Majority Leader | Remark | Remarks | THE NEWSROOM | Repub...Skip to primary navigation Skip to content×Close THE NEWSROOMRemarks Press Releases The Leader Board Op-Eds Videos SENATE RESOURCESRepublican Senators Committees Congressional Record Congress.gov Senate Floor Webcast ABOUT LEADER THUNE×Close THE NEWSROOMRemarks Press Releases The Leader Board Op-Eds Videos SENATE RESOURCESRepublican Senators Committees Congressional Record Congress.gov Senate Floor Webcast ABOUT LEADER THUNExxsearchxMENUFacebookXInstagramFacebookXInstagramVisit Leader Thune's South Dakota Site Here THE NEWSROOMRemarks Press Releases The Leader Board Op-Eds Videos SENATE RESOURCESRepublican Senators Committees Congressional Record Congress.gov Senate Floor Webcast ABOUT LEADER THUNExxsearchxMENUHomeTHE NEWSROOMRemarks12.10.25Thune: Health Care 101: How Democrats’ Policies Fail Patients and Families“[A] three-year extension without reforms, and furthermore, a three-year extension that actually backtracks on some of the reforms that have been made earlier - and that also is in Democrats’ bill - creates more fraud, more waste, more abuse, higher prices, and a higher cost for the American taxpayer.” Click here to watch the video. WASHINGTON — U.S. Senate Majority Leader John Thune (R-S.D.) today delivered the following remarks on the Senate floor:Thune’s remarks below (as delivered):“Mr. President, tomorrow we’re going to be voting on the Democrats’ partisan messaging exercise, which is their three-year extension of the Biden COVID bonuses.“Now, the Democrat leader came down here yesterday, and has a number of times now, and taken anybody who is listening here in the chamber or elsewhere around the country on a tour of fantasy land.“A tour of fantasy land, narrated by the Democrat leader.“Because, Mr. President, what he is saying about a Democrat plan that will lower health care costs is a fantasy.“It just is – it’s a fantasy.“I’m going to explain to you why in just a moment.“And it’s not any less a fantasy today than it was yesterday, than it was the day before that.“It’s that – it’s a fantasy.“Now, Mr. President, interestingly enough, the Democrat proposal, which is a three-year extension of the status quo, is an attempt to disguise the real impact of Obamacare’s spiraling health care costs.“So if we do this, if we extend this for three years – at a cost of $83 billion, taxpayers, $83 billion to the taxpayers – what happens after three years?“Another three-year extension or patch as Obamacare costs continue to spiral?“Mr. President, during the Democrats’ shutdown, one Democrat senator came to the floor, and to his credit, he admitted the truth, and this is what he said.“He said, ‘We did fail to bring down the cost of healthcare.’“That was his quote, Mr. President.“‘We did fail to bring down the cost of healthcare.’“And so what is the Democrat answer to that failure, Mr. President?“An extension of the status quo, while health care costs continue to spiral for the American people.“Now, Mr. President, I’m going to show you here, first off, where most people get their health insurance coverage in this country.“So you’ve got, in the individual marketplace, which is the blue here, almost 50 percent of Americans – that’s about 150 million Americans – who get their health care coverage through their employer.“So they’re in the small group plan, the large group plan, but it’s something that when they get their job, they get health care coverage.“You’ve got another almost 40 percent of the population – about 140 million Americans – who get it through Medicaid, 21 percent, as you can see; Medicare, about 15 percent.“And then the balance here, some are uninsured, and then there are some who get it in the non-group market. There’s a sliver there for the military.“But in this non-group individual market, Mr. President, that’s what we’re talking about here, we’re talking about that sliver right there.“So remember again, 150 million Americans, almost 50 percent, get their coverage through their employer.“Another almost 40 percent – 140 million Americans – get theirs through Medicare or Medicaid.“And then this little sliver right here, which represents about 23 to 24 million Americans are in the Obamacare exchanges.“Now I, just as a point of fact, want to show you, next slide, what’s actually happened in those various markets.“Of course, Medicare and Medicaid is something that the federal government, those are programs that have been in place for a really long time.“But if you look at what’s happened in the Consumer Price Index since 2014, so let’s take this stretch right here, that’s the blue line.“The blue line is how much costs have gone up in our economy overall.“That’s about 39 percent over the past 10, 11, 12 years.“And then if you look at what’s happened in the employer-provided market – remember I just said that about 50 percent, almost, 150 million Americans, get their health insurance coverage in the employer-provided marketplace.“In other words, they’re in a small group plan or a large group plan, and that rate of insurance increase – although way too high, I would argue – over that same 10- or 11-year period is 68 percent.“So, Consumer Price Index is 39 percent, the large group market, employer market, went up at 69 percent – so what do you think the premium cost increase was in the individual marketplace, in the Obamacare exchange?“Mr. President, it went up 129 percent, and that’s since 2014.“If you go back to 2013, it’s gone up 221 percent, because insurance companies, when this program was introduced, automatically significantly increased and boosted their rates.