Vote Smart - Facts For All

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Floor Speech

By: Chuck Grassley

Date: Dec. 9, 2025

Location: Washington, DC

BREAK IN TRANSCRIPT

Mr. GRASSLEY. Mr. President, when the Affordable Care Act became law, President Obama promised affordable healthcare. Contrary to Obama's promises, in reality, ObamaCare has spiked health insurance premiums and led to higher costs.

Instead of fixing ObamaCare and lowering costs, Democrats established a new, temporary COVID subsidy for wealthy households--temporary. That ``temporary'' ends December 31. Democrats want to extend it way beyond that. It is another example of a temporary program never being very temporary. So this temporary subsidy has driven more taxpayer dollars into broken systems where premiums keep going up and more money is shoved to insurance companies.

Now, remember the promises of 2010--ObamaCare's passage that year. It promised to bring down healthcare costs by $2,500, and we see now, 15 years later, it is up at least $5,000. So you can see the promise in 2010 by President Obama was off by $7,500.

I want to explain how we got here, discuss my concerns about fraud, waste, and abuse in ObamaCare, and provide some commonsense solutions to bring down healthcare costs.

When ObamaCare became law, it established taxpayer-funded subsidies through the Federal Health Insurance Marketplace to reduce a household's monthly insurance premiums. However, these subsidies go directly to insurance companies, not to the consumer.

In the United States today, the median household income is $84,000 a year. Permanent law gives ObamaCare premium subsidies to a family of three making up to four times the Federal poverty line, which is about $106,000 a year. That means that someone making $20,000 more than the median household income is eligible for a subsidy under permanent law.

I assume the ObamaCare authors probably figured households making much more than the median household income made enough money to buy insurance without taxpayers subsidizing it.

Nothing in this debate takes away middle-income households' subsidies. A family making up to $106,000 is at 400 percent of the poverty line. Let me make it very clear, those families are eligible for a subsidy today, next year, the year after, and so on until the law is changed, and I don't expect it will be changed.

In 2021, things changed. It was supposed to be temporary. As I pointed out, temporary laws in this country soon become permanent. In 2021, the Democrats passed their partisan reconciliation law that temporarily lifted the income cap on ObamaCare subsidies. Now, that was supposed to be temporary. The cap, which was at four times the poverty line, was removed temporarily in the name of COVID. In other words, the country was facing a very dramatic health issue. The Federal Government shut down the economy, 22 million people were unemployed, and we didn't really know what it was all about.

Now, we learned a lot of lessons from that, and those lessons will not be repeated hopefully. But this temporary program was set up in this time of great distress about what the future held.

Now, as a result of this temporary program because of ObamaCare and COVID, wealthy households making $600,000, which is well above the median household income, are eligible for the temporary taxpayer-funded ObamaCare subsidies or better known as COVID bonuses. The expansion of ObamaCare subsidies for wealthy earners has cost billions, and the Congressional Budget Office, CBO, projections for its costs keep going up.

In 2021, anticipating some of these problems, I wrote a letter to the then-Health and Human Services Secretary and also the IRS Commissioner. In that letter, I expressed concern about the lack of fiscal responsibility in the ObamaCare subsidy expansion and how that expansion would lead to more waste, fraud, and abuse. At the time, the DHS Secretary responded saying:

HHS and the IRS take program integrity seriously.

The Health and Human Services Secretary outlined all the ways that the Agency was preventing fraud, waste, and abuse.

I can only conclude that the Biden administration's response was just empty rhetoric. Since my letter to the HHS Secretary, the Government Accountability Office has found ongoing fraud risks in these ObamaCare subsidies.

In the last 2 years, the Government Accountability Office successfully enrolled 96 percent of its fictitious applicants in ObamaCare. I really mean fictitious people. This was a test by the Government Accountability Office to see how easy it was to defraud.

Now, when they started it out, they didn't know that that might be the result, but I am going to tell you that that is the result. For example, the Government Accountability Office succeeded in enrolling these fake people despite rules requiring documentation to confirm citizenship status and income. The Government Accountability Office also found that HHS had let Social Security numbers be misused by allowing the same number to be used more than once. The Agency also failed to match enrollment data with Social Security's death data and chose not to reconcile tax credit overpayments with IRS tax data.

