Providing for Congressional Disapproval Under Chapter 8 of Title United States Code, of the Rule Submitted By the Centers for Medicare Medicaid Services Relating to ``Patient Protection and Affordable Care

Floor Speech

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Mr. KAINE. Mr. President, I am glad to join my colleagues to talk about the upcoming vote on S.J. Res. 84, the use of the Congressional Review Act to strike down a recent regulatory attack on the Affordable Care Act launched by the Trump administration.

I think my colleagues have done a pretty good job of explaining what is at stake. Even the Trump administration's own experts at CMS, the Centers for Medicaid and Medicare Services, say that implementation of this rule could lead up to 1.8 million people to lose health insurance just this year, 2026. That would be devastating.

On top of the premium increases that people have seen because the Affordable Care Act extended tax credits were not extended when tax cuts for the wealthiest were extended, this additional burden on this 1.8 million-person population is unacceptable, and the vote we will cast today gives us all an opportunity to sort of shore up the healthcare network for those nearly 2 million people.

I wanted to focus, in particular, on the kind of person who is really going to be affected by the Trump rule if we do not affirmatively embrace this Congressional Review Act resolution, and that is self- employed entrepreneurs and gig workers.

You know, one of the challenges about the American healthcare system before the Affordable Care Act was it was very, very difficult to buy health insurance if you were an individual entrepreneur, if you had a very small business.

Without exchanges and the offering of policies on the exchanges with premium support for those who were lower or middle income, you had a lot of people who were self-employed entrepreneurs who couldn't buy insurance at all, and then you also had a huge group of people working with companies that had insurance that had this great American dream of an idea to start their own business, but they couldn't do it because if they were to leave their large employer to go off and follow their dream, they couldn't get health insurance.

And one of the very salutary effects of the ACA, through the creation of exchanges with premium support, has been to enable people to pursue their dream and become innovators or entrepreneurs or gig workers and work in the way and in the flexible circumstance they choose. And I speak from experience because two of my three kids fit into this category.

The rule that has been put in place by the Trump administration isn't going to make it particularly hard for large group plans to just re-up insurance, but it will make it very hard for those individuals that don't have an HR department fighting for them, that have to figure it out all on their own. It will make it very hard for them to negotiate the marketplace and buy insurance.

And, sometimes, their income is up, and, sometimes, their income is down. And, sometimes, they want to enroll, and, at other times, they don't. It is precisely this kind of person that is going to be hit the hardest by the Trump rule and why I am so strongly in support of my colleagues' efforts to repeal it.

You know, we often say--and I will conclude--that small businesses and startups are the backbones of the American economy, and they are. I grew up in a house with a dad who worked for a huge company, and it was his dream to start his own business. And he bought a little iron working shop that, at the time that he bought it, had like four employees. And during the entire growing-up period when I worked in my Dad's shop, in a good year, it would be seven employees, and in a bad year, it would be four, plus my mom and my two brothers and me.

So many American businesses are just like this. They are one or two employees. They are somebody who even has another gig, maybe as an artist, and they are moonlighting in some area where they can make just enough to afford to buy health insurance on the exchange, if we don't crush them with high premiums and if we don't make the paperwork burdens so substantial.

The CRA that my colleagues are offering will be directly responsive to the needs of this very, very important group of American innovators and entrepreneurs. And that is why I so strongly support it and urge my colleagues to do the same.

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