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“Defining Our Healthcare Problem, and Principles We Should Follow to Solve it”

Senate HSGAC Permanent Subcommittee on Investigations

December 10th, 2025 (recording linked here)

WITNESS & TESTIMONY

• Christopher Briggs: Victim of Obamacare - Self-described

• Nick Stehle: Victim of Obamacare - Self-described

• Joel White: President, Council for Affordable Health Coverage

• Tarren Bragdon: President and Chief Executive Officer, Foundation for Government Accountability

• Dan Jacobs: Small Business Owner and ACA Marketplace Enrollee

• Aaron Lehman: Farmer and ACA Marketplace Enrollee

HEARING HIGHLIGHTS

MEMBER OPENING STATEMENTS

• Chair Johnson (R-WI) opened the hearing by criticizing the Affordable Care Act (ACA), calling it a "miserable failure" and accusing Democrats of being in denial about its impact. He referenced a Wisconsin family's financial hardship under the ACA and emphasized that earlier, more affordable plans had been replaced by high-cost, low-coverage options. Johnson previewed the witnesses, stating their stories would highlight how Obamacare harmed patients and inflated costs through government interference. He concluded that free-market competition, not federal control, was the key to improving quality, service, and affordability in health care.

• Ranking Member Blumenthal (D-CT) responded by stating that the hearing repeated long-standing Republican efforts to repeal the ACA. He acknowledged flaws in the system, including fraud and rising costs, but stressed the importance of preserving subsidies that allow millions of Americans to afford coverage. Blumenthal highlighted the real-world impact on families and small businesses, warning that failure to extend subsidies would result in skyrocketing premiums and lives lost due to lack of insurance. He concluded by urging bipartisan cooperation to strengthen, rather than repeal, the ACA.

WITNESS OPENING STATEMENTS

• Mr. Briggs testified that the ACA left his daughter, who had leukemia, without access to essential care and forced his family into financial ruin. He explained that before the ACA, his family had access to broader networks and lower premiums, but the law narrowed their options and dramatically increased their costs. He described multiple instances when ACA plans failed to cover necessary treatment, leaving them to beg for government intervention. Briggs warned that Obamacare has created a generation of Americans permanently uninsurable and called for its repeal in favor of a true free-market model.

• Mr. Stehle described how his son Luke, who has severe autism and epilepsy, had been stuck on a Medicaid waitlist for over a decade due to Medicaid expansion prioritizing able-bodied adults. He criticized the current structure that, he said, diverted funds from the truly needy to those who could work but chose not to. Stehle stressed that many families lack the resources his does and face unacceptable delays for critical services. He urged lawmakers to reform Medicaid in a way that protects the vulnerable and restores its original mission.

• Mr. White argued that Obamacare primarily benefited large insurers and health care conglomerates, not patients. He detailed how policy designs like the medical loss ratio incentivized insurers to raise spending and profits through vertical integration. White emphasized that the ACA had undermined consumer choice and driven up premiums and fraud while enriching insurance companies. He advocated for reforms including price transparency, direct subsidies to consumers, and more plan flexibility to restore competition and lower costs.

• Mr. Bragdon testified that Medicaid expansion under the ACA had diverted funding from the elderly, disabled, and children to able-bodied adults. He cited widespread fraud, eligibility misreporting, and poor verification systems as major failures of the program. Bragdon claimed that protections for people with pre-existing conditions had backfired, resulting in higher premiums and less access to high-quality providers. He recommended targeted state-level reforms, such as reinsurance and flexible plan designs, as more effective alternatives.

• Mr. Jacobs, a small business owner with Kennedy’s disease, stated that the ACA allowed him to continue running his restaurants and offering health care to his employees. He explained that before the ACA, his pre-existing condition would have made him uninsurable, threatening both his health and business. Jacobs emphasized that small businesses form the backbone of the U.S. economy and rely on the ACA to stay competitive with large corporations in offering benefits. He urged Congress to protect the ACA for the sake of entrepreneurs, workers, and equitable access to coverage.

• Mr. Lehman, a fifth-generation Iowa farmer, testified that the ACA had been a game changer for rural families by expanding access and making insurance more affordable. He explained that enhanced subsidies allowed his wife, a breast cancer survivor, to retrain for a new career while helping on the farm, and that they would have lacked coverage without the ACA. Lehman warned that if federal subsidies expire, premiums would more than double, jeopardizing rural economies and health systems. He concluded that supporting the ACA was crucial for farmers, rural hospitals, and long-term economic resilience.