“So today, if you’re in the individual marketplace, this is how much your insurance rates have gone up since Obamacare, since its inception a little over a decade ago.“That, Mr. President, is double – double – the rate of increase in the employer-provided marketplace, and triple – triple – the CPI, which is the cost we pay for everything else out there.“So the idea that this has made health care less costly and more affordable for people in the Obama exchanges is just a fantasy.“It’s a fantasy.“Let’s go to the next chart here.“So, what has happened as a result of that?“You have this dramatic increase in the individual marketplace, in the Obamacare exchange – which is, like I said, double what you would get if you were getting your insurance from your employer in the marketplace.“So, what’s happened?“A lot of employers, particularly small employers – let’s take the 25- to 49-employee small business – what is happening in that marketplace?“So, a lot of those companies used to offer their employees insurance.“And that insurance, as I pointed out, is about half of the cost of increase over this time period that you would get in the individual marketplace, in the Obamacare exchanges.“So, what’s happened is people in this market – and this is, again, 25 to 49 employees, who, up until a few years ago, actually did, in many cases, try and provide some sort of health care coverage for their employees – what they are now doing is they are dropping coverage.“Look what’s happened.“From 2010 it went from 92 percent, in 2020 down to 70 percent, and then in 2025 down to 64 percent.“So the employer marketplace is shrinking.“Why is that? That’s a good question, right?“So, why would people be dropping out of the employee marketplace and going into the individual exchanges?“Well, I think the answer is pretty obvious.“If you are an employer or you’re an employee, and you can get into a marketplace where the government is subsidizing your premiums – if you’re an employer, they’re just responding to, obviously, what most employers do, and that’s a way to reduce their cost and to transfer that cost to the federal government.“So the employer market, particularly the small business market, is shrinking.“At the same time, the Obamacare market is expanding, and expanding pretty dramatically, and premium costs about double of what you would see in the employer marketplace.“So let’s go to the next chart.“And the thing that you’ve got to remember here, Mr. President, is, if you look at – this was promised at the time when Obamacare was being debated, and I happened to be here at the time, that this was actually going to reduce costs.“This was going to score as an overall savings to the federal government.“Here is what, in the exchanges now, what Obamacare actually costs.“You can see [it] dramatically increased right about here when the enhanced subsidies, the Biden COVID bonuses passed by the Democrats, not a single Republican vote in 2021, and then extended in 2022, set to expire this year – this, all of their own making.“I mean, somehow they have tried to shift the narrative here, that this is somehow a problem of Republicans’ making.“They set the expiration date, and they passed the legislation in 2021 and 2022 that led to this explosion in costs.“And so now, the 10-year score on this program, the 10-year score on this program is now $1.3 trillion.“$1.3 trillion [cost] to the taxpayers, to subsidize, in the individual marketplace, the 23 or 24 million Americans who receive their coverage there.“That is, that’s just flat staggering. Look at that.“So we’re looking at ‘24, ‘25 now, 150 billion a year over a 10-year period, as I said, it ends up being, it’s been scored by the CBO at about $1.3 trillion.“But here’s what happened: The spending went up dramatically when the very issue that we’re talking about here today, which is these Biden COVID bonuses.“They were designed to be in response to the pandemic when they were enacted in 2021.“Now, in 2021 as most people remember, we were kind of past the pandemic, and that particular legislation, the Inflation Reduction Act – so-called Inflation Reduction Act, obviously not the case – passed in August of 2021.“We were well past the pandemic, but it gave the Democrats an excuse to put more federal money into a failing program that is driving up costs and increasing, dramatically, costs to the federal taxpayer.“And then in 2022, … they still had the majority, and so they said, ‘Well, let’s extend this thing.’“So they extend it.“I should say, 2021 was, I think, American Rescue Plan; 2022 was the Inflation Reduction Act.“But they decided to extend this program and these Biden COVID bonuses – which, in 2022, as I recall, the pandemic was pretty well past us, right?“So they decided, ‘Well, let’s keep this thing going. This is such a great deal. You know, we’re passing all these costs on the American taxpayer. And we can go to people in the marketplace and tell them, “We’re reducing your premiums.”’“So that’s what’s happened.“Now, go to the next chart here.“Now, interestingly enough, this is another, I think, effect of all this, and this is what has happened in this marketplace, again, just an example.“Because, the way this thing is structured, now – and this is ironic to me, because I’ve always thought of Democrats as, you know … at least their narrative is they stand up to big business, they stand up for the little guy, you know, the person out there that’s struggling to make ends meet – and yet, the way this program is structured, the payments go directly to the insurance companies.