Vote Smart - Facts For All

OFFICIALS LEGISLATION INTEREST GROUPS PUBLIC STATEMENTS COMMITTEES VETOES

-9999

Floor Speech

By: Mike Crapo

Date: Dec. 9, 2025

Location: Washington, DC

BREAK IN TRANSCRIPT

Mr. CRAPO. Mr. President, this week, we are going to spend a lot of time discussing problems with our healthcare system. To do that, we need to understand just how we got here.

Concerns about the rising healthcare costs are not new. In 2009, Democrats highlighted shortcomings in the American healthcare system as proof that the Federal Government had to intervene.

President Obama told us how to judge his healthcare plan. He told us that Americans would be able to keep their insurance plans and their doctors, and he also told us that insurance premiums would go down. As everyone knows, these predictions did not come true.

But there were signs from the start that ObamaCare would not work, which is why not one single Republican voted for it. That is also why the Democrats created the premium tax credits in the first place. They did not trust the one-size-fits-all nature of ObamaCare to lower costs and expand options.

Instead of decreasing, over the last 15 years, ObamaCare premiums have increased over 220 percent. A family of four pays $10,000 more for coverage today than they did before ObamaCare, and their deductibles have doubled. Insurance providers have dried up, and rural hospitals are struggling. ObamaCare has undermined healthcare in America.

In 2021, the Democrats again decided that premiums were too high and that a Federal response was necessary. But rather than fix the structural flaws in ObamaCare, they created an even bigger subsidy with fewer guardrails to entice more people into a broken program. Not only did they make the subsidy bigger, they made everyone eligible, regardless of their income. So families making $600,000 a year began to qualify. Democrats also temporarily eliminated reviews to confirm accurate payments and allowed individuals to continuously enroll throughout the year.

Because those changes were made under the premise of responding to the pandemic, the enhancements were only supposed to last for 2 years. But before they expired, the Democrats extended them for 3 more years-- again, without a single Republican vote.

With those expanded subsidies again about to expire--and by the way, on a date set by my Democrat colleagues--the pattern has become clear: Democrats respond to rising premiums by throwing taxpayer dollars at the problem. Their supposedly ``short-term'' fixes only drive premiums higher and make the problem harder to solve, leaving us with apparently no choice other than to do the same thing again and again and again.

ObamaCare is broken, and throwing good taxpayer money after bad policy is not going to fix it.

The enhanced premium tax credits account for only about 4 percentage points of next year's projected 20 percent increase in insurance premiums.

Let me say that again. These enhanced premium tax credits that we are talking about only account for about 4 percentage points of next year's projected 20 percent increase in insurance premiums.

Extending them will not solve the crisis. What it will do is cause tens of billions more dollars to be paid directly to insurance companies without improving patient care or choice. With taxpayers footing the bill, these subsidies give insurance companies every single reason they need to keep hiking premiums.

Even the Washington Post just yesterday explained in their words that ``Obamacare subsidies make it too easy to scam the system.''

Last year, the Centers for Medicare and Medicaid Services found that 1.6 million Americans were enrolled in both Medicaid and ObamaCare plans. This year, 6.4 million Americans were improperly enrolled in the enhanced premium tax credits, at a cost of $27 billion. Another 12 million subsidized plans reported no claims in 2024, suggesting that many of them were opened on behalf of people who did not even know they were insured.

Because insurance companies receive the subsidies regardless of whether a plan is used, there is no incentive on their part to check the enrollment status. In 2024, $35 billion was paid out for these unused plans.

My colleagues in the House asked the Government Accountability Office to look into the fraud surrounding the ObamaCare tax credits. Their findings, the findings of the GAO, were shocking.

The GAO created fake identities and attempted to enroll them in ObamaCare plans. All four of their fake applicants in 2024 received a subsidy. This year, 18 out of 20 fake applicants received subsidies.