QUESTION AND ANSWER SUMMARY

• Sen. Scott (R-FL) asked whether redirecting subsidies to consumers and allowing cross-state plans would reduce costs and increase access. Mr. White said the ACA had weakened the small group market and supported Scott’s proposed tax credit for employers. Mr. Bragdon shared a personal story illustrating how ACA plan pricing was inefficient, arguing that giving patients direct control would increase transparency and lower costs.

• Ranking Member Blumenthal asked how ACA subsidies impacted families and whether the law helped small businesses and patients with serious conditions. Mr. Lehman said premiums threatened the long-term viability of his farm, and Mr. Jacobs said that although ACA subsidies helped his employees, his own premiums had risen by $5,000. Mr. Jacobs also noted that the ACA capped his prescription costs, making care for his rare disease manageable.

• Chair Johnson asked whether the ACA’s structure caused rising premiums and what alternatives worked better. Mr. White said subsidies tied to premiums incentivized price hikes. Mr. Bragdon argued that taking patients out of decision-making raised costs. Mr. Stehle said Medicaid expansion prioritized able-bodied adults over disabled children due to a 90/10 match, and Mr. Briggs said ACA-era plans excluded top cancer centers.

  Chair Johnson endorsed pre-ACA solutions like high-risk pools and more employer choice, and criticized the ACA for centralizing control and encouraging insurer profiteering.

• Sen. Moreno (R-OH) clarified the vote concerned only enhanced ACA subsidies and criticized Congress for not addressing broader affordability failures. Mr. White said the ACA failed to deliver on cost reduction promises and had enriched large insurers. Mr. Bragdon said patients were often charged far more through insurance than if paying cash and called for broader price transparency.

  Sen. Moreno advocated for association health plans, PBM reform, tort reform, and HSAs, and urged bipartisan engagement beyond short-term fixes.

• Sen. Slotkin (D-MI) asked how rising ACA premiums affected his farm and his family's ability to continue farming. Mr. Lehman said his 2025 plan would more than double in cost, which would force budget cuts in equipment, land management, and farm inputs, and reduce the likelihood that younger generations stay in farming. He said affordability was critical for rural families making long-term decisions.

  Sen. Slotkin called the ACA a “band-aid on a broken system” but defended its protections, especially for those with pre-existing conditions. She urged serious bipartisan reform but insisted that subsidies should not be removed without a replacement.

• Chair Johnson challenged Sen. Slotkin’s defense of the ACA, stating that most people would retain standard subsidies and that only those above 400% of poverty would lose enhanced credits.

  Chair Johnson asked what percentage of income he believed was fair to pay before qualifying for subsidies. Mr. Lehman said the answer was complex due to student loans and farm economics but stressed affordability was essential.

  Chair Johnson reiterated that the ACA’s structure, not subsidy expiration, was the main driver of high premiums.

• Sen. Hawley (R-MO) proposed exempting all consumer health spending from taxes, premiums, deductibles, and out-of-pocket expenses, and asked the panel’s opinion. Mr. Bragdon and Mr. White strongly supported the idea, saying it would treat all consumers equally and force competition. Mr. Stehle and Mr. Briggs agreed, noting it would have significantly eased their financial burden. Mr. Lehman and Mr. Jacobs declined to offer tax policy views, citing lack of expertise.

• Chair Johnson agreed with Sen. Hawley’s tax proposal and emphasized the need to break up healthcare “oligopolies” and restore consumer control. Mr. Briggs likened the ACA to a grocery store where prices vary based on income and said price inequality was the system’s fatal flaw. Mr. Stehle warned that funding priorities still placed able-bodied adults ahead of the truly needy. Mr. White endorsed the Crapo-Cassidy bill and called for giving consumers—not insurers—control over healthcare dollars. Mr. Bragdon warned that enhanced subsidies rewarded insurers while patients with pre-existing conditions still faced huge out-of-pocket costs. Mr. Jacobs cautioned against removing help before reforms are in place. Mr. Lehman concluded by stating that affordable care supports rural economies, farm succession, and community health.