“So the insurance companies are incentivized to get more people into these programs, because when they do, they get paid by the federal government.“And there are a couple other features about this plan today, Mr. President, that make this thing even more, I think, staggering to the American people, and [one] is that there are no income caps.“Now, another feature of the Democrats’ narrative is that … ‘We want to be for the little guy, for the guy who’s trying to make it out there, you know, the person that’s really struggling to get by, lower-income category.’“But what this does is this forces hard-working taxpayers, people who are out there trying to get by, to subsidize the insurance costs of affluent, wealthy people.“Why?“Because in 2021, they took off the income caps.“There are no income caps on this program!“It used to be 400 percent of poverty, which for a family of four, is about 128,000 a year.“They took the caps completely off, blew the caps up!“So now, you’ve got people making five, 600,000 a year, who are getting subsidies from people who are making $25,000 a year in this marketplace.“That, Mr. President, is pretty remarkable.“Pretty stunning, really.“And so you have insurance companies, big insurance companies, being the beneficiaries, and affluent people with no income caps in this program.“But the other feature of the program is this: There are zero-dollar premiums.“And so what does that mean?“There are a lot of people who are getting covered by insurance companies because they meet the eligibility requirements, who aren’t paying anything for coverage.“There’s no premium whatsoever.“These are, we call them zero-dollar premiums, and those have exploded.“And one of the reasons they’ve exploded is because an insurance company can say, ‘I found somebody in this particular population group who meets these criteria, these eligibility; we’re signing them up.’“And since they don’t have to pay a premium, they don’t even know they’re covered.“So what’s happened in the past few years?“The number of people who haven’t filed claims, literally, since 2021 has tripled.“Now, as I’ve said before, there are lots of reasons why people don’t file claims.“You might have a good, healthy year.“You may be a younger person who doesn’t have health issues.“But the fact of the matter that you would see from 2021 when they made this change to take the lid off of income, to create zero-dollar premiums, and then to see this explode, the number of people who didn’t file a claim tripled – tripled – in the last four years.“Now, what does that suggest?“I would argue, Mr. President, it suggests that there are a lot of people out there who have no idea that they’re even covered.“They have no idea they have coverage because they’re not paying anything for it, and the insurance company is incentivized to auto-enroll because they are getting the payment directly from the American taxpayer.“That, Mr. President, is how this program is structured.“And that, Mr. President, is why it is never going to reduce costs.“Insurance companies are incentivized to increase premiums.“Businesses are incentivized to, you know, push people out of their marketplace into the individual marketplace where the taxpayers will subsidize the premiums, the cost of health care.“And then what you get is a dramatic run-up in health care costs, an explosion in health care costs.“And again, I just want to put that … second chart … which shows the difference in these different marketplaces.“So this number right here, Mr. President, the orange number, that is the individual marketplace. That’s the Obamacare exchanges.“This is the employer market – half – half the cost.“Well, again, if the taxpayers are paying the premiums, the incentives are all there to continue to run up the costs.“Mr. President, this is nothing more than a failed program, partly because it is a failed structure with no incentives to reduce costs.“And where insurance companies decide to cover you, you may not even know you have coverage.“In which high-income people, people making $500,000, $600,000 a year, can go into this marketplace and get subsidies from the federal taxpayers, from people who are making $25,000 to $30,000, $35,000 a year.“That’s what we are talking about.“That is the fantasy land that the Democrats are trying to take the American people for a tour of.“So, Mr. President, we will vote on that, the extension, the three-year extension, with no reforms.“And by the way, and I don’t have the chart here, but the Government Accountability Office … did a study of this marketplace, and … they submitted fraudulent claims.“In other words, they got people to submit to try and get into the program.“They tried to get into the program, and what the Government Accountability Office found was that 95 percent of these got enrolled by the insurance companies.“That audit was not done two years ago, five years ago – that audit was just released last week.“The Government Accountability Office said that, in their survey population – they looked at a group of people, a population – and found that 95 percent of these people that the insurance company signed up were fraudulent.“So you have a program that is rife with waste, fraud, and abuse.“So what would you think you would want to do?“Here’s, I would think, what I would want to do if I were them and I actually wanted to fix this thing, I would be interested in reforming it.“I’d be looking at some income caps.“I’d do away with zero-dollar premiums.