GAO also found tens of thousands of cases of apparent identity theft and hundreds of thousands of cases where insurers or brokers changed people's plans or enrolled them in new ones without their consent.

Perhaps worst of all, they found that over $21 billion worth of subsidies--nearly one-third of all subsidies paid in 2023--had not been double-checked against enrollees' income. That means that there was nothing stopping these enrollees from misrepresenting their incomes to receive higher subsidies than those for which they were eligible.

Ultimately, it is not just the taxpayers that are hurt by this fraud, although taxpayers should not be on the hook for it to begin with; the other Americans who rely on Federal health programs suffer as these program dollars go to waste.

Republicans addressed some of these program integrity issues in the One Big Beautiful Bill--the Working Families Tax Cut Act--when we tightened eligibility and verification standards for Federal healthcare programs, but no degree of oversight and enforcement is as effective as addressing the basic incentives in the system that result in fraud.

I appreciate that some of my Democratic colleagues have finally acknowledged these issues, but the fact remains they have not offered any ideas on how to solve them. Extending these expensive, fraud-ridden subsidies for another 3 years with no reforms--I repeat, no reforms--is a nonstarter. Continuing to pour billions of dollars more into the pockets of big insurance companies and fraudsters will not lower healthcare costs for American families, especially when you consider that the vast majority of Americans are not insured through the ObamaCare Marketplace and are therefore not even eligible for these subsidies in the first place.

Senator Cassidy and I have a different plan. The motivating principle is simple: Patients should decide where their healthcare spending goes, not insurance companies.

In line with President Trump's call to direct money to patients instead of insurance companies, this approach builds on the success of the Working Families Tax Cut Act, which expanded health savings accounts and their eligibility to be paired with more affordable insurance plans.

These prefunded, patient-driven accounts will help Americans pay for the out-of-pocket costs that are making healthcare unaffordable. Our plan would take some of the money that otherwise would be spent on the COVID bonuses and direct it to health savings accounts attached to ObamaCare bronze or catastrophic plans as monthly deposits totaling $1,000 to $1,500 per year. Families can use that money to cover costs not handled by their insurance policies without waiting for insurance companies to approve their treatment decisions. Because families want the best value for their money, they will seek out the most appropriate treatment. Over time, this should result in lower healthcare costs as providers compete for patients.

Our plan would also fund cost-sharing reduction subsidies, which mitigate out-of-pocket costs for low-income enrollees, reducing premiums by over 10 percent and saving taxpayers money. I will repeat that. Our plan will reduce premiums by 10 percent and save taxpayers money. These cost-sharing reductions would finally change the notion that Americans should simply accept ever-escalating premiums as the norm. In contrast, the Democrats' temporary COVID bonuses do not lower costs or premiums at all. They throw billions of dollars at insurance companies, up to 20 percent of which can go into profit and overhead. Our plan avoids that issue and empowers patients to control their own healthcare.

We cannot transform our broken healthcare system overnight, but we can make real progress. We still have a chance to enact reforms that will do more than paper over the cracks in our healthcare system. We should take that opportunity instead of making the enhanced premium tax credit mistake all over once again. It is time to lay the groundwork for giving Americans more control over their healthcare choices and making quality healthcare more affordable.

BREAK IN TRANSCRIPT

Source

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Python		3.12.3
crispy_forms	Crispy_Forms	2.0
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-9999

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django.contrib.staticfiles.finders.FileSystemFinder (498 files)

django.contrib.staticfiles.finders.AppDirectoriesFinder (171 files)

