Rep. Mike Lawler (R-NY) explains his bipartisan discharge petition to force a vote on Obamacare subsidies, after Democrats shut down the government in 2023 over premium tax credits and blocked his proposed reforms—including $600K income limits, $5/month nominal fees, HSA expansions, and PBM changes. Since 2010, ACA premiums surged 96% nationally, with insurer profits up 2,000%, while 88% of subsidies benefit just 24M people, leaving 93% facing higher costs. Lawler rejects Medicare for All due to unsustainable debt and favors competition-driven reforms like catastrophic plans, but insists the ACA’s core flaws—written by insurers—demand bipartisan fixes over partisan blame. [Automatically generated summary]
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Can you start by telling us about your decision to join three other Republicans and sign that discharge petition led by Democrats on forcing a vote on Obamacare subsidies?
Well, remember, just two months ago, Democrats shut the government down for 43 days, and they said that the expiration of this enhanced premium tax credit was an existential issue.
And so when the enhanced premium tax credit was set to expire at the end of this year, many of my colleagues got together and were talking about what we could do in a bipartisan way to address this.
And so we worked over the past few weeks once the government reopened to come up with bipartisan compromise plan.
And so that plan includes a two-year extension with income limits so that somebody making $600,000, for instance, is not getting subsidized by taxpayers to purchase health care,
as well as insurance reforms, PBM reforms, HSA expansion to allow HSAs to be used to pay for premiums as well as to roll over into the next year so you're not stuck in this use it or lose it situation, and to eliminate zero premium plans so that everyone has a little bit of skin in the game and you pay a nominal fee of $5 a month or a $60 upfront fee.
This was a bipartisan compromise that we put forward.
We worked with Republican leadership to try and get this on the floor for an up or down vote.
Unfortunately, for a myriad of reasons, including hide language pertaining to federal funding of abortion, as well as the fact that many of my colleagues do not want to extend these temporary subsidies that were put in place during COVID to serve as a temporary enhancement, we couldn't get an agreement with leadership to put the bill on the floor.
And so that really led to the four of us that signed the discharge being left with no choice but to force a vote.
Now, Congressman Lawler, you mentioned the 43-day shutdown, and now that you are willing to compromise on an Obamacare subsidy extension, why did we have to have this shutdown?
So, Congressman, you said that now that the discharge petition has reached the minimum required, there will be a vote, although it won't be this year.
So how does this help the people that have had to already make the decision on their ACA and whether or not they're going to be able to afford it anymore?
Well, again, I think you have to look at the larger issue here, which is that since Obamacare took effect in 2010, the health insurance premiums for Americans have skyrocketed by 96%.
And on the open market, which is the core of Obamacare, by upwards of 125%.
Meanwhile, insurance company profits have skyrocketed by 2,000%.
Why?
Because Obamacare was written by and for insurance companies.
And so if we want to tackle this issue, it's two-pronged.
It's not just the extension of the enhanced premium tax credit, which people need to understand one thing.
The enhanced premium tax credit means that the federal government is footing the bill for 88% of the premium.
If the enhanced premium tax credit goes away, the premium tax credit is still in effect, and the federal government is footing 78% of the premium for this 7% of the market that we're talking about, the 22 to 24 million people that this impacts.
The other, you know, 93% of Americans continue to see their health insurance skyrocket because Obamacare has failed to actually do what the Democrats said it would, which is reduce health care premiums.
So how do we actually deal with this entire situation?
You need a short-term extension with reforms, and you need to address the larger issues in health care, which we started to do yesterday, and every single Democrat voted against it.
We passed a bill that would address, for instance, associated health plans, which would allow the self-employed, small businesses, larger companies to pool together to purchase a cheaper insurance plan.
The CBO scored it, and they said it would reduce health insurance premiums by 11% nationwide.
That is a positive step forward, and yet every Democrat voted against that yesterday.
PBM reform, transparency, that was part of the bill.
Democrats voted against that.
So this is dual track.
You can't just try to say this is all about the enhanced premium tax credit because that's not the basis for why health insurance premiums are going up.
Again, because this is two simultaneous issues to deal with.
One is the ACA extension of the enhanced premium tax credit.
The second is the larger issue of health care costs in America.
And how do we actually start to reduce costs?
This is but one step.
When we come back in January, there's going to be another series of bills that we focus on.
One of the things that I've been advocating for, for instance, United Healthcare, the largest insurance company in America, they own providers.
