WASHINGTON – U.S. Sen. Jon Husted delivered a detailed healthcare policy pitch in a Senate floor speech Thursday, outlining his approach to resolving a dispute over Affordable Care Act premium subsidies that was a sticking point during the 43-day government shutdown that ended earlier this month.

The Columbus-area Republican, who was appointed to fill Vice President JD Vance’s seat in January and must win a November 2026 special election to keep the job, focused on what he called a “fraud, freeze and fix approach” to healthcare reform, which he said could be paired with “a short extension of the premium subsidies” to address ACA shortcomings.

“I have been in the Senate less than a year, and I wasn’t here when Congress passed Obamacare or the Biden COVID subsidies that have been used to prop up the ACA exchanges,” said Husted, who serves on the Senate’s Health, Education, Labor and Pensions Committee. “But I want to be part of the solution.”

Husted, who faces a competitive 2026 race against former Democratic U.S. Sen. Sherrod Brown, noted that bipartisan legislation he sponsored called the SMART OTC Act, became law this month when it was included in recent government funding legislation.

The legislation reforms the Food and Drug Administration’s process for converting prescription drugs to over-the-counter status. Husted noted that when prescription drugs become available over the counter, “prices go down. In fact, on average, cases where we’ve been able to do this reduces prices from 30 to 95%.”

The bulk of Husted’s speech focused on what he called a “fraud, freeze and fix approach” to healthcare reform, which he said could be paired with “a short extension of the premium subsidies” to address ACA shortcomings.

Using a chart displayed on the Senate floor, Husted argued that healthcare inflation has been “the number one driver of inflation in the 21st century,” claiming the ACA made medical costs go up.

Husted highlighted what he described as widespread fraud in ACA marketplace enrollment, attributing much of it to zero-premium subsidies created in 2021. He said brokers enroll people who didn’t ask for coverage, insurance companies get paid, the brokers get commissions, and taxpayers foot the bills.

He claimed that “hard-working taxpayers have footed the bill for almost $35 billion to insurers who enrolled people who did not use the plan a single time,” adding there have been “criminal convictions in many states” related to such fraud.

The fraud problem Husted described is well-documented. Between January and August 2024, federal regulators received approximately 275,000 complaints about unauthorized enrollments or plan changes, according to the Commonwealth Fund, a private foundation that aims to improve healthcare systems and promote health equity in the United States through research, policy analysis, and grantmaking.

This week, a federal jury in West Palm Beach convicted two men for their roles in a scheme that sought over $233 million in fraudulent ACA plan subsidies, according to the Justice Department.

The fraud typically works through lead-generating firms running fraudulent ads that lure consumers with false promises of cash benefits, then enrolling them without their knowledge in zero-premium plans. Armed with only a person’s name, date of birth and state, a licensed agent can access coverage through the federal exchange.

Husted proposed requiring everyone receiving a premium tax credit to pay at least a small amount toward their healthcare insurance, saying this would “help realign the incentives and reduce fraud” and ensure Americans cannot be enrolled in plans without their knowledge.

The “freeze” component

Husted called for limiting subsidies “to where they are right now” to prevent the burden on taxpayers from growing. He proposed appropriating cost-sharing reduction payments, which he said could “lower premiums by 10 to 20% while also delivering savings to the taxpayer.”

This refers to a complicated ACA pricing mechanism known as “silver loading.” After a 2017 federal court ruling found that cost-sharing reduction payments violated the appropriations clause, the Trump administration ended direct federal payments to insurers, though insurers remained required to provide the reductions. Most insurers responded by raising premiums on silver marketplace plans to cover these costs, a practice called silver loading. Because ACA premium subsidies are calculated based on the second-lowest-cost silver plan, silver loading has increased federal subsidy spending beyond what it would have been with direct payments.

The “fix” portion

The “fix” portion, which Husted called “the most important part,” focused on several bipartisan healthcare initiatives he said would lower actual costs rather than just transferring the burden.

“Subsidies do not lower costs, they transfer the burden,” Husted said.

He highlighted price transparency as “one of the most bipartisan ideas in this chamber,” saying it would give patients, employers and small businesses the power to see and compare prices.

Husted also pointed to pharmacy benefit manager reform, saying there’s “bipartisan appetite to lower the cost of prescription drugs by addressing the role that middlemen play” in increasing costs.

The senator also endorsed President Trump’s proposal for Health Savings Account expansion, “where we send money to the consumers rather than to the insurance companies,” though he noted transparency is necessary “if you expect people to shop.”

Political context

The healthcare speech comes as Husted faces his first election campaign for the Senate seat. Former Democratic U.S. Sen. Sherrod Brown, who served three terms before losing to Westlake Republican Sen. Bernie Moreno last November, announced in August he would seek Husted’s seat.

An Emerson College poll released in August showed Husted leading Brown 50% to 44%, though a more recent Hart Research poll conducted for the Ohio Federation of Teachers found Brown ahead 48% to 45%.

Healthcare has emerged as a key issue in the race. On November 9, Brown posted on X that “half a million Ohioans are facing monthly premiums that are double or triple what they were paying,” calling it “a problem created by Jon Husted and his special interest friends.”

In his floor speech, Husted framed his approach as protecting both families and the federal budget. “Two things we need to do: Protect families from the cost, the inflationary costs that the ACA has created, but also protect the taxpayer,” he said.

He positioned himself as seeking middle ground: “If this debate ends with one side saying extend everything and the other side saying we oppose everything, nothing will get done, and we will have failed the American people.”

Emphasizing his newcomer status, Husted said, “I am the newest member of the U.S. Senate. I wasn’t here when Congress created this problem, but these ideas are part of the solution.”

“We have a chance right now to do better, help families afford coverage, pass bipartisan reforms that cut costs and refuse to add another $350 billion to the national debt,” he continued.

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