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IGNORABLE_404_URLS	`[]`
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LANGUAGE_CODE	`'en-us'`
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Signal	Receivers
class_prepared
connection_created	register_type_handlers
got_request_exception
m2m_changed
post_delete
post_init	ImageField.update_dimension_fields, ImageField.update_dimension_fields, ImageField.update_dimension_fields
post_migrate	create_permissions, create_contenttypes, create_default_site
post_save	create_user_profile, TagField._save
pre_delete	clear_site_cache
pre_init
pre_migrate	inject_rename_contenttypes_operations
pre_save	clear_site_cache, set_zip4_userprofile
request_finished	close_old_connections, close_caches, reset_urlconf
request_started	reset_queries, close_old_connections
setting_changed	reset_cache, clear_cache_handlers, update_installed_apps, update_connections_time_zone, clear_routers_cache, reset_template_engines, clear_serializers_cache, language_changed, localize_settings_changed, file_storage_changed, complex_setting_changed, root_urlconf_changed, static_storage_changed, static_finders_changed, auth_password_validators_changed, user_model_swapped, update_toolbar_config, reset_hashers, reload_api_settings, reload_api_settings, uninstall_if_needed, clear_caches, FileSystemStorage._clear_cached_properties, FileSystemStorage._clear_cached_properties, FileSystemStorage._clear_cached_properties, FileSystemStorage._clear_cached_properties, StaticFilesStorage._clear_cached_properties

Path	Location
.DS_Store	/var/www/justfacts/assets/.DS_Store
.well-known/apple-developer-merchantid-domain-association	/var/www/justfacts/assets/.well-known/apple-developer-merchantid-domain-association
pdfs/Mobile_Messaging_Terms_and_conditions.pdf	/var/www/justfacts/assets/pdfs/Mobile_Messaging_Terms_and_conditions.pdf
pdfs/CNIP-signed-bylaws-2023.pdf	/var/www/justfacts/assets/pdfs/CNIP-signed-bylaws-2023.pdf
pdfs/PolicyforFundraisingandGiftAcceptance_1.3_Edition.pdf	/var/www/justfacts/assets/pdfs/PolicyforFundraisingandGiftAcceptance_1.3_Edition.pdf
pdfs/CNIP2018.pdf	/var/www/justfacts/assets/pdfs/CNIP2018.pdf
pdfs/CNIP2019.pdf	/var/www/justfacts/assets/pdfs/CNIP2019.pdf
pdfs/2021/162017-Vote Smart-Brochure-Proof.pdf	/var/www/justfacts/assets/pdfs/2021/162017-Vote Smart-Brochure-Proof.pdf
pdfs/2021/990-2021.pdf	/var/www/justfacts/assets/pdfs/2021/990-2021.pdf
pdfs/2020/CNIP2020.pdf	/var/www/justfacts/assets/pdfs/2020/CNIP2020.pdf
pdfs/2020/Vote-Smart-FY21-Audit-Report-Final-Signed.pdf	/var/www/justfacts/assets/pdfs/2020/Vote-Smart-FY21-Audit-Report-Final-Signed.pdf
pdfs/2020/VoteSmartbrochure.pdf	/var/www/justfacts/assets/pdfs/2020/VoteSmartbrochure.pdf
pdfs/forcandidates/2023_states/2023_New_Jersey_State_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/2023_states/2023_New_Jersey_State_PCT.pdf
pdfs/forcandidates/2023_states/2023_Mississippi_State_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/2023_states/2023_Mississippi_State_PCT.pdf
pdfs/forcandidates/2023_states/2023_Virginia_State_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/2023_states/2023_Virginia_State_PCT.pdf
pdfs/forcandidates/2023_states/2023_Kentucky_State_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/2023_states/2023_Kentucky_State_PCT.pdf
pdfs/forcandidates/2023_states/2023_Louisiana_State_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/2023_states/2023_Louisiana_State_PCT.pdf
pdfs/forcandidates/states/2022_MS_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_MS_PCT.pdf
pdfs/forcandidates/states/2022_IN_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_IN_PCT.pdf
pdfs/forcandidates/states/2022_AL_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_AL_PCT.pdf
pdfs/forcandidates/states/2022_WY_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_WY_PCT.pdf
pdfs/forcandidates/states/2022_NY_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_NY_PCT.pdf
pdfs/forcandidates/states/2022_NJ_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_NJ_PCT.pdf
pdfs/forcandidates/states/2022_SC_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_SC_PCT.pdf
pdfs/forcandidates/states/2022_MA_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_MA_PCT.pdf
pdfs/forcandidates/states/2022_NM_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_NM_PCT.pdf
pdfs/forcandidates/states/2022_NB_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_NB_PCT.pdf
pdfs/forcandidates/states/2022_MD_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_MD_PCT.pdf
pdfs/forcandidates/states/2022_MO_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_MO_PCT.pdf
pdfs/forcandidates/states/2022_MINN_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_MINN_PCT.pdf
pdfs/forcandidates/states/2022_AZ_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_AZ_PCT.pdf
pdfs/forcandidates/states/2022_PA_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_PA_PCT.pdf
pdfs/forcandidates/states/2022_OK_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_OK_PCT.pdf
pdfs/forcandidates/states/2022_OH_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_OH_PCT.pdf
pdfs/forcandidates/states/2022_NV_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_NV_PCT.pdf
pdfs/forcandidates/states/2022_WA_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_WA_PCT.pdf
pdfs/forcandidates/states/2022_FL_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_FL_PCT.pdf
pdfs/forcandidates/states/2022_MI_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_MI_PCT.pdf
pdfs/forcandidates/states/2022_CO_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_CO_PCT.pdf
pdfs/forcandidates/states/2022_OR_PCT.pdf	/var/www/justfacts/assets/pdfs/forcandidates/states/2022_OR_PCT.pdf