That should be banned.
You should not be able, as an insurance company, to own a provider or Aetna owning CVS CareMark.
You cannot own PBMs.
This needs to be addressed if we actually want to break up the insurance monopoly and start reducing overall costs within the system.
You need to allow purchasing of health care plans across state lines so that you have more competition in the marketplace, among other critical reforms.
So to me, there's a lot of work ahead, but just voting no, as the Democrats did yesterday, is not actually solving the health care crisis.
I look at how we deal with this in a multi-pronged approach.
I think that it's important that no matter what decisions we make within the country, that we make those decisions together, united, and also afford patience in finding decisions.
So where we haven't found a decision yet, let us be patient with one another, no matter what party you're in, and continue to walk in faith, hope, and laws.
Let's talk to Jim in Frederick, Maryland, Democrat.
Good morning, Jim.
unidentified
Good morning.
First off, I'd like to thank you very much for coming online and really realizing that we need to come to some solution to the problem.
We have to stop pointing fingers.
And I'm a Democrat, so believe me, I'm not saying Republicans pointing at Democrats or Democrats or Republicans.
Everybody's pointing at each other.
I think my basic question is, I mean, I know this is difficult.
I mean, I think like a lot of Americans, I cannot understand the complications nor all the proposals that are being made.
It's just, it's so complicated that you guys have to work overtime.
I guess what I'm frustrated about is why we always seem to have to wait till the last minute and really make it such a problem for people who depend on it.
So that's my basic question.
I don't know what your answer is going to be because it happens for so many things.
Everything is governed by crisis and deadline as opposed to addressing these issues in a practical and realistic way.
It's why I proposed earlier this year in conversation with leadership that we address this issue.
Jen Kiggins, myself, and several other Republicans put a bill forward in September to extend the ACA enhanced premium tax credit for one year so that we could actually address some of the larger issues.
To me, this requires bipartisan compromise.
You cannot govern my way or the highway.
That's why the clean three-year extension is not realistic.
I signed the discharge to force a vote so that we can use that vehicle to actually get bipartisan compromise out of the Senate, which I met with a bunch of senators yesterday after I signed the discharge, bipartisan, bicameral meeting, and we talked about the need to do this.
So, the reality, Jim, is in America, if you want lasting change, it requires bipartisan compromise, and that's what I'm focused on.
I'm a member of Problem Solvers.
I've been rated the fourth most bipartisan member of Congress.
Last Congress, I was rated the number one most effective freshman legislator because I actually sit down and do the work, and that's critically important, and I'm committed to it.
Gloria in Kansas, Republican line, you're on the air.
unidentified
Yes, I want to know why you are agreeing with the Democrats on the subsidies when the Democrats refuse to get rid of the fraud that is in the subsidies, which is wasting a lot of our tax dollars.
Another reason, the reason this is at the last minute is because the Democrats closed the government down and you couldn't deal with it for six weeks.
Gloria, you are correct about the fact that the Democrats shut the government down and wasted a lot of time that we could have been dealing with this issue, which is what I said repeatedly during the shutdown.
Immediately following the shutdown, I sat down in a good faith, bipartisan way to actually craft legislation, as I said at the beginning, that did reform the fraud that you're talking about, that did go after the insurance companies, that did eliminate zero premium plans, that required a $5 nominal fee, and that put income limits in place so that people who are making $600,000 are not being subsidized by taxpayers.
The problem with this entire thing is that the money is not going to the individual.
It's going to the insurance companies.
And the insurance companies just keep increasing premiums without any real transparency, accountability, or oversight.
And so the whole system needs to be reformed.
And the bill that I put forth, along with Brian Fitzpatrick, would actually do that because we put the reforms in.
The problem is that I and Brian and others worked to get our Republican leadership to put the bill on the floor for a vote.
And they wouldn't do it.
They wouldn't come to an agreement with us on it.
And there's a lot of reasons why that didn't happen.
I'm not pointing fingers or blaming the Speaker.
It is what it is.
But we have a deadline.
And so from my vantage point, the objective was to force a vote on the floor so that we could pass a bill that could go to the Senate and the Senate can use that vehicle to come back with a bipartisan compromise.
And the clean three-year extension is not going to pass the Senate.
We know that because that just happened last week when they voted it down.
Thank you, Cease Banton, for being a show that is so informative.
