U.S. Senate Finance Committee Chairman Mike Crapo (R-Idaho) spoke on the Senate floor, urging support for the Health Care Freedom for Patients Act. The proposed legislation aims to reduce health care costs and allow families greater control over their medical spending.
Crapo criticized the Affordable Care Act (ACA), also known as Obamacare, stating, “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 or to 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.”
He argued that extending enhanced ACA subsidies would not resolve rising premiums or benefit patients directly: “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 four percentage points of next year’s projected 20 percent increase in insurance premiums. Extending them will not solve this crisis. What it will do is cause tens of billions in more dollars to be paid directly to insurance companies without improving patient care or choice.”
Crapo highlighted concerns about fraud related to expanded ACA subsidies during recent pandemic relief efforts: “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 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 enhanced premium tax credits at a cost of $27 billion.”
He continued by citing additional issues with enrollment integrity: “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 dollars were paid out for these unused plans.”
Introducing his legislative alternative alongside Senator Cassidy (R-Louisiana), Crapo stated: “Senator Cassidy and I have a different plan. The motivating principle is simple: patients should decide where their health care spending goes, not insurance companies.” He said their approach aligns with former President Trump’s call to direct funds toward patients rather than insurers.
The proposal builds on prior reforms by expanding Health Savings Account (HSA) eligibility paired with affordable insurance options: “These pre-funded, patient-driven accounts will help Americans pay for the out-of-pocket costs that are making health care unaffordable,” Crapo explained.
He outlined how funds previously allocated toward pandemic-related health care bonuses could be redirected into HSAs attached to certain ACA plans as monthly deposits between $1,000 and $1,500 annually per family: “Families can use that money to cover costs not handled by their insurance policy, without waiting for insurance companies to approve their treatment decisions.”
The plan would also fund cost-sharing reduction subsidies intended to reduce out-of-pocket expenses for low-income enrollees while lowering premiums by more than ten percent.
“It is time to lay the groundwork for giving Americans more control over their health care choices and truly making quality health care more affordable,” Crapo concluded.