Path	Location
admin/img/icon-no.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-no.svg
admin/img/README.txt	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/README.txt
admin/img/icon-yes.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-yes.svg
admin/img/inline-delete.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/inline-delete.svg
admin/img/selector-icons.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/selector-icons.svg
admin/img/icon-calendar.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-calendar.svg
admin/img/search.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/search.svg
admin/img/LICENSE	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/LICENSE
admin/img/icon-unknown.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-unknown.svg
admin/img/icon-viewlink.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-viewlink.svg
admin/img/icon-changelink.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-changelink.svg
admin/img/calendar-icons.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/calendar-icons.svg
admin/img/icon-alert.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-alert.svg
admin/img/icon-unknown-alt.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-unknown-alt.svg
admin/img/tooltag-add.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/tooltag-add.svg
admin/img/icon-addlink.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-addlink.svg
admin/img/sorting-icons.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/sorting-icons.svg
admin/img/icon-clock.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-clock.svg
admin/img/icon-deletelink.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/icon-deletelink.svg
admin/img/tooltag-arrowright.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/tooltag-arrowright.svg
admin/img/gis/move_vertex_off.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/gis/move_vertex_off.svg
admin/img/gis/move_vertex_on.svg	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/img/gis/move_vertex_on.svg
admin/fonts/README.txt	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/fonts/README.txt
admin/fonts/LICENSE.txt	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/fonts/LICENSE.txt
admin/fonts/Roboto-Regular-webfont.woff	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/fonts/Roboto-Regular-webfont.woff
admin/fonts/Roboto-Light-webfont.woff	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/fonts/Roboto-Light-webfont.woff
admin/fonts/Roboto-Bold-webfont.woff	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/fonts/Roboto-Bold-webfont.woff
admin/js/SelectFilter2.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/SelectFilter2.js
admin/js/nav_sidebar.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/nav_sidebar.js
admin/js/core.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/core.js
admin/js/popup_response.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/popup_response.js
admin/js/collapse.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/collapse.js
admin/js/autocomplete.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/autocomplete.js
admin/js/change_form.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/change_form.js
admin/js/jquery.init.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/jquery.init.js
admin/js/calendar.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/calendar.js
admin/js/urlify.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/urlify.js
admin/js/cancel.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/cancel.js
admin/js/prepopulate_init.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/prepopulate_init.js
admin/js/actions.js	/usr/local/lib/python3.12/dist-packages/django/contrib/admin/static/admin/js/actions.js