And I wanted to thank the Congressman for having the guts to come on the show, because many of your colleagues will not talk to anyone.
I've been screaming from the rafters, calling everyone I can about a specific issue concerning the health care that I wanted to ask you about.
But I would be remiss to just say, and I'm an independent, I'm an equal opportunity basher of both parties, but this Republican Party, led by Donald Trump and Mike Johnson, is so depraved, they just don't care about people.
And Democrats and Republicans fighting with each other as a senior citizen, born in Philadelphia, lives in Atlantic City.
I'm a Jewish American.
It's a disgrace.
To all the citizens out there, please vote.
You have the power.
Okay.
My question is to you, Congressman.
I'm a senior citizen.
I am on my husband's insurance field, but I have Medicare also.
And my mother is 92, and she has Medicare, and she's blind.
And we've been using telehealth.
And I don't say, I've been screaming from the rafters.
I really want you to try to promise me that you'll bring this up because telehealth is going away.
I'm in Atlantic City, AtlanticAr in Atlanta County is no longer able to provide telehealth services to senior citizens.
Well, I believe it got birded out through the Bird rule.
But all of us are in agreement about the need to extend telehealth.
That was one of the few positive things that obviously happened during COVID was telehealth and the expansion of telehealth services.
I think most medical professionals will tell you it's been a tremendous godsend in terms of the ability to serve the community and to be able to provide medical care to patients, especially in more rural areas where it may be harder to have access to a doctor.
And so that is something we all agree needs to be extended, and I am a big proponent of that and will continue to fight for it.
I would just push back respectfully on your notion that Republicans don't care about people, don't care about Americans.
That's not true.
We have fought tirelessly to address numerous issues from securing the border, stopping the massive influx of drugs into our country, which kill 75,000 Americans every year.
We have fought tirelessly to address the affordability crisis, passing the largest tax cut in American history, including for seniors who are going to get a $6,000 tax deduction next year when you go to file, lifting the cap on salt, which was critical for New York, so that people can be able to afford where they live, afford their mortgage payments, afford their grocery bills, afford their energy costs.
We work tirelessly to address issues like combating anti-Semitism.
We have seen the ugly scourge of anti-Semitism in this country and around the globe, standing up and protecting people every day against violent crime in major cities.
So these issues matter, and we care deeply about people, and I know I do, representing the people that I represent in the 17th Congressional District of New York.
Well, of course, when you look at our country, regardless of party, everybody wants a few basic things in life.
They want a good paying job to provide for their families, a quality education for their children, access to housing and health care, and they want to live in a safe neighborhood.
I don't think there's any question we want to make sure people have access to health care.
The question is how you deliver that.
Democrats proposed Obamacare 15 years ago to increase access and reduce cost.
Many more people are insured.
The problem is the entire basis of that is based on government subsidies and funding to provide that care and coverage.
And so the cost of that program has exploded and the cost of premiums has risen dramatically.
So when Democrats say we have an affordability crisis in health care, they're right.
They created it.
You have to look at how to address this.
If you think you're going to have Medicare for all or single-payer health care, that will be trillions upon trillions upon trillions of dollars in new taxes.
You cannot afford that.
We are already $38 trillion in debt.
We are running $7 trillion budgets with $2 trillion deficits.
That's why we're in this crisis as a federal government.
So yes, we want people to be able to have access to health care.
It requires us actually reforming the health care system, creating more competition in the marketplace so that people can get cheaper plans and can actually purchase health care, that small businesses and larger corporations can actually provide plans to their employees.
You need catastrophic plan coverage.
You need to pool together small businesses to be able to purchase plans at a cheaper rate.
As I said, the associated health plans, you can actually pool together, and CBO estimates it's going to reduce premiums by 11%.
So there's a lot we can and should do to reduce the cost of health care and increase access in the marketplace for people to be able to purchase their plans.
And what the president is talking about is rather than subsidizing insurance companies, we actually give the money directly to the American people through tax credits or in HSA accounts so that they can purchase their health care plans and pay for their premiums.
Hey, listen, and I heard your answer about why we can't do original Medicare for everybody.
You know, I got dropped from original Medicare this year and got put into an Advantage plan.
And I think that there's probably some insurance companies that were delighted about that.
I mean, if we're not going to let the insurance companies just scrabble over the 20% that Original Medicare doesn't pay for if we went to Medicare for all, I have a suggestion.
