anything for it, and the insurance companies are getting the payment. So the insurance companies are incentivized to go out and autoenroll all these people across the country. So what you have today are literally millions of people of the 23 to 24 million people who get their coverage in the exchanges--millions of those have no idea that they are even covered because the insurance company is getting the subsidy, autoenrolling them, which might explain why last year 40 percent of the people who get their insurance coverage through the exchanges didn't file a claim.
Now, you could say that maybe they are healthy; maybe they are younger. That is all partially true, but do you think 40 percent of the people in the exchanges didn't file a claim? I mean, think about that. That means there are literally millions of people out there--millions of people who don't know they have coverage, and the insurance companies are getting the payments and making bank at the expense of everybody else in this country. And those who are paying premiums are seeing those premiums go up, as I said, 221 percent since these exchanges went live 10 years ago.
So this is not something the Republicans--they blame the Republicans for the healthcare crisis. The healthcare crisis was created by Democrats with all Democrat votes in 2021 and then again in 2022, setting them up to expire at the end of this year and with no income limits and zero-dollar premiums and the subsidies going directly to the insurance companies instead of into the pockets of the American people.
Now, there is a better way to do this, but it is going to take cooperation from both sides to do that. It seems to me, at least, that what the Democrats would rather have than a solution is an issue. They want a political issue, and they want to blame Republicans. But you have to come back to the basic premise that facts are stubborn things.
These are the facts: In 2021, these Biden COVID bonuses went into effect. Lifted the cap, so there is no cap, so you can have unlimited amounts of income and still get coverage in the exchanges; zero-dollar premiums, so some people are paying nothing for their health insurance premiums; and insurance companies that are incentivized to autoenroll those very people. In many cases, those people have no idea they are covered. That is a pretty amazing contraption, if you will, and, some would argue, scam on behalf of the insurance companies in this country but certainly to the detriment of the American people, who do need more affordable coverage. They need to be able to afford healthcare along with the other things they buy on a daily basis. People need access to healthcare in this country, and they need affordability when it comes to healthcare in this country.
I would say there is a path forward here. It can't happen unless there are significant reforms because you can't have people who are making unlimited amounts of money being able to qualify for government subsidies in these exchanges. Nor should you have, in my view, people who pay absolutely nothing--not one dollar--for coverage getting coverage and insurance companies being incentivized, because they get a subsidy for doing it, to cover these very people who don't even know they are covered. That is a really, really bizarre business model. I mean, you couldn't make this stuff up.
Now the Democrats are saying: Oh, we created this, but it is your problem. Please, please fix it. If you don't, if you don't do something that will extend this program that has premiums that continue to go up like this for the American people, we will use it against you in a political campaign as a political issue.
That is the state of play right now, which is why we need a solution and a solution that brings us back to where the American people have options, where there are some sort of income limits, where there are people at least paying something for their coverage, where the insurance companies aren't being enriched at the expense of the American people, and where the American people have choices and options to get the plan they want that works for them and for their families. That is a business model that works. Competition, optionality, market forces, driving down prices, giving the American people more choices to buy the insurance they want at a price they can afford--that is a business model.
The business model we are operating under today was created by the Democrats, and now there is some expectation that somehow Republicans are supposed to come here and fix the problem they created.
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