WASHINGTON - Senator Bill Cassidy, M.D. (R-LA), chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, delivered remarks during today's hearing examining the escalating health care costs and increasing strain on patients, families, and the federal government.
Click here to watch the full hearing.
Cassidy’s speech as prepared for delivery can be found below:
The Senate Committee on Health, Education, Labor, and Pensions will please come to order.
People cannot afford health care. Prices are up for everyone. The status quo is not sustainable. We have to work together to find solutions.
In July, this Committee discussed affordability across the entire commercial insurance market. Today, we’re trying to find out why costs are going up so much within the individual and small business marketplaces. If you’re in these marketplaces, you cannot find affordable care.
During the COVID pandemic, Democrats passed extended temporary enhanced Premium Tax Credits, or ePTCs, which ultimately send money to giant, highly consolidated insurance companies—I’m not knocking insurers, I’m just pointing it out—hiding the true cost of premiums.
This doesn’t do anything to lower the actual cost of health care, but masks it—papers over it. It is a Band-Aid on a broken bone.
Let’s give some facts. In 2014, taxpayers covered 68 percent of the Obamacare exchanges enrollees’ premiums.
By 2020, that increased to about 80 percent.
From 2021 to 2025, the era of the enhanced PTCs, taxpayers’ share grew to 93 percent.
Despite this increase in subsidy, total premiums never went down—the ePTCs simply mask the cost. In fact, increased subsidization actually increases prices for the unsubsidized and the small group market when they are included in the same actuarial pool.
Clearly, we should go to the root cause of rising health care costs.
Now, to be sure, we have two conversations: how do we lower health care costs going forward, and a very immediate conversation about January 1, 2026. What do we do for folks—particularly those in their fifties and sixties—whose health care is unaffordable?
Republicans are not interested in the status quo—putting a band-aid over a broken bone. We are absolutely interested in figuring out a solution that helps makes health care more affordable for American patients in 2026 and beyond.
And I am speaking to my Democratic and Republican colleagues to find a bill that can get 60 votes on the floor of the Senate to take care of that problem.
It shouldn’t be a Republican solution, it shouldn’t be a Democratic solution, it should be an American solution. And this Committee is the place where it starts. So let’s not yell at each other, let’s find a solution.
And by the way, for those who push extreme, grandiose ideas on the right or the left, we’ve got to have a solution two or three weeks from now. Don’t waste time focusing on something Americans would reject, like Medicare for All. We’ve got to fix it now. We’ve got to minimize the amount of new law if we want to help people in 2026. I’m just speaking practically. If you want an American solution, this is the reality.
But there is a sweet spot between that which the Republicans and the Democrats wish to do, knowing that we’ve got to have a solution within three weeks.
We’ve got two choices: Nothing. We accept the premise that no deal is possible. The ePTCs go away, no reforms are made to a failing system, and we have a failed floor vote.
Alternatively, we roll up our sleeves and seek out a true middle ground. From my perspective, that includes recognizing that increased support for some patients will continue in some manner. But it also includes shifting dollars away from the current structure of the ePTCs and repurposing the dollars for pre-funded HSAs paired with a bronze plan. Under that approach, we give one hundred percent of the dollars directly to patients to use for care that meets their needs, not giving all the money to insurance companies and letting them take up to 20 percent for profit and administrative costs.
Let's address the elephant—or, in respect to this side of the dais—the donkey in the room. There are people with strongly held positions on the issue of life on both sides. We have to acknowledge that, we have to have honest conversations about that. I am pro-life, and I will not compromise that value. We have found ways through the annual appropriations process to find common ground for many years. We can do that on a bipartisan deal once again.
President Trump supports the concept of this third approach, which clearly strengthens its chance of passing. I’m pleased to say some Democratic colleagues have approached me to have productive conversations. They want an American plan, not just a side-by-side Republican or Democratic plan, which is destined to fail like so much fails here in Congress. And the American people want something to pass this Congress. So let’s find our common ground.
Let's give power to the patient, not profit to the insurance company. Let’s make health care affordable again.
With that, I recognize Senator Sanders.
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