And I know it's going to sound humorous, but What if we had like a big TV show like the Oscars or the, in fact, it could be at the Super Bowl, and we could put the top 20 healthiest, cost-effective systems everywhere else on the planet on a big wheel and just spin the wheel.
And we could let President Trump, he would love this, he could throw a dart.
We could only do better than what we're doing now.
Look, I think there's no question Medicare Advantage needs to be reformed.
I mean, the insurance companies are bilking the system here.
But the fact is that, again, we want to be able to protect Medicare and make sure that our seniors have the health care that they need and that they have paid into for all these years.
We have sought to protect Medicaid and root out the waste, fraud, and abuse and make sure that the system is not losing billions upon billions of dollars every year, as CBO has said, as the GAO has said over repeatedly to waste fraud abuse.
We want to protect that for the most vulnerable, the IDD community, children, single mothers, seniors, veterans, et cetera.
But we have to address the issue of health care affordability.
And that's why I have been working in a bipartisan way to do that, to reform this system, especially in the private insurance market and in the Obamacare exchanges, because it's not working.
People are paying through the nose for health care.
This didn't just start this year.
And for Democrats to act as though this is just a result of Republicans, you know, fails to recognize that this is the system they created.
This is the system they wanted.
And it's not working.
They have to acknowledge that, and we have to work together to fix it.
So on the issue of consolidation, that's been a major problem.
And you see all of these doctors, these health care providers being gobbled up by either private equity, larger corporations, or the hospital systems.
And so access has become a major challenge across the country.
As I said, Medicare Advantage needs to be reformed.
This is not working, certainly not the way that people had hoped it would.
And, you know, again, with respect to Medicaid, we want to protect it for the most vulnerable, for the poor, for the people that really rely on that system and make sure it is not being abused.
We put in place reforms that were necessary, including citizenship verification, work requirements, eligibility verification, and rooting out some of the corruption that was going on with the states, like the provider tax, which is really a scam.
It's a way for the states to get more federal dollars without doing a state match.
And so we've put a cap on that.
The state-directed payments, we've brought back to what it was prior to Joe Biden changing the law and allowing state-directed payments for Medicaid to be paid out at private insurance rates as opposed to a one-to-one ratio with Medicare.
We've phased out the MCO tax, which again, like the provider tax, is just a way for the states to get more federal dollars without any control.
And the program was exploding.
I mean, Medicaid doubled in the last five years.
You can't sustain that.
And that's what we were rooting out while protecting it for the IDD community, for working single mothers, for our seniors who rely on these critical services.
Henry Woodruff, South Carolina, Independent Online, good morning.
unidentified
Merry Christmas to everyone.
I would like for the Congressman to tell me where I'm wrong in this historical analysis of ACA.
ACA is actually a brainchild of the Republican Party.
When Mitch Romney was governor of Massachusetts, he instituted a very similar program there, which President Obama drew from.
So this is actually a brainchild of the ACA, I mean of the Republican Party.
The second thing, and tell me where I'm wrong on this, is that from the beginning, there has been a unified effort from the Republican Congress to the governors to set out to make the ACA fail.
And for 15 years now, instead of working together with the Democrats or independents and making this a better program, it's always been just to destroy it, just to destroy it.
And I believe with all of my heart, it was because President Barack Obama was the author of it because there was an elderly lady, local, Caucasian lady, and she said, I don't want that Obamacare.
I want my ACA, but I don't want that Obamacare.
And when she was told they were one and the same, she looked so baffled.
So this thing about Obamacare has some connotations.
Whether you call it RomneyCare, Obamacare, Affordable Care Act, the fact is it was actually written by the insurance companies for the insurance companies.
They've seen their profits skyrocket by over 2,000 percent over the last 15 years while health care premiums have soared.
It is not affordable.
It is not working the way it was intended, or at least the way they told us it was intended.
And so from my vantage point, it's not about casting blame at this point.
It's about looking at the system and saying, how do we fix this?
Democrats are saying health care costs are an existential threat, yet they don't want to acknowledge that this is the system they created.
This is the program that they said would solve the problem, and clearly it has not.
So how do we actually fix the system is the question.
How do we improve upon the existing law?
I'm not interested in repeal and replace and the drama of the tit-for-tat political game.
I want to fix the system so that we actually reduce health care costs.
That should be the focus.
And I don't care if the idea comes from the left or the right.
If it's actually going to ensure that people have access and it's going to reduce overall costs, we should embrace it.