“I’d figure out a way to structure this so the money isn’t going to the insurance companies.“But that’s not what they did.“They just said, ‘We’re going to extend this for three years’ – at a cost, I might add, of $83 billion, scored by the CBO.“No changes. Just continue to run up the cost, run up the cost in the individual marketplace like that, but have the American taxpayers pay for it and then go tell people that you’re trying to keep their premiums down.“This does nothing – nothing – to lower the cost of health insurance, Mr. President.“And so Republicans will offer up something as an alternative.“And just as a point of fact, it has some, contains some provisions in it, which tries to move us away from a couple of the features of the Obamacare exchanges.“One is it tries to get the money in the hands of the American people.“And by doing that, creating health savings accounts where money flows into the health savings accounts that individuals control, rather than having it controlled by the insurance companies.“Now, you’d still get your insurance in the marketplace, but now you would have more dollars at your discretion to decide how you are going to use them.“Instead of taking a silver plan in the Obamacare exchange, you might take a bronze plan.“A bronze plan would mean you’re paying less for it – sometimes might have a higher deductible, but with the proposal that we’re going to put forward, there would be money coming in to these HSAs that the individual would control.“So it’s about individual control versus government control, first and foremost.“It’s also about actually lowering costs.“Now, interestingly enough, if you put the next chart up there, and this will be too small for most people who are trying to watch this – although there’re probably not many on television.“But it also has the advantage of scoring a savings.“So the proposal we’re going to put on the floor will actually reduce premiums, according to Congressional Budget Office, by about 10 to 11 percent.“So, double-digit reduction in premiums, double-digit reduction in premiums under this proposal, and save some taxpayers’ money.“It scores as a $30 billion savings.“Now, instead of taking that $30 billion and giving it to the insurance companies, what we would suggest here is that you actually do let the American people – the consumer, the patient, if you will – manage this and have these dollars available to them at their discretion.“That, Mr. President, is a very different business model than what is being offered up by the Democrats.“It also has the added advantage of actually, as a matter of scoring by the Congressional Budget Office, reducing premiums.“Reducing premiums, something that their plan will never, ever be able to say.“And this is the average reduction in premiums across the country, state by state.“And like I said, it’s going to be too far away for you to see, but in my state of South Dakota, it’s going to reduce them by $900, and that’s pretty much going to be true everywhere.“Now, we can do a lot better, if we can continue to make some of these reforms and changes in these programs and get those premium rates even lower.“But I would argue that, actually, a reduction, a double-digit reduction in premiums – relative to what they’re offering up, which is a dramatic, dramatic increase in spending, increase in premiums, increase in costs, which goes on indefinitely.“This is a three-year extension with no reforms.“Doesn’t adjust income limits. You can still get unlimited income, still qualify in the exchanges.“Doesn’t do anything about zero-dollar premiums, and continues to incentivize insurance companies to auto-enroll people, many of whom will never know they’re enrolled.“The insurance company is getting paid and this program continues to drive up costs in the individual marketplace – which, as I said, is about double what it is in the employer marketplace.“So, you tell me: Is that the bet you want to make?“Now, the Democrats seem hard over on doing this, and I understand, there’s a lot of pressure – ‘Just do it, just do it, just extend it.’“But a three-year extension without reforms, and furthermore, a three-year extension that actually backtracks on some of the reforms that have been made earlier – and that also is in their bill – creates more fraud, more waste, more abuse, higher prices, and a higher cost for the American taxpayer.“It’s a pretty bad bet, Mr. President.“That’s what this is all about for them.“The question is, you want the government deciding this?“[Or do] you want to put this power and these resources into the hands of the American people, American taxpayers, patients?“That’s what we’re about, Mr. President, and so when we have that vote tomorrow, that’s what’s at stake.“Like I said, I don’t have any expectation, probably, that we’re going to get Democrat votes for our proposal, but we are offering something that actually does reduce health care costs and premiums, puts power back in the hands of individuals.“And that really is what this ought to be about.“It ought to be about the American people being able to buy the insurance that they want, the coverage they want, at a price that they can afford.“So, Mr. President, that’ll be the vote tomorrow.“And thank you all for indulging me in walking through a little bit about the history of this, because sometimes it’s been very color-coded by our colleagues on the other side.“But this is real.“This isn’t a fantasy.“What they’ve described for you the past few days here is a fantasy.”PrintEmailTweetPreviousTHE NEWSROOMSENATE RESOURCESABOUT LEADER THUNEFacebookXInstagram