Fraud, waste, and abuse don't stop with those examples. This summer, the Trump administration found that 1.6 million people were dually enrolled in 2024 in Medicaid and ObamaCare, leading to billions in waste. Now, understand, 1.6 million people having 2 sources of healthcare and then, at the same time, we keep telling the public how many people in this country--the millions that don't have any insurance at all, and here we have 1.6 million people who were enrolled in 2 healthcare systems.

My own oversight has shown how billions in ObamaCare subsidy overpayments were not collected and--can you believe this?--rules let billions go uncollected.

The COVID bonuses created incentives to misestimate income to qualify for larger ObamaCare subsidies, leading to billions of wastes--yes, higher income people reporting lower income than they actually had just to get a government subsidy.

Lastly, insurance agents are using targeted internet ads to fraudulently enroll consumers with false income verification extension requests.

Extending the COVID bonus permanently increases the deficit by $350 billion and lets billions more go to fraud, waste, and abuse.

CBO has found that 3.9 million Americans would lose their employer- sponsored health insurance if we make these subsidies for wealthy earners permanent. In other words, because of a government program that was supposed to be temporary--if it is continued, employers are smart enough to stop their healthcare program, health insurance program, and turn it over to the government and the government subsidy that goes with it.

My colleagues on the other side of the aisle will suggest that they are only asking for another ``temporary'' extension of the COVID bonuses for wealthy households. Yet their bill will cost taxpayers nearly $300 billion, and there are no reforms to stop fraud, waste, and abuse.

Despite warnings from the Government Accountability Office, the Centers for Medicare and Medicaid Services last issued a comprehensive fraud risk assessment of ObamaCare subsidies in 2018. Now, the law doesn't require that report every year, but the Government Accountability Office said it ought to be issued every year. So by not issuing that on a regular basis--the Agency failing to update its fraud risk assessment plan--it doesn't surprise me that we have a lot of fraud.

My oversight in 2013 found the Obama administration at that time tried to exempt ObamaCare from certain Federal anti-fraud provisions. Yes, the administration at that time wanted anti-fraud provisions to be ignored. So any wonder why you have an environment for fraud.

The full arsenal of civil and criminal anti-fraud protections must be used. I have introduced the Fraud Risk Assessment of ObamaCare Subsidies Accountability Act. My bill simply requires the Agency to update its fraud risk assessment of ObamaCare and update it yearly.

I am glad the Agency is already working to update its fraud risk assessment, but we must hold the Agency accountable to complete this.

I am glad the Republican-led Congress and the Trump administration have begun cracking down on ObamaCare fraud, waste, and abuse, thanks to the One Big Beautiful Bill that the President signed on July 4. The new law stops resources from going to illegal immigrants and those not here permanently, establishes improved preenrollment verification, and requires excess subsidies to be repaid. It is a start, but more work needs to be done.

We can lower healthcare costs and increase quality. It starts with expanding access and competition to high-quality, affordable health insurance through health saving accounts, association health plans, and other consumer-driven health plans.

Lowering healthcare costs requires action to reduce prescription drug prices through pharmacy benefit managers and reforming that program. I have been leading the charge to hold PBMs accountable and put sunshine on their opaque business practices.

We also need price transparency. I am a cosponsor of a bill that is entitled Patients Deserve Price Tags Act and supported the Trump administration's efforts to establish price transparency on hospitals and health insurance companies through regulations.

Just like all of my colleagues on this side of the aisle, I am committed to finding solutions to bring down healthcare costs for American families and not extending government handouts to insurance companies.

BREAK IN TRANSCRIPT

Source

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Python		3.12.3
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TEST_NON_SERIALIZED_APPS	`[]`
TEST_RUNNER	`'django.test.runner.DiscoverRunner'`
THOUSAND_SEPARATOR	`','`
TIME_FORMAT	`'P'`
TIME_INPUT_FORMATS	`['%H:%M:%S', '%H:%M:%S.%f', '%H:%M']`
TIME_ZONE	`'UTC'`
TWITTER_CONSUMER_KEY	`'********************'`
TWITTER_CONSUMER_SECRET	`'********************'`
USE_I18N	`True`
USE_L10N	`True`
USE_THOUSAND_SEPARATOR	`False`
USE_TZ	`False`
USE_X_FORWARDED_HOST	`False`
USE_X_FORWARDED_PORT	`False`
WSGI_APPLICATION	`'justfacts_project.wsgi.application'`
X_FRAME_OPTIONS	`'DENY'`
YEAR_MONTH_FORMAT	`'F